Ask the Expert: How can we help our son to handle his tics?
Some young children aren’t aware of their tics or compulsive behaviours or, if they are aware, they can be very defensive or sensitive talking about them. Even though he is expressing frustration, it is a good sign that your son is already talking to you about the behaviours, as this means he is open to your support and help. Photograph: Thinkstock
Q Our eldest son is nearly eight years old. In the past couple of years he has developed several motor and vocal tics, and we are unsure how to help him deal with them.
Up to last year we mostly ignored them and reassured him they would go away. However, he began to become more aware of them and they were bothering him, so we brought him to see a psychiatrist privately who confirmed he has mixed motor tics – but not Tourette’s syndrome – and said he thought they would fade as he got older.
Since then he has developed a repetitive tic that involves counting and symmetry. For example, if he touches something, he feels the need to touch it twice, or if he jumps to one side, he will have to jump to the other side. Sometimes he has to say things twice too.
For a while the tics were not really affecting his life; it was happening only three or four times a day. But now they are increasing in frequency, and he is frustrated and upset by them.
He doesn’t seem to be upset or anxious about anything in particular so I’m not sure why it’s getting worse. He is well behaved and does well at school, although he’s quite shy. However, he can be very disruptive and challenging at home, with regular outbursts and tantrums. In between these flare-ups, he is a happy-go-lucky, loving and funny little boy. We are worried for him, even though we never let him know that, so we’d love to know if there are any strategies we can use to help.
A It sounds as if your son is experiencing a number of different compulsive symptoms, whether these are the motor and vocal tics he experienced previously or his more recent behaviours of having to jump to one side or having to touch or say things twice.
These more recent behaviours sound more like obsessive compulsive symptoms, though it is common for children who have motor and vocal tics to have some obsessive-compulsive and other anxiety symptoms as well. It is also common for certain tics or repetitive behaviours to change and to be replaced by others.
As the psychiatrist you attended said, for most children these behaviours tend to fade over time and only a small subset of children get diagnosed with a formal disorder such as Tourette’s syndrome or obsessive compulsive disorder.
Generally, the best tactic is to ignore these behaviours when they happen, or to distract your child gently and positively, without drawing too much attention to the behaviour. However, if your son is becoming bothered by the symptoms or if you feel they are interfering with his life, then it can be helpful to teach him some coping strategies.
Listen carefully when your son talks about the symptoms
Some young children aren’t aware of their tics or compulsive behaviours
or, if they are aware, they can be very defensive or sensitive talking about them. Even though he is expressing frustration, it is a good sign that your son is already talking to you about the behaviours, as this means he is open to your support and help.