14 Jul

From Your Anxious Child: Emails to Parents by Edward H. Plimpton, PhD



The landscape of the anxious child can include learning disabilities, sensory sensitivities, and other problems such as ADHD and, sometimes, tics. In a tic, a part of the body suddenly makes a repetitive and stereotyped movement. Tics tend to be fast movements without any purpose. Common tics involve eye blinking, shoulder twitches and the neck jerking. Tics are categorized medically in terms of the length of time they have been present and the range of tics displayed — Tourette’s syndrome representing the extreme. Medical evaluations are important here so that certain diseases can be excluded from consideration. In various manifestations, tics have been estimated to occur in 12% to 18% of all school-aged children. Tics often first manifest themselves at ages 5-7, and are most intense around 12-14 years of age. After that, for many, they gradually decrease over time. So while early adolescence isn’t a great time to stand out and be different, for most children tics decrease in severity over their childhood. Another commonly noted feature of tics is that they tend to wax and wane over time and can change in form and appearance. Because they can’t take their body as a given to behave itself, a consequence is that these children often develop a precocious self-awareness. The presence of tics forces them to become more aware of themselves in a way that other children are not forced to do.

For many parents and children, the tics are an annoyance but the least of their concerns. Other problems such as OCD, ADHD and various learning problems may exert a more disruptive effect on the child’s life.

What can be done about tics? First, it is important to note that for many children, as mentioned above, the tics get less severe and pronounced over time. So the thing to do is nothing and not to make a big deal about it. Second, for some children medication may offer some help in decreasing tic severity, but unfortunately there is no panacea right now. Third, tics can draw attention to a child and consequently the potential to be ridiculed or bullied by peers is a possibility.  What is helpful here is educating other people about tics. School-based educational interventions around Tourette’s can be helpful in decreasing the ignorance and fear that is often behind bullying. Fourth, the intensity of the tics may be also managed by a behavioral training program involving habit reversal or developing a competing response. For many children, the tics are preceded by a feeling that has been variously described as “an inside itch” “inner tension” or “not right feeling” and performing the tic provides momentary relief from this feeling. The treatment involves performing a response that is incompatible with the tic until the urge for it goes away. Finally, identifying the situations in which the tics occur in can provide valuable clues about how to either reduce the stress or manage the boredom that triggers the tic.

For the child and the family, it can be extremely annoying to have your body take on a life of its own, but fortunately for many it is a problem that decreases in severity over time.

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