tics?

[Vintagecollector]

greetings all,

I’m looking for advice about my 9.5 year old son who has adhd, dyslexia, dysgraphia… we’ve been having a hard year so far in 4th grade.

emotional, angry in the evening especially around homework. Mean to his 5 year old brother and really seems to be competing with him suddenly. We think this is due to how hard he is working to keep it together at school where he really struggles to keep up. We are looking into moving him to a specialized school.

recently he has established what I would call a tic (seeing his doctor next week).

he repeatedly tips his chin down and sticks his neck out. It started slow, like a few times in an afternoon and the last few days it’s all day.

has anyone experienced this? We are so concerned he will hurt himself. And also realized that kids at school will likely tease him which is the last thing this poor kiddo needs.

tha is in advance for any input!

tired mama

[STEM_Dad]

Is he on any medications? If so, did the tic develop after starting on a medication or change in dosage?

Has he been evaluated for OCD (obsessive compulsive disorder) or ASD (autism spectrum disorder)? Tics are most commonly associated with OCD, and then often associated with ASD. From what I've read, tics appearing with ADHD are often related to medication.

Behavior changes can also come about due to a biological change, and children go through several changes like this. His age is around one of those periods of change (I think the prepubescent phase is about 8-11 for girls and 9-12 for boys, but can vary by the individual).

I know that some children will also go through times of experimentation with their own body movements. At around your son's age, I was experimenting with putting my hands together and twisting my fingers in different ways to make animal faces. (I can still remember how to do a few of them.)

Have you asked your son why he does it? (The answer might simply be "I don't know", like my son says when I ask him why he's doing some of the things he does. In my case, my answer was that I was a lonely kid on a long bus ride, so I was making animal faces out of my fingers just to entertain myself.)

[Vintagecollector in reply to STEM_Dad]

First, thank you for your thoughtful reply, I really appreciate it.

He is taking Adderall and a 1mg dose of guanfacine but has been for many months. 3 weeks ago they increased Adderall does slightly but he’s been having different “tics” for a while. Last spring for a month or so he did a hand motion where he’d squeeze his legs subtly while walking.

I have asked him about his chin movements and he doesn’t really know he’s doing it.

OCD and ASD have been ruled out previously.

I know he is really struggling at school so I’m concerned this is a reflection of that. That his anxiety is getting worse and revealing in tics.

I appreciate your insight! I think about his age and puberty and all that is happening for him now too. All your pints make sense and helps my perspective so thank you!

[STEM_Dad in reply to Vintagecollector]

These tics of his might be the sort of nervous habits that anxiety can bring on. In other words, they might be self-soothing behaviors.

I've dealt with anxiety most of my life. From my youth until now, I've had the nervous habit of cleaning my nails. I also fidget with pens and pencils, and while it might be due to my ADHD need to fidget, I've noticed that the fidgeting gets faster and more frequent when I'm feeling anxious. (When I don't have anything available to fidget with, it can make me feel a bit anxious.)

When asked if a behavior is for self-soothing, most people who do such things would probably answer that they don't know why they do it.

Then again, it's impossible to rule out other possible causes of inexplicable behavior without thorough examination by medical and behavioral experts. As a layman, I only know of a few, but I'm sure that there are a number of other potential causes.

I'm surprised that I initially forgot about the condition most associated with tics: Tourettes.

Another neurodiversity which can possibly cause tics is dyspraxia.

However, with a known diagnosis of ADHD, the most likely explanation is the the tics are due to the ADHD itself. (I believe that it's the sudden appearance of tics after starting an ADHD medication is likely to be due to the medication...but I'm not a doctor, I'm just relating what remember from what I've read.)

Do your son's teachers and educational specialists express any concerns? These should be noted and relayed to his doctor for consideration (including severity and frequency).

[Kd1970]

My daughter has tics. She is 14 and has had them for a few years now. The main one right now is a sniffing thing that she does. She also has a squealing noise that she makes when watching tv or when very excited. I asked the school if she needed a small group accommodation for testing because of it being disruptive to other kids. Oddly enough, none of her teachers knew what I was talking about. Somehow, she manages to control it at school but lets loose when she gets home. I think my daughter’s tics are related to medication. Best wishes to you and your son!

[Mamamichl]

My daughter is 9 in fourth grade too. She had audio tics start when she started an adhd stimulant med. we took her off and it got better a bit until stress of homelessness exacerbated it immensely. We’ve been in our new home 6 weeks or so now and they have almost completely disappeared. (Hers was more like clearing throat). She was definitely picked on because of it, but communication with the teacher helped. She also just started a new school, and none of the kids heard her tics, so I’m hoping this continues. It has been replaced by some attitude though, so I’m hoping I can talk her though this too.

As for homework, last year she had issues doing hers during the week. We gathered the homework and told teacher we wouldn’t be doing homework during the week. It was an accommodation we will probably need to put on iep if it continues, but since she started her new school, she is receptive to the homework (but it’s been one week). It’s really not going to hurt too terribly if he doesn’t get homework done during the week. My daughter needed that down time because she masks all day and needs a vent. This would be one of the situations where your son’s mental health is more important than the academic one, imo.

Counseling was her biggest help. Also, other than asking about it initially, I noticed she got embarrassed so I stopped asking. It helped in the “recovery”.

[STEM_Dad in reply to Mamamichl]

I concur 100% that a child's mental health takes priority over academic progress.

I lived my life masking, not knowing until my 40s that I have ADHD. Since my ADHD diagnosis, I've been allowing myself to be more my authentic self.

Question:

So, I'm genuinely curious about something. Since your daughter knows about her ADHD, why does she mask so much?

• I presume it's to "fit in" and to try to meet behavioral expectations at school (as I did as a kid and through my my adulthood up until my ADHD diagnosis). I remember having beer strong feelings as a kid about wanting to fit in, before eventually deciding that because I'm just "weird", then I should be okay just being me. (I was generally liked, a little picked on, but didn't have a lot of friends. Most of my teachers seemed to love that I was a committed student, aka "teacher's pet", despite my regular inattentiveness.)

{I still behave largely the same...same person, same personality , but less strain to try to act like other people. I don't try to hide my ADHD, though I do find myself explaining it to others sometimes... never as an excuse, but just to be transparent.}

[Mamamichl in reply to STEM_Dad]

Good question! She’s embarrassed about being called out for the tics and her impulsiveness. Her teacher actually said that another kid came up to her (the teacher) and said my daughter did something (mild as kids do). When the teacher went to her to ask her side of the story, my daughter shut down. She also doesn’t ask for help when she gets overwhelmed or doesn’t know something. We are communicating this to her counselor so that she can improve on this.

She (and I) is a lot like you describe. She wants to fit in immensely. Any picking on or mild injury puts her in a spiraling. She wants to be a teachers pet but is a lot better with socialization with peers than I was. She does have a stubborn streak and pushes her ideals on other kids, and needs more redirection, but hates being singled out. We went from urban public school (where she felt safe and learning nothing) to a charter school that she’s thriving in. The structure does a lot better than I had as well. She makes a ton of friends, but sometimes it’s hard to keep them because of needing to learn true leadership skills rather than abrasives.

We explain things like this to educators too. My daughters new principal was freaked out to hear she had a 504 and any accommodations was hard. We explained that she was mild and we just are advocating parents, so the rest of the staff are receptive.

[STEM_Dad in reply to Mamamichl]

Your daughter sounds like a mix between my son (wants to be social with peers, wants to be a leader, but can be abrasive) and my daughter (tries to figure things out her own way, will shut down when a parent or teacher comes to her about an issue... she sometimes seems to have selective mutism, but I think I'm the only one who has noticed). Both my kids can be very stubborn (which I think they get from their mom).

My son (11) has displayed hypermobile traits at home for years. He always sits in one place okay, but would change positions frequently...but if you're not paying attention, you don't notice it. (But when he has to stand in one place, his legs start wriggling, so it looks like he's either trying to dance the cha-cha, or he has to run to the bathroom.)

Surprisingly (to me, at least), it's my daughter (almost 9) who has been singled out for fidgeting a lot in class. While my son has been praised for being so well behaved. At my house, he has much more behavioral issues than his sister. I don't see her fidgeting much (though she does draw a lot), and he fidgets whenever he doesn't have a game controller, TV remote, or book in his hands.

[Mamamichl in reply to STEM_Dad]

Hyper mobile… I think about my daughter, but I think she has hyper mobile and hyper flexibility. As long as forgetting doesn’t distract other kids, it shouldn’t be an issue. We embrace it so much our living room has a whole bin of fidgets.

[STEM_Dad in reply to Mamamichl]

I misused the term "hyper mobile". I meant hyperactive.

Since my kids seem to have mild ADHD, my son's hyperactivity shows up mostly as making a lot of smaller movements in one place. (Not tics. Some fidgeting with his hands, but a lot of just repositioning his body.)

e.g. During the pandemic, I was working from home a lot and watched him as he was doing his homeschooling on the living room floor. I glanced at him about every two minutes for a bit one day, and each time he was in a completely different position...but in the exact same place. On other days, I noticed the same. Now, at my house, I have gotten him different types of chairs and a yoga ball, and he will swap between them whenever he wants a change...but he likes to sit in his favorite spot in the living room.

[Mamamichl in reply to STEM_Dad]

That is awesome that you accommodate his repositioning. In the classrooms, we sometimes have a special chair with a yoga ball built in.it works with some kids. My current classroom has an i shaped “wobble chair”. Some of our kids try to stand on it, and one of our coworkers almost broke her arm by not having awesome balance on it. Watching myself in presentation videos, I get so self conscious because I shake my leg so much it’s unnerving. No one ever mentioned to get tested until 2 years ago though.

[ScienceAndTravel]

As a 43 year old with ADHD I have had tics all my life. I have found that my tics are ways that I use to create movement to reduce tension and anxiety. When I try to control my tics they tend to get worse but when I find another physical activity to engage in the need to tic dissipates. Usually 100 jumping jacks, some time on the trampoline or dancing to a song will both dissipate my need to tick and make it easier to get back to homework. Your son may be different from me but you could give physical activity a try. Vintagecollector you have got this!

[SurvivorFan]

Hi!My son (8) also has tics. They come and go. They started over a year after medication began.

His are sometimes a throat clearing or a motion of wiping his face. The more we talked about it in the beginning the more we saw them. We took a different approach and showed him other kids and adults who have tics. Sometimes they seem brought on by an anxious time and other times not. He can have one of them for a week then we don't see it for months.

We also came up with some ideas together of ways he could get that release in his brain but by doing something less noticeable. He was surprised to learn that I have several. There was one boy at school who asked why he "kept making that noise" and my son was prepared to say that he has tics, lots of people have them and it just feels good to his brain to do it and it's not a big deal. That was the end of it.

[STEM_Dad in reply to SurvivorFan]

That is awesome that your son has developed such a positive perception of his tics, and was able to explain tics to his classmate in such a straightforward way.

[SurvivorFan in reply to STEM_Dad]

Definitely a proud moment. I had found a video of another kid his age explaining that if you just tell other kids who ask about your tic right away that it's not a big deal, that it's just something your brain does sometimes than the weirdness/what's that all about will usually just go away.

[Elijah1]

A good information source regarding tics is the Tourette Association of America webpage (tourette.org). Don't get stuck on the name - Tourette syndrome is just a chronic (more than 1 year duration) tic disorder. Tics occur in about 12% of the ADHD population. Most of the time, classmate don't unduly tease about the tics. Agree that anxiety tendency should be assessed.

[wiroots]

My son has had tics since he was 3-4 years old, and has just recently been diagnosed with ADHD (it's been there, we just didn't realize). They cycle for him as far as type and severity. When he was young the general advice was not to call attention to it. As he is now 14, I'm trying to make him more aware of his own triggers, which seem to be stress, when he doesn't eat well, and possibly chlorine (who knew?). Doing a topical magnesium rub seemed to help him for a spell, but we're still trying to get to the bottom of things. It seems that some studies link tics (start or worsening of) to medication and some not, so I can only assume it's unique to the person. It's not lost on me that ADHD, tics, OCD, mood dysregulation etc are all comorbidities and I can't help to wonder what the common source is...I'm always searching. Best of luck to you.

[Knitting20projects]

Is he getting enough support academically at school? I am wondering if the school thinks he’s doing ok, and actually he’s working super hard all day just to stay afloat? Can you explore additional supports before changing schools? I am sorry you’re facing all this. Sounds very stressful.