Tourette’s syndrome means that the child has had movement and sound ethics for at least one year. It is common for tics to differ frequently and to vary between movements and sounds. Children with Tourette’s syndrome can get good help with getting rid of tics or tics less.

Tics are involuntary, sudden and recurring movements or sounds. Tics can occur in simple or difficult forms. Sometimes tics can reduce or disappear by themselves.

In this article, the word child is used for children and young people up to 18 years. The article is aimed at you who are custodians or close relatives of a child who has tics.

Symptoms of Tourette’s syndrome

It is common for the child to get the first tics between four and six years. It is often eye flashes or facial movements, also called simple tics. Tics tend to increase or decrease during periods. For example, they may become worse when the child feels stress or anxiety or is tired. Some children may have felt when tics are coming.

There are different types of tics

There are simple and difficult tics that can both occur as sounds or movements. Tics that are movements are also called motor tics. Tics that are sound are also called vocal tics.

Simple tics can be sounds or movements

Simple motor tics can be one of the following movements:

  • The child flashes his eyes or wrinkles his nose.
  • The child shrugs flaps his arms or the like.

Simple audio tics may be, for example, that the child harkens, coughs, wheezes or whistles.

Tics can be difficult

Having difficult tics means that several muscle groups are active. Sometimes they are also called complex tics. They take longer to perform than simple tics. Some difficult tics may seem common in the situation the child is in, others may be perceived as odd.

Sounds and movements that are difficult tics

Here are some examples of difficult movement ethics:

  • The child strikes against his own body.
  • The child mimics someone else’s behavior.
  • The child makes sexual gestures.
  • The child touches someone else in a way that is perceived as inappropriate.

Difficult audio tics can be one of the following examples:

  • The child repeats certain words or sentences.
  • The child changes the volume or pitch in a particular way as they speak.
  • The child repeats what others say.
  • The child repeats what they themselves have said.
  • The child says words that have a sexual meaning.

The diagnosis of Tourette’s syndrome means that the child has had motion and audio tics for at least one year. The tics should also have come in close succession for at least three months in a row. The child can sometimes have movement ethics and sometimes sound tics, but both types of tics can also occur at the same time. In Tourette’s syndrome, the child has received the first tics before the age of 18. The child may also have difficulty concentrating and controlling impulses or compulsive behavior.

When and where should I seek care?

Contact a health care center if your child shows signs of repeated involuntary movements, uncontrolled sounds and restless behavior for an extended period of time.

You can contact many receptions by logging in.

You can also contact a pediatrician or BUP’s local clinics.

Contact the student health if the child has one or more of the following problems:

  • The child has difficulty meeting the requirements of the school.
  • The child has difficulty getting to rest or concentrating.
  • The child has a hard time getting friends.

Investigations

You and the child meet with a doctor or psychologist when you arrive at the reception that will do the investigation. There you can tell about the child’s problems. You may also answer questions that the practitioner asks on the basis of questionnaires. Older children and teenagers may need to fill out questionnaires themselves.

Sometimes the therapist needs to find out if the child has any other psychiatric diagnosis or a disability besides Tourette’s syndrome. In order to exclude physical illness, the child also receives a physical examination.

The therapist can also check for neurological explanations for the child’s movements or sounds. This may be due to the child making movements or sounds without occasionally reducing or increasing them.

The child may have other conditions

A child with Tourette’s syndrome may also have other diagnoses. It is common for Tourette’s syndrome to occur simultaneously with obsessive-compulsive disorder. The child may also instead have the obsessive-compulsive disorder with symptoms similar to Tourette’s syndrome. Sometimes it can be difficult for the healthcare provider to give a clear answer, which of the two diseases the child has.

The child may also have other diagnoses in combination with Tourette’s syndrome. For example, it can be  ADHD  or some form of autism. A child with Tourette’s syndrome and ADHD can often find it difficult to concentrate.

Treatment of Tourette’s syndrome

The need for support varies from child to child and also looks different depending on the child’s age. A good first aid can be that the child and you as guardians get information about Tourette’s syndrome as early as possible.

Knowledge of the disease is often sufficient if the child has tics that are transient and do not cause any major disability. The child needs support as early as possible if they have Tourette’s syndrome and other difficulties, such as learning problems or ADHD. This could mean, for example, that the child receives adapted education at school.

Therapies that help with Tourette’s syndrome

Children with Tourette’s syndrome may need psychological treatment with cognitive behavioral therapy, KBT if the tics make it difficult for the child to cope with everyday life. It is also good to receive treatment if the child experiences the tics as very disturbing.

Habit-Reversal Training teaches the child counter-movements

One form of cognitive-behavioral therapy that is adapted to treatment in Tourette’s syndrome is Habit-Reversal Training, HRT. Habit Reversal Training consists of the three parts of consciousness training, counter-movement training, and confirmation. The therapy is about making the child aware when a tic is coming. The child should then make a counter-movement that is purely physically impossible to perform simultaneously with tics.

Exposure and response prevention help to resist

Another psychological therapy adapted for treatment of Tourette’s syndrome is Exposure and Response Prevention, ERP. The therapy should help the child learn to resist tics for as long as possible. The child is gradually practicing to resist the tics for longer.

Drug treatment

Sometimes the child may need medication if they experience tics as very disruptive. Another reason for treatment with drugs may be that the child has a severe disability or has difficulty coping with his or her everyday life. Tourette’s syndrome is mainly treated with antipsychotic drugs.

The child often needs drug treatment if they have ADHD at the same time.

What can you and the child do for themselves?

It is good if you can have an everyday life that is developing and safe. This means, for example, to ensure that the child sleeps sufficiently and eats regularly and healthy. As a custodian, you are encouraged to encourage the child to be active in his / her free time. For example, the child can play football, draw or play music, preferably with others.

Inform the environment about the child’s tics

It is good to inform the school and the child’s other surroundings about the tics. In this way, you can create an understanding that the child can sometimes behave differently than other peers. Also, explain to the environment that the child cannot control the tics with their will. It becomes less difficult for the child if they have the tics without the surroundings commenting or paying attention to the tics unnecessarily.

Although the child has several tics during certain periods, it is good to remember that the tics can decrease or disappear as the child gets older.

What could it be?

It is unclear what causes Tourette’s syndrome, but it is common for many in a family or family to have the disease. Therefore, Tourette’s syndrome may be partly hereditary.

Some may have the tics left

Many children get rid of their tics as they get older, but some may have tics as adults. Most adults with tics have learned to deal with them by finding different strategies, including using countermovement.

Just like children, adults can also have Tourette’s syndrome and other diagnoses at the same time.

Questions and answers

Here are questions and answers about Tourette’s syndrome:

How to help a person with Tourette’s syndrome?

What can I do to get rid of my tics myself?

My son has strange sounds to himself as he reads. What could it be and how can he help him?

Influence and participate in your care

You and the child can seek care at any health care center you want throughout the country. This also applies if you want to seek care at open specialist clinics. Sometimes a referral is required. Being able to influence and participate in their care is a right that is regulated by the Patient Act.

Ask if you do not understand

In order for you and the child to be able to participate in the child’s care, it is important that you understand what the care staff says. Ask questions if you don’t understand. When you have received information about the treatment, you can give your consent or express a yes in another way. You can also refuse treatment.

Fixed care contact and interpreter can be a good support

You and the child have the right to a so-called permanent care contact if the child meets many different people in connection with their care. It is a person who among other things helps to coordinate the child’s care.

The interpreter can often be booked by the care center or the reception that is treating the child. It is good to inform the healthcare provider at the first contact if you need interpretation. The interpreter has a duty of confidentiality  just like everyone else who works in the health care sector. This means that they are not allowed to disclose information about the child.

Ehtisham Nadeem

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