Ask Dr. Ticcy: My Child Won’t Go to School

Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dr Ticcy:

Help! My kid won’t go to school. I tell them to go and they say no. They say they feel sick, they cry and they tell me that their stomach hurts. They get really anxious. I don’t what to do!

From,

Out-of-options

 

Dear Out-of-Options,

It’s common for kids to feel some anxiety about going back to school. Being firm with your kids and telling them, “you must go back to school” is an option. For many, this may be enough. However, like yourself, some parents try this and things don’t get better. If separation anxiety or back-to-school anxiety becomes overwhelming or disruptive, it is time to think about doing something about it.

Where to begin? There are several options and possible strategies you might consider:

Professional support Speak to a professional counsellor, doctor, or psychologist.  They can make further recommendations, which may include behavioural therapy, prescription medication, gradual re-entry to school, and rewards for school attendance.

Transitional objects Teachers can encourage students to bring a “transitional object” from home (ex. favourite stuffed animal) and to take a special object home with them, such a drawing or a book. This can help your son or daughter feel more comfortable.

Touching base during the day You might try pre-arranging a particular time when your son or daughter gets to call, text, or email you. This could be a reward for completing work or simply a plan to help them get through the day.

Improve the drop-off Morning drop-off can be particularly tough. If possible, you might consider having someone else drop off your child to make it easier for your child to separate and enter the school.

Some separation is okay You may be tempted to spend every waking second with your child but this can make it harder to seperate. Consider trying to systematically increase the amount of time your son or daughter is separated from you while in the home or outside of school.

Additional Support Additional adult support may be needed during interactions with peers, lunch hour, and during transitions. During new or novel situations, teachers can help students by providing them with specific instructions or special tasks. For example, a teacher could tell the student, “When we get to on our field trip tomorrow, you can help by checking off each student’s name as they get on and off the bus.”

Take the scariness out presentations Talking in front of the class can be a source of panic and anxiety. It may be a good idea to allow anxious students to watch others do their presentations before asking them to get up in front of the class. Talk to your child’s teacher if you think this may help. Practicing presentations at home can help too!

Make a plan Together with the student, teaching staff (and possibly parents) can plan what the student should do when they feel panicky. This plan may include breathing techniques (ex. diaphragmatic breathing for 10 breaths), thinking about how a good friend might handle the same situation, exiting the classroom for a brief walk, standing out in the hall for a few moments, and/or going to the office or special education resource room.

I hope these suggestions help you and your child.

Best wishes,

Dr. Ticcy 

Ask Dr. Ticcy: Do kids with Tourette understand sarcasm?

Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to admin@tourette.ca with the salutation “Dear Dr. Ticcy.”

To Dr. Ticcy:

I’ve read that kids with TS can have trouble understanding sarcasm. Is this true?

From:

T.J.

Dear T.J.

You ask an interesting question.

Research has found that it can be hard for adults with TS to understand what people mean when they aren’t literal. A recent study examined whether this applies to children as well.

To test whether the children involved in the study understood sarcasm, the researchers presented them with three different kinds of scenarios.

The first kind of scenario ended with a literal or sincere remark. The second kind ended with a sarcastic remark that could be understood simply by reversing the meaning of the remark. An example of this kind of remark would be “Having Tourette is always really easy” (the truth is the reverse – it is not always easy). The final type of scenario ended with sarcasm that wasn’t straight forward. In other words, this remark couldn’t be understood just by reversing the meaning of the comment.

Kids with TS scored the same as those without TS on interpreting direct or sincere comments and they scored better when it came to direct sarcasm (where they could reverse the meaning of the comment). When it came to interpreting indirect sarcastic remarks, they scored below the children without TS. The most common type of error that children with Tourette made was to interpret the sarcastic comment literally, even though it was not meant to be sincere.

The authors concluded that children with TS may have some difficulty understanding sarcasm, however, this difficulty is fairly subtle.

What do you think?

Do you know of children with TS who have a hard time with sarcasm?

Ask Dr. Ticcy: Tics past age 30

Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to admin@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dear Dr. Ticcy,

I thought that my tics would decrease as I got older but I am 30 years old and my tics are worse than ever. Does this mean that I don’t actually have TS? Will my tics ever decrease or go away?

Sincerely,

Ticcing-at-30

Dear Ticcing-at-30,

Typically, when someone has TS, their tics usually begin early around age 5-7. They increase with time peaking between the ages of 10-12 and then after puberty, their tics start to decrease in intensity. There are some cases, however, that do not fit this pattern. Some people with TS have tics that are intense in both childhood and adulthood.

Others, like yourself, have tics that are mild in childhood and more intense or frequent in adulthood. While this is rare, it is possible though the reasons for this pattern are not well understood by scientists. Some possible explanations have been suggested such as cocaine abuse, use of anabolic steroids or extraordinary life stress.

Your question about whether your tics will ever decrease is difficult to answer. It is difficult to say how they will progress with time. On the plus side, since TS is not considered a progressive condition, we have no reason to assume that they will continue to become worse or more intense as you age.

If your tics are interfering with your daily functioning or if they are causing you any physical pain or discomfort, you may wish to visit a specialist to discuss potential treatment options. Possible treatments include behaviour therapy and/or medication. Keep in mind that stress, positive or negative excitement, tiredness, and illness are likely to increase your tics. In contrast, good sleep hygiene, exercise, healthy eating, and generally good mental and physical health have the opposite effect on tics.

If you would like some more information about treatment options, specialists, or tic triggers, please contact a local volunteer or the National Office of Tourette Canada.

Sincerely,

Dr. Ticcy

Ask Dr. Ticcy: Should I monitor my other son for signs of TS?

Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dear Dr. Ticcy,

What are the odds of two boys in the same family having Tourette? Our eight-year-old was recently diagnosed with TS and now we are noticing a lot of the same signs in our six-year-old. It’s only been going on for about a month and I know that a correct diagnosis of TS needs to have at least one year of tics. Should we continue to monitor?

Concerned Parent

Dear Concerned Parent,

Continue reading

Ask Dr. Ticcy: Do my tics mean that I have TS?

Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dear Dr. Ticcy,

My younger brother saw a doctor about his tics because they were bothering him. He was diagnosed with TS. When I found out, I started reading about TS because I wanted to learn more about the condition. Then I started noticing that that my dad, my older brother and I all do or say things that fit the definition of a tic.

Is it possible that we (my dad, older brother, younger brother and I) all have TS? I’m wondering if everyone in my family has TS, but my brother’s tics are the worst so he is the only who saw a doctor and got diagnosed?

Thanks!

TS or Not?

Continue reading

Ask Dr. Ticcy: What about relaxation techniques?

Ask_Dr_Ticcy_Logo-238x250Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dear Dr. Ticcy,

Where can I find more information about relaxation techniques?

Thanks,
F.

Dear F.,

Great question.

Relaxation is important for everyone, and can be especially helpful to someone with Tourette Syndrome. Since stress, excitement and anxiety may intensify or fuel tics, relaxation can assist with symptom mitigation. That is why non-pharmaceutical treatments like Comprehensive Behavioural Intervention for Tics (CBIT) and Habit Reversal Therapy (HRT) are often combined with relaxation therapy/techniques.

To learn more about relaxation techniques try:

1. CPRI Brake Shop Clinic

Video: http://www.cpri.ca/videos/Stress%20Techniques%20F.swf
Handouts: http://www.cpri.ca/uploads/section000162/files/handout_stress.pdf
http://www.cpri.ca/uploads/section000162/files/handout_relax.pdf
http://www.cpri.ca/uploads/section000162/files/breathing%20triangle.pdf

2. Dr. Leslie E. Packer’s website “Tourette Syndrome Plus”
http://www.tourettesyndrome.net/disorders/anxiety-disorders/relax/

3.The TSFC Forum

Try threads like these: http://www.tourettesyndrome.ca/showthread.php?7005-Teach-Yourself-Your-Child-Relaxation
http://www.tourettesyndrome.ca/showthread.php?5029-Relaxation-Techniques

4. Asking an Occupation Therapist or Another Trained Professional

Sincerely,
Dr. Ticcy

Ask Dr. Ticcy: What is the genetic probability of passing on TS?

Ask_Dr_Ticcy_Logo-238x250Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dear Dr. Ticcy,

I am writing to inquire about some information on the genetics of Tourette Syndrome. I look on the TSFC website and the Tourette Blog, and it seems like there are two conflicting stats. On the Tourette Blog, there is a stat that says the probability that genes are passed when with ONE parent has Tourette is 10 percent, but the website states that the rate is 50 percent.

Could you please break this information down for me, as I am kind of confused and am trying to distinguish the genetic probability of Tourette. Thank you!

Kindest,
Confused About Genetics Continue reading

Ask Dr. Ticcy: Will my child be born with TS?

Ask_Dr_Ticcy_Logo-238x250

Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dear Dr. Ticcy,

I have TS and I am thinking about having a baby. Will my child be born with TS too?

Thanks for your help,
Possible Parent

Continue reading

Ask Dr. Ticcy: Can I be evicted for my tics?

Ask_Dr_Ticcy_Logo-238x250Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dear Dr. Ticcy,

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I just moved into an apartment building. I am worried that a neighbour will complain about my tics, particularly my coprolalia. I’ve been ticcing a lot because I am a little stressed about living alone for the first time. What if they try to evict me? What do I do or say?

Thanks,
Ticcing In My Apartment Continue reading

Ask Dr. Ticcy: How do I support the caregiver of a person with TS?

Ask_Dr_Ticcy_Logo-238x250Dr. Ticcy is a pseudonym for the Tourette Syndrome Foundation of Canada National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to tsfc@tourette.ca with the salutation “Dear Dr. Ticcy.”

Dear Dr. Ticcy,

HELP! My grandson has been diagnosed with TS complete with the Jekyll and Hyde rages, which are overwhelming for my daughter to say the least. He is 6, and tells her that he hates her and wishes she was dead. He would like to stick nails in her eyes and so on. So, tics are one thing but these rages are frightening to say the least.

I am feeling helpless to help! He is on medication including one for his ADHD. I don’t even know why I’m writing this other than as a mother and grandmother I’m feeling absolutely powerless so I can only imagine how my daughter is feeling. How can I help her?

Thanks for listening,
Concerned Mom/Grandmother Continue reading