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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,

While some families have only one child with TS, many families have multiple children with TS. This reflects the fact that TS is a genetic condition passed on from parent to child. Statistically, if a person has TS, they have a 5-15% chance of having a first degree relative (parent, child, or sibling) with TS.

This means that your 6-year-old may have as high as a 15% chance of having TS given their sibling’s recent diagnosis. Keep in mind TS is not the only type of tic disorder and the other milder tic disorders are more heritable or common than TS. It could be that your son’s tics are due one of these other conditions. You can find more information on tic disorders other than Tourette on our blog here.

In order to be diagnosed with TS, a person must experience tics for more than one year (the year starts the day that the first tic appears). During this period, the person’s tics may wax and wane or come and go in frequency. The old diagnostic criteria stated that in order to be diagnosed with TS, a person must not have a tic-free period longer than three months.

This is not included in the most recent set of diagnostic criteria (DSM-V) and it is therefore not considered by physicians during their assessment. Other important criteria including having more than one motor tic and one or more vocal tics that appear before the age of 18 (hence TS is considered a child-onset condition).

You may continue to monitor your six-year-old, keeping in mind that just because their sibling has TS doesn’t necessarily mean that they do, too. Record your child’s symptoms, including what they are, their frequency, and any potential triggers in a tic journal or log. Bring this information with you to future medical appointments.

Additionally, remember that just like your older child, your younger one will require a referral if they are to see a specialist and specialists often have long wait times. You may want to factor this in by obtaining a referral and getting on the wait list sooner rather than later.

Finally, consider getting some support for yourself and your family. Locate your local TS chapter to connect with families and resources in your community. The TSFC offers a number of supports and services including free e-counselling for parents, adults and young adults with TS and peer support groups.

You may also want to consider purchasing some reading material like the TSFC’s book Understanding Tourette Syndrome: A Handbook for Families, which will help you to better understand TS and give you strategies for supporting your children.

If you have any questions, ask a local TSFC volunteer or contact the National Office at 1-800-361-3120 or tsfc@tourette.ca.

Sincerely,

Dr. Ticcy

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