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Ask Dr. Ticcy: How do I deal with my child’s coprolalia?

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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,

How do I deal with my child’s coprolalia?

Thanks,
Perplexed Parent

Dear Perplexed,

First, let’s ensure that you and all of our readers fully understand coprolalia.

It is a type of vocal tic that involves involuntary utterances of socially inappropriate language, be it swearing or something politically incorrect or hurtful. It is not just a “swearing tic.” It may include but is not limited to commenting negatively on someone’s physical appearance and racial slurs.

This is not intentional. If I were to touch a hot stove element, I might say a bad swear word involuntarily. The same thing happens to a child with coprolalia. They say it without meaning to and often feel guilty for doing so.

Because the element of intentionality is absent, the meaning of the swearing or socially inappropriate language is not the same. That said, it is still appropriate to encourage a child to apologize for hurt feelings with the understanding that though he or she did nothing wrong, they are still responsible for the outcomes of their action(s).

Many parents are confused about when a child is performing a tic and when they are acting out. It is hard to tell in certain situations, and unfortunately, there is no definitive way to know for sure. Here are some steps to assess the situation, which will help you to respond appropriately:

  1. Talk to your child: ask whether this was a tic.
  2. Consider the context: what happened right before the tic? Did you just tell the child they couldn’t go to the movies because their room was dirty? If so, it may not be coprolahia. Not every situation is that clear cut, however, it is still important to consider lead-up events as this may help you to learn your child’s triggers.
  3. Err on the side of compassion: it is better to believe that it is coprolalia and be wrong than the reverse. The reverse may mean punishing the child for something they had no control over.

Once you assess it to be an instance of coprolalia, consider the advice of author Ross Greene. Greene advises us to think about the why.

Why did the child swear?

Answer: They have a medical condition.

The answer to the why informs your response: the child has a problem—a medical condition—but they are not the problem themselves.

What should you do?

Work together on changing the words to something else. For example, instead of f—, the child could say Ferrari or fudge.

Allow the child to move to a quiet space where they can let their tics out without disrupting others.

Consider ignoring the words and move on quickly once the child has a chance to give a brief apology.

Teach the rest of the class or family members about the tics and learn to re-direct the situation as much as possible. For example, if you say pass the potatoes and the response is a socially inappropriate vocal tic, simply move on without drawing attention to the matter. Someone else can pass the potatoes if the child is still symptomatic or the child can pass the potatoes themselves.

Thank you for your great question, keep ‘em coming!

Sincerely,
Dr. Ticcy

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