Most of you have heard about Tourette’s syndrome or Tourette’s disorder, but did you know that Tourette’s syndrome is just one of the few Tic disorders. Yes, Tourette’s syndrome is a part of a greater disorder which is divided into groups depending on the symptoms. Tic disorder can be recognized in a person by persistent tics that come out of the blue without a warning, mostly movements and sounds that are uncontrolled and always seem out of context. The bright side of it is that those tics are painless and that in most cases children with Tic disorder will simply grow out of it and the problem will go away, but in some cases those tics continue over time and grow into a complex and severe disorder.
Child can be diagnosed with one of the four types of Tic disorders:
- Transient tic disorder which consists of both physical and vocal tics that last between 4 and 12 months, but never more than 12 months.
- Chronic tic disorder is characterized by either motor or vocal disorder that lasts over a year, but never both.
- Tourette's disorder is characterized by both motor and vocal tics that last over a year.
- Tic Disorder NOS is when a child has tics but they do not fall under any of the above mentioned Tic disorders.
Once a diagnosis is set you can begin treatment. Depending on the disorder and its severity there are several methods for treatment. There is a holistic approach to treatment where parents are involved and that sort of treatment may include:
- Education of the family about the disorder
- Direct observation methods in addition to diagnosis tests and self reports
- Advanced assessment with child’s cognitive skills, motor skills, perception and behavior.
- Making a healthy school environment
- Therapy
- Evaluation of the medication therapy is needed
The bottom line is you have two choices, therapy or medication. In most cases doctors and specialists will first recommend therapy, only in severe cases will medication be recommended from the start. Here is what you may expect of regular types of therapy:
- Massed negative practice, this is the most used form of therapy and it consists of making the patient deliberately perform tic movements and sounds for a specific period of time. This method has shown a decrease in the frequency of tic movements, but long term benefits are still unclear.
- Contingency management, this fall under behavior treatment. This type of treatment is rarely used as there is limited control over the therapy. The practice is that parents create such an environment so that the child gets praised and rewarded for not performing tics, but once a child is out of the house and in a new environment that may not be controlled.
- Self monitoring is another form of therapy that raises child’s awareness. The child is carrying a wrist counter that records the number of tics and the child is to write them down in a notebook, this method can be very effective.
- The most positive effect has the Habit reversal therapy; it consists of the previous methods described. The combination of awareness training, relaxation exercises and contingency management, the method has 64% to 100% success rate.
You should place all of your energy into these therapies as I assure you that you wouldn’t want your child to take medications. Some form of medication therapy even includes chewing on nicotine gums as they appear to reduce the number of tics, but most of these medications have side effects. You might also consider alternative therapies which have been growing in popularity.
