Monday, October 5, 2015

How to deal with Tourette syndrome in children

A six-year-old boy has multiple tics and has been diagnosed with Tourette syndrome. His behaviour is challenging and his parents are worried about the  boy's future, but they don’t want to go down the medication route. How can parents help their child cope with the condition?

The key feature of this inherited neurological condition is uncontrollable and entirely involuntary movements (such as blinking, facial twitches and shoulder shrugging) and sounds.
One mother described her seven-year-old ‘making a continuous stream of whooshing, growling and animal-type noises at home at the end of a school day’.

There are no specific diagnostic tests for Tourette syndrome (TS) but it is thought to affect one schoolchild in every 100, the majority boys, and a much smaller number of adults. 

The important message is that most children outgrow the condition, according to psychologist Dr Tara Murphy and psychiatrist Dr Isobel Heyman from the TS clinic at Great Ormond Street Hospital for Children. 
‘Even if tics do not completely disappear, young adults generally cope with them well. So feeling optimistic and making sure that your son is not defined by the tics is crucial. 
'He will be helped by adults accepting him, advising him on how to manage tics and emphasising his strengths,’ they say.

Oppositional behaviour – being defiant and disruptive – is one of the most common behavioural problems in young children generally and even more common in children with TS. 

Behaviour management strategies work well: ‘The basic principle is to reinforce and reward the behaviour you want to see and pay as little attention as possible when the child is naughty or difficult. 
'Your GP can help you to access this treatment via your local child and adolescent mental health services.’

These techniques can reduce the intensity and impact of tics in some children. 
Comprehensive behavioural intervention for tics is beginning to be available for adults via telemedicine, eg, Skype.

Relaxation training, yoga, meditation, bodywork, gentle stretching exercise, aromatherapy and hypnotherapy may help, according to the charity Tourettes Action ( 

Research is ongoing into the role of mobile apps in helping young people with TS, for instance with habit reduction and relaxation.

Children may be referred for an educational psychology report to help parents and teachers know how best to support them from day to day. 

The parent of one child found it helpful to know he has ‘loop thinking’, meaning he gets stuck on the same idea. 

Addressing him by name, making eye contact and asking him clearly to do something different helps to break the cycle.

Nutritional therapy may prove useful, although there is little scientific evidence so far, apart from a German study suggesting that caffeinated drinks might worsen tics, according to Drs Murphy and Heyman. 

Some health professionals such as naturopath Dr Sonya Doherty ( recommend diets that help rebalance the gut, repopulating it with good bacteria.


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