tics | Autism PDD

I have been thinking a lot lately about stimming and tics. I am approaching the conclusion that both have to do with sensory issues, but I am not sure I am all the way there yet. What do you see as the difference between stimming and tics? (I am logging off for tonight, but will check for this post again tomorrow.)

Not professionally speaking of course, but my observance, and the reason that I wonder if this new thing is a stem is because, she seems to have more control over it.  And I noticed the other day, I walked into her bedroom and she was not aware that I was there and she was doing it (the new eye roll tic) and the way she was doing it just seemed like she was escaping.  That's the best way I can describe in my own words what a stem looks like to me, an escape.  When my daughter tics with the eye blinking it looks like it is annoying her.  When my son handflaps, he looks like he is enjoying it.  That's the way this new thing looks.  Like she is getting some sort of satisfaction from it.  Anyway, very non-professional but that is what I feel.I briefly mentioned this in another post, but I wonder if anyone else's child that has a tic disorder does this.  My ten year old daughter has started a new tic within the last week or so and she first widens her eyes and then she rolls them upward and to the side.  Several times a minute off and on through out the day.  More on than off.  She also still has her eye blinking tick.  I wondered if this new tic is a compensation for the eye blinking because she is trying not to do it too much, but, she still has the eye blinking tick also.  Anyway I would be interested to know if anyone elses child does this.  I also wondered if this could be a stem, although she does not have a diagnosis yet for autism spectrum disorder.  I have strongly suspected that she may be somewhere mildy on the spectrum, but if so this is the first noticable stem, if in fact it is a stem.  My son stems all the time, his is mainly hand flapping though, although he does jump up and down and sometimes he crosses his eyes while he is flapping his hands.  Anyway, feedback would be greatly appreciated.

My son has tics. We started noticing them when he was 11 (he is 13 now). Yes, he did/does and eye roll thing, he also blows on his hands and has a tic that is like a startle response (plus several others). The tics vary in intensity and the tics sometimes change. We did take him to a neurologist to rule out seizure activity, but he thinks it is just tics.

My daughter has been diagnosed with "Chronic Tic Syndrome".  She has had tics since she was four years old.  Mostly eye blinking, but some facial grimacing as well.  They started her on Tenex last year and it had greatly decreased for a while.  However, now she has developed a new tic.  And it is the first time that I have wondered if this might be a stem instead of a tic.Take your daughter to a pediatric neurologist or child psychiatrist who is familiar with autism. Tic disorders are common co-morbid issues.  It's sometimes very hard to distinguish a tic from a stim.  A doctor should be able to help determine which is which.  There are good medications for tics nowadays, but you really need to go to an expert in autism for advice about this.Thank you both for the info. Very helpful.

Apparently it's not always easy to tell the difference between a stim  and a tic (especially complex motor tics).  Here's how they compare (source:  http://p069.ezboard.com/ftourettesyndromenowwhatfrm5.showMes sage?topicID=134.topic but for some reason the link doesn't always work)

Table 7.2 Characteristics of the movement disorders of Tourette Syndrome (tics) versus autism (stereotypies)

T = tics
S = stereotypies

T: Universal
S: Frequent, not universal

T: School-age onset
S: Toddler onset

T: May remit for months
S: More persistent; may become miniaturized with age

T: Vary a great deal over time
S: Less variable

T: Preceded by urge
S: May be preceded by urge

T: Suppressible for a time
S: Suppressible for a time

T: Sudden, rapid, darting
S: Not as abrupt or rapid

T: Brief
S: Longer

T: Repetitive, irregular
S: Repetitive, rhythmical

T: Asymmetrical
S: Often (not always) bilateral or generalized (e.g., flapping, jumping, pacing)

T: May be small (simple tics) and inconspicuous, or bizarre, even grotesque (complex tics)
S: May be simple or complex. More gesture-like or manneristic

T: Frequency and severity unrelated to IQ
S: More frequent in individuals with low IQ

T: Self-injury uncommon, "accidental," e.g., by repetitive poking
S: Self-injury relatively frequent, "intended"; e.g., biting, picking, head banging, slapping. Associated with low IQ and aggressiveness in some but not all individuals.

T: Not deliberately aggressive; sudden compulsive touching or approaching others.
S: Aggression such as pinching or hitting frequent

T: Respiratory tics, sudden vocalizations, coprolalia
S: Humming, singing, muttering

T: Worsened by anxiety
S: Worsened by anxiety, idleness

T: Lessened by activity, concentration
S: Lessened by activity, concentration

T: May persist in sleep
S: Not present in sleep

Here is an article about identifying tic triggers (I think you've already read it rubyruby).  Not sure if it mentions sensory triggers.

http://www.latitudes.org/articles/finding_triggers.htm

Good luck to everyone dealing with this.

 

bumping for suggestion.

Anyone? Please?
I was just about to start a new topic on this very subject and luckily I found this first. Here is the problem. My dd who is going to be 8 years old in 19 days, she has ADD, just dx'd with an anxiety disorder. She started with a new therapist last week for the anxiety and we had also discussed the possibility of her having mild-moderate Asperger's, and she has been with the most awesome psychiatrist that is treating her for the ADD. Within the last 6 months she has been treated with FocalinXR 15mg daily and she started having really bad pain in her eyes, so her doctor changed her to Concerta 36mg daily. Well over the last month, she has started with this tic (i am assuming that is what it is). At first it was mostly in the afternoons about 3:30 or so when I would notice it. Well over the weekend, I would sit and watch her and especially when we are sitting and reading together. To describe it, she squints her eyes really hard, then rolls them, squints again, wrinkles her nose and mouth and her head jerks slightly to her left. It is getting worse everyday, and I am so confused as to what is causing it. The meds, stress, etc. I am putting in a call to her psychiatrist this morning to see about switching her meds to Adderall. Thats just me assuming that it has something to do with the methylphenidate in the other meds that she was on and in the Concerta. Adderall doesn't have the methylphenidate in it, so I thought maybe a change in the meds might fix the problem. But it has gotten to the point that it makes her uncomfortable and she keeps asking me "mommy, why does this happen"? I just wish that I had an answer, she knows that it shouldn't be happening and it is scaring her.

Do any of you have any suggestions? I am worried to death and don't know which way to go with this.

UPDATE: I have spoken to her psychiatrist and he is going to see her tomorrow. I just got off of the phone with dd's teacher and asked her if she had noticed anything, and she stated that she noticed it on the first day of school, but thought that it was because she is just a nervous child. But she has noticed that it is increasing in severity and is happening very often and that it is making my daughter very uncomfortable because she doesnt know why it is happening and that she gets embarrassed about it. She is going to send a letter home with my daughter this afternoon stating everything she has noticed, so that her doctor can see it tomorrow.
mandyanthony39356.3734375 [QUOTE=rubyruby] I briefly mentioned this in another post, but I wonder if anyone else's child that has a tic disorder does this.  My ten year old daughter has started a new tic within the last week or so and she first widens her eyes and then she rolls them upward and to the side.  Several times a minute off and on through out the day.  More on than off.  She also still has her eye blinking tick.  I wondered if this new tic is a compensation for the eye blinking because she is trying not to do it too much, but, she still has the eye blinking tick also.  Anyway I would be interested to know if anyone elses child does this.  [/QUOTE]

I have this tic. Not as often as what you are describing, maybe 15-20 times a day or so (usually clustered -- not evenly spaced out over the entire day). But anyway, I find myself doing it because my eyes get uncomfortable, and for some reason, rolling my eyes upward like that seems to help. Maybe the air hitting a part of my eye that it does not normally touch takes my attention away from the discomfort. That's the best I can come up with as a theory. I haven't really put much thought into why it happens but I do know that it's sensory.

I also have the one that looks like a startle response. I have no idea why this happens -- it happens so quickly that I don't really have time to recount it. It happens randomly and usually no one notices it because it's not really a violent twitch. But I notice it because it feels like every muscle in my body twitches at the same time without any warning.stickboy2639355.8603472222

Stickboy26,

Thanks for explaining about the way tics feel. I ask my son things like do you know if you are going to tic, but mostly he just says he doesn't know.

 

tsnw --

Thanks for all the great material you have posted on the Tourette Syndrome website.  I'm very sorry about the copyright issue I created. 

Links posted on our forum have a tendency to get broken (blank spaces are often added into the address for some reason).  I didn't realize this at the time I originally posted the table several months ago, so I thought that your server was unstable.  After I discovered the problem on our website, it didn't occur to me that this was what had caused the problem in accessing your website, but of course it was obvious once you pointed it out.

I would like to continue telling people about the helpful information at your website -- the table is such a good summary, and the other material is also very much worth reading.  If you'd prefer that I post only the address and not any excerpts, I will certainly respect that. 

Thanks for all your hard work gathering the autism/TS information in one place.

 

Thank you posting the (partial) information from the Tourette Syndrome - Now What? forum on distinguishing tics from stereotypies; the link always works, but was apparently broken here (which creates a copyright issue :-)  I don't know how to make a link here.

The correct link is:

http://p069.ezboard.com/ftourettesyndromenowwhatfrm5.showMes sage?topicID=134.topic

In case that doesn't get you there, you can go to:

http://p069.ezboard.com/btourettesyndromenowwhat

And negotiate to the Tourette's syndrome research forum.  ALso, tics are not only comorbid with autism; tics are part of the autism spectrum, so a secondary diagnosis isn't always helpful.  See

http://p069.ezboard.com/ftourettesyndromenowwhatfrm5.showMes sage?topicID=7.topic

which is Secondary Causes of tics (tourettism) in the Research forum.

I hope that helps; please stop by if you have any tic questions.

tsnw39355.7696412037

No problem, Norwaymom, thanks for the explanation!  I'm glad the info is helpful.

The main reason I worry is that I give credit to the original authors on my board, so it's important that credit or link be included so we don't get too far away from the original sources of the material. 

Because this board breaks the links, you might remind people to go to

http://p069.ezboard.com/btourettesyndromenowwhat

and then navigate to the Research forum, the Tourette's versus Autism thread.

Best regards, TSNW

http://tourettenowwhat.tripod.com

Well here is the update on Zoe. We took her to her psychiatrist the day before yesterday and he took her off of her ADD meds ( Concerta, and was previously on FocalinXR). Well she went back to school yesterday un-medicated and needless to say, I spent yesterday afternoon on the phone with her teacher. Zoe has turned into a complete monster. I understand (having the same issues that she has) that you will go through withdrawals from the stimulants. Well the complete opposite happened. She has NEVER been a hyper child and her teacher said that the tic got much much worse yesterday, it was constant, she would out of the blue just start laughing hysterically out loud, getting out of her chair and walking around, singing and was completely disrespectful to her teacher. Thank goodness that her teacher was made aware of the situation the day before we took her to the doctor, because that was the only thing that saved Zoe from being suspended for one day from school yesterday. So much more happened in class for me to even go into, but ONE day off of the medication and she almost gets suspended from school. Now this is a child that was put into Gifted and Talent program in Kindergarten and has been an A honor roll student ever since, to THIS!

I called her psychiatrist last night and he is at a total loss, we were able to rule out allergies and whatnot, and he wants her in his office first thing tomorrow morning (only because he is out of the office today), but he is having me keep her out of school for the rest of the week until we can get to the bottom of this.

Any suggestions as to what this could be? What is causing this kind of reaction?

Please, someone help me!!
Thanks guys! The note that her teacher sent home yesterday like to had done me in. She stated that she has noticed it from the 1st day of school and that they have gradually gotten worse. Explained it exactly the way I did in my post and said that it happens every 2-3 minutes in multiples of 3. Now this terrifies me!!! I am so scared and don't know what to think. All I know is that I want it to stop torturing my baby. Zoe cried for about an hour yesterday about it, she knows that something is wrong and she is having a hard time dealing with it (especially considering she has an anxiety disorder on top of it). A slight stutter has been noticed, it comes and goes. Zoe says that she was totally unaware that her head jerks to the side when this happens. That she is aware of the squinting and wrinkling her face and rolling her eyes, but she had no idea that her head was jerking to one side.

Anyway, I will let you guys know what the doctor tells us this afternoon.
I'm sorry no one had an answer for you, mandyanthony.  Let us know how the doctor's appointment goes.I too am sorry you are going through this!  My daughters tics are calmer now that she is on Tenex, even though she still has them.  The reason we sought help, (meds) after 4 years of ticcing was because her tic became so bad, it was interfering with her school work.  This was mainly her eye blinking tic.  Her reading level dropped tremendously and yes she was made fun of.  It was such a problem, especially at the beginning of last year that they counciled her class and gave a little presentation about tics.  Things did get better, but my daughter is (for lack of better words), like "Damaged goods"  as far as her confidence level is concerned.  You know kids can go through something like this and be made fun of and even though things change and get better they still suffer for the things that occurred.  It breaks my heart.  I worry all the time about what the future will hold and if these tics will get worse, if they will go away, if they will develop into Tourettes.  She is only ten, so she is not past that threshhold.  Good luck with things! 

Mandyanthony: Check the feingold diet.  My son is on it, and I can see a big difference on and off it.  It even allowed me to reduce/eliminate the ADD meds and therefore reduce the tics without decreasing his performance at school.  It may take up to 6 weeks to see results.  I also did fish oil, Nordic naturals.  My son is also on Tenex, and although the tics are still there, they are less often.

Personally I think the diet is very helpful, but not magical.  I would not claim it cures ADHD but helps a great deal to control it with less medication.  Right now he is without the meds on weekends and most days, and I will give him a the lowest daytrana patch on special ocasions like tests at school.

I for one had no idea what the TAT was (similar to the Rorschach).  Does he want to use it to help identify her feelings of anxiety and other emotional issues?

Talk about some hefty withdrawal!  I thought the doctor's warning sounded weird (having no experience with psych meds myself), but that reaction at McDonalds shows he was totally on the ball!

I hope things get better quickly.

 

Oh, forgot to mention:  Concerta has BHT, petroleum based, I've heard from other parents to cause that kind of reaction of withdrawl.  That's why I went with daytrana.  Just a personal opinion

 

Thanks guys. I guess all that I can really do is wait and see what her doctor wants to do next.

Mandyanthony --

How has Zoe been doing the last few days?

Well we went to see her psychiatrist on Friday morning and he put her on Straterra 18mg and .25mg of Risperdal. She took her first dose of Straterra that same morning, we got home at about 10 am and she came in and went straight to sleep. Bless her heart, she slept all day, and was sweating something horrible. She would wake up about every hour and get something to drink, within 5 minutes or so, she was sound asleep again. I thank goodness that she slept right through the withdrawals and has been a totally different child since. I was put under strict instruction to keep her out of the heat, no direct sunlight for more than about 15 minutes at a time, no running, no jumping, no spinning around and so on and so forth for her for the next 3-4 weeks. The doctor said that her chemicals had been thrown into shock and simply standing to quickly could cause her to faint. Her best friend (who is like a sister to Zoe) had her birthday party yesterday at McDonald's ( on the playground inside) and I was sitting and watching her play (back to being my sweet and happy angel) and my best friend told me "Mandy, you need to get Zoe over here", so I called her over to us and she was twitching so bad (full body twitches at that), I made her sit down with me, drink her sprite and she ate a couple of pieces of ice, and I could literally see the twitching stop as her body temperature came down. Now I say this, because just a few minutes before that, I was asking myself if I was being overly careful by restricting life according to doctor's orders, and I now see that he was right. Her and I have had a long talk about the restrictions that she is under for now, and after yesterday, she completely understands. Her teacher called me yesterday to check on her (This lady is awesome, and completely understands what is going on, she has two daughters of her own who have multiple disabilities), and I got to telling her everything that has went on since she last saw Zoe on Wednesday, and what the doctor had said, and she is willing to do anything to help me pull Zoe through this. She did say that when the class goes out for recess, she will let Zoe and another student or two go to the computer class and play games on the computers (by sending another student or two, not making Zoe feel so singled out), and that she will make a special effort to make sure that Zoe does not fall behind and gets a little extra one on one time. I also got a chance to talk to her P.E coach at the party yesterday and she was telling me that they are starting the school's Walk-a-thon tomorrow, and that she will have Zoe got to the library with a friend or something really cool for her to do so that she doesn't feel like she is being punished by not being allowed to participate. Zoe and I talked about all of this, and she is ok with it and understands that it is not going to last forever, that things WILL get back to normal with a little time and work.

With all of that said, Thursday was total hell for Zoe and I, she was being so mean and just plain hateful all day and that is NOT my Zoe, but after Friday, she is my baby girl again, happy, laughing, and every chance she gets, I get an "I love you mommy".

And before I go, I do need to mention one more thing, her psychiatrist has written a referral to the school district IEP wanting to have the TAT test done in considering "Other Health Issues" to try and get us some extra assistance in school to help keep thing running as smoothly as possible for Zoe. I have felt so blessed to have the support from you guys, my friends, family and most of all Zoe's teachers.

And for those of you (like me who have no idea what the heck the TAT test is)...
TAT Test

And here is a big and a THANKS for those of you who took time to answer my questions and read this and a double to you NorwayMom for asking how Zoe has been doing.
Thats what I am thinking, but really don't know for sure. She went back to school today, and when she got off of the bus this afternoon, she had a note on her shirt saying that she had a Great Day!!

I agree, that he was totally on the ball. She does tell me often that she feels better now than she did before. She does seem to be back to normal for the most part, a little anxious, but I guess that is to be expected when you have an anxiety disorder. She gets it honest, and that makes me feel terrible. You are never happy with knowing that your children's issues were inherited by you.

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