compulsions vs. motor/vocal tics

Doreen - posted on 10/15/2010 ( 9 moms have responded )

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I hoping someone can give me some insight on this. My son has many motor skill vics and compulsions. How can I determine the difference? Justin was screaming at the top of his lungs for a few days last week. Just a loud scream-when I brought him to the neurologist he said that was a compulsion. Justin has a new thing (tic or compulsion?) He sucks in his stomach so his ribs show and then stick his fingers up under his ribs. I dont know if that is a tic or compulsion. He walks and with every step he drags his toes. The dr says it is a compulsion but I dont see it being that. Justin doesnt even realize he is doing it.



If anyone knows, please help me understand how to identify a compulsion vs. a tic....

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Lisa - posted on 05/11/2011

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I have a % yr old who was doing the same thing with the fingers under the ribs. He has been on concerta now for abotut 6 months. He has started clonidine .1 mg 1/2 at bed ans 1/4 in morning. He has terrible facial tics. I am going to try magnesium. It helped with verbal tics he use to have.

Colleen - posted on 01/31/2011

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I am hoping that what my son is going through is normal.he has t.s. and just recently told me that he thinks of harming himself.he has violent thoughts pop in his head all day.I hope this is normal for t.s. I just want him to be happy

Leslie - posted on 11/13/2010

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I know how you feel...We are figuring it out as we go, and I learn a lot from all of you too.

Doreen - posted on 11/10/2010

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You have helped me tremendously!!!! I have been so confused and all i want to do is help my son. Thank you so much

Leslie - posted on 10/22/2010

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The discovery we have made recently and that has changed everything is that sometimes the same behaviors/actions are driven by different things. My daughter's skin-picking is a tic, a compulsion, a body-focused repetitive self- injurious behavior and a tactile defensiveness behavior resulting from sensory processing disorder. My daughter is learning to recognize the difference...but at first she had no idea what drove her actions. She is older..thirteen...but maturity-wise and emotionally she is still eight or nine; she has normal intelligence, just delayed maturation. I am saying that, because I am hopeful that younger kids might benefit from her experience. I hope that they can learn to do what she is learning to do...and that is to recognize for herself what is driving the behavior. She has learned to delay tics by doing "finger sequences" and "toe sequences" that she was taught by her neuropsychologist. She will still have to perform the tic...but she can do it in private. She has learned to recognize OCD thoughts...and she knows how to confront them and force herself not to perform the compulsion. She came up with her own tactic for the sensory thing...She puts a band-aid on her skin and pulls it off....It gives her the sensory input of pulling off a scab without doing the damage. As far as the body focused thing is concerned, we are working on that in behavioral therapy. She resents that her body is ahead of her...She isn't ready for puberty. She still wants Zhu Zhu Pets. We're trying to show her the positives in growing up.

Anyway, my point is...I've learned a lot this year. No doctor can tell us for certain what is a tic or what is compulsion. We have to learn to recognize them ourselves...and sometimes, a behavior/action is a combination of tic, compulsion, habit, sensory input...and in those instances, the only person who can learn to tell the difference is the child.

These are the factors we are using to determine whether my daughter's actions are driven by TS, OCD, BFRSIB, or SPD:
1. Is the action driven by a feeling...stinging, itching, burning or tension...that won't go away until the action is performed? (Tic)
2. Does your child do it in their sleep? (tic)
3. Is it driven by a thought process...that something bad is going to happen unless the action is performed? (compulsion)
3. Was the action driven by discomfort from clothing, sounds, any other sensory input? (SPD)
4. Must the action be performed in the same way, at the same time? Is it more regulated and structured? (Compulsion.)
5. Was self-esteem low/ depression evident? Was there an event that increased self-consciousness? (Could be any of the above, but also BFRSIB.)

I am afraid that by sharing this that I might have worried you even more...but it has been a breakthrough for us, because when I was spending so much time re-directing her, sometimes I was making her tics worse because I didn't recognize that they were tics. Now that she is learning to recognize the difference...after months of asking the same questions, months of the habit reversal training, reading books like "Standing up to OCD," or "When My Brain Gets Stuck," she is feeling empowered, and she is doing better.

Doreen, it is pretty obvious that your son's behavior is a tic.... and I would try to help him learn to delay it...but controlling tics is just that...delaying tics. They still have to happen, and should never be reprimanded.
I hope that I haven't gone on and on and on too much...

Dana - posted on 10/20/2010

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It's so good to hear that I am not alone!! I've been feeling the same way about my son. Trying to figure out what he can control and what he can't. When do I reprimand him for his actions and when do I not? The only difference is our doctor says my son is impulsive. I agree with Cynthia, by the way your son describes the feeling it sounds like a tic.

Cynthia - posted on 10/18/2010

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I'm still really new to this, so I could be wrong, but Micah can control most of his tics, too. I have read that most people with TS can control them, certain times and in certain places. But, do you notice that he does it more or louder if he does control it? It sounds like a tic to me, but like I said before I am so new to all this, I could be wrong!

There is a therapy called habit reversal training that actually TEACHES the children to gradually change a problematic tic into one that's less noticeable, or more socially appropriate. So, this tells me that tics CAN be controlled. Does your son's neurologist have much experience with TS? Is it his focus? If this is a big issue to you, you might want to consider a second opinion.

Doreen - posted on 10/18/2010

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Thanks Cynthia-my son says he feel like his throat is tightening up and the only way to relieve it is to scream. His neurologist said that is not a tic but a compulsion. To me the way he describes it is is like a tic. BUT when I tell him to control it-he can. So I am totally confused

Cynthia - posted on 10/16/2010

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I have no personal knowledge of this, but I was just reading in a book that tics feel like an itch, that they "have to" do them or it just won't "feel right." Compulsions are more when they think something bad will happen if they don't do it.

If you are interested, the book is called Tourette's Syndrome Finding Answers and Getting Help by Mitzi Waltz. It is a heavy read, I'm barely 1/2 way through, and I've had it from the library for probably 2 months.

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