Do tics go hand in hand with AS?

[mrsbaffled]

Just wondered. Ds1(8) has suspected AS and we are awaiting assessment. I spoke to the GP today as the referral is taking its time to come through and mentioned that he has developed some tics too (his brother, DS2(5), has been ticcing for over a year and has been referred to a neurologist, but are waiting for that to come through too....). The doctor seemed surprised that DS1 would have them too...I thought lots of AS children tic'ed??

[flowwithit]

My Ds has tics too eye blinking head nodding etc but it comes and goes and stress makes it worse. Dx ASD possible dyspraxia and although I have mentioned it never Dx Tourette's so I thought it was part of ASD?

[KOKOagainandagain]

DS1 has tics that come and go with stress but he has been Dx Tourette's as well as ASD (by Daphne Keen).

[flowwithit]

I wonder if it is severity of tics that make a Dx. My Ds has had tics since age 6 but they come for a month or so then disappear then maybe a few months later a different one?

[moosemama]

Ds1 has AS and has several tics that are exacerbated by stress. They started when he was around 8 years old and he is almost 11 now.

His Paed told us that tics are very common in children who have ASD and they are related to stress, trying to contain themselves and cope all day at school and in some cases sensory issues.

I think flowwithit is probably right, about it being the severity, as well as perhaps trigger and duration that makes a difference to the dx.

Ds's has several tics that can disappear completely (generally in the school holidays) and can either appear all together or one at a time and they come and go all the time.

[EnterNicknameHere]

My DS age 10 has aspergers and he also has tics such as throat clearing and finger sniffing and noises, I also have tics, I am curious if they will diagnose tourettes with DS too or whether it is a part of aspergers.

[KOKOagainandagain]

I think the dx of Tourette's depends on how long a particular tic has been present - I think it has to be over 6 months.

It is definitely stress related - DS1 is tic-free for the first time in about 6 years and is currently out of school pending tribunal.

[EnterNicknameHere]

DS has had tics for around a year so that is interesting and I have had them since childhood.

DS' tics are getting much more noticable he is also much more anxious though so I do wonder if they are stress related.

[mrsbaffled]

Ds2 has had his nose and face tic for over a year. He has others that come and go, but last for a few weeks or months at a time, then go. He has had a loud gasping one, but hasn't done that one for a while.

Ds1, on the other hand, has developed a nose twitch in the last couple of weeks, and does a weird eye bulging thing if he is really over-excited, but it isn't all the time like his brother.

[KOKOagainandagain]

ime DS1's tics were a response to chronic (day after day stress) as well as to acute stress.

In DS1's case the tics exacerbated due to social stress - desperately wanting to pass as 'normal' with certain popular peer-group friendships. When it all got too much and he had been dx with SpLD but not ASD he gave up trying to fit in with that group and joined with another boy with SpLD and the tics which had become multiple and were becoming more severe (throat-clearing, coughing, sniffing, snorting, blinking, facial grimaces, shoulder shrugging etc) started to recede. Ironically it was the increase in tics that was becoming more problematic for him in terms of trying to pass as normal.

DS1 camoflagued his behaviour at school. I see his tics as the chronic stress that this produces 'leaking' out. I'm not sure that is the same thing as Tourette's. It might be a predispostion to manifesting stress in particular ways but there are people with Tourette's who tic in when minimally stressed.

[moosemama]

KeepOn, it's been similar for ds. (He has a head shake, vocal hum, throat clear, eye blink, cough and facial grimace.) The harder he tries socially, the more his tics come out, which of course adversely affects his chances of being accepted.

School insisted he wasn't tic-ing while he was there. They were proven to be lying when Mum and I attended a couple of assemblies and sat there watching him tic-ing away.

[moosemama]

DSM-IV-TR diagnostic criteria for Tourettes Syndrome

I think the two most relevant criteria for our dcs are:

• Both multiple motor and one or more vocal tics must be present at some time during the illness, although not necessarily concurrently
  
  
• The tics occur many times a day (usually in bouts) nearly every day or intermittently over more than 1 year, during which time there must not have been a tic-free period of more than 3 consecutive month.

[mrsbaffled]

School haven't noticed ds2 ticcing. But I help in his class one afternoon a week and he is always ticcing away at carpet time. I think they are so busy they don't notice....no real time for any of them. It has been mentioned to me lots by family and church friends, though....

[mrsbaffled]

Ds2 does this humming noise when he eats. Would that count as a tic? It is only when he eats....

[crappypatty]

Ds is 8 with dx of ASD, he has always had tics and I have often wondered were the line is drawn between part of ASD or Tourette's. I have looked over the criteria and he easily fits it, however they don't disturb his life to the level that I have seen when watching documentaries covering TS.

I am just going to mention it to paediatrician next appointment if we ever get to it, it's been rearranged four times, not been seen since last Jan, was due last week and then cancelled three days before and moved to Aug. bloody joke.

[moosemama]

Moved to August! That's outrageous and totally unacceptable - can you call them and ask to be put down for a cancellation - or contact PALS (Patient Liaison Service at the hospital) and complain about how many times you've had the appointment bumped, let alone how far ahead it's been moved?

[crappypatty]

The secretary said she will try and put us in for a cancellation. Not good enough. Was thinking of taking him GP, is it a neurologist he would be referred to for TS.

[moosemama]

From what I've read, yes, a neurologist is the usual first referral, although according to the NHS there may also be referrals to psych/ed psych to rule out other causes, as the diagnosis is one of elimination to some extent.

Agree about 'trying' to put him in for a cancellation not being good enough. I still think it would be worth a chat with PALS to see if they can suggest anything to speed up your paed appointment.

[bishybashyboshy]

my son has been referred to a pediatric neurologist due to possible epilepsy but not sure if they test for neurological deficits in general or if they will be looking just the signs of epilepsy.

[mrsbaffled]

Yes, neurologist. DS2 was referred by GP to community paed locally, but he has re-referred us onto neurologist in a big city.

[moosemama]

If he already has a neuro referral, might it be worth asking your GP to send a follow up letter asking them to consider assessing for Tourettes as well?

[BiddyPop]

DD has a blinking tic, which is actually a lot more noticable now that she is on meds for Asp Syn rather than before she started them.

Otherwise, nothing I can say is a tic, but there are lots and lots of movements all day long (ADHD as well).

[mrsbaffled]

Biddy, what meds does she have for AS? I didn't think they could medicate?

[BiddyPop]

Sorry, meds are for ADHD rather than Aspergers. We have NO help on As side of things yet (apparently the schemes that were run have been closed due to funding problems).

So she is on concerta for ADHD, and that has made the blinking tic (which psych says is Aspergers related) become obvious as a tic rather than just regular blinking. But if we don't draw attention to it, it is less obvious (when DD is "aware" of it, she ends up blinking a lot more, but not on purpose she really can't help it).