TS child struggling to control speech - disinhibition?

[mrsbaffled]

My DS2 (6) was dx with TS (Tourette's) over a year ago and it has mostly just manifested in classic tics so far, but over the summer he has started jabbering incessantly. Some of it is echolalia and most of it phrases stuck together incoherently.

He has in the past struggled to control his impulses to lash out, even to the point of kicking the old ladies in church - the shame! But it has got so much worse over the last month or so - he is constantly hurting his brother (10)...I found bruises on his upper arm today and last night he poked him in the eyes. He often calls us names like "stupid idiot" and declares "you are the worst mum in the world" for the smallest things. Thing is he doesn't mean it and when he is calm he is sorry about it, saying he finds it really hard not to say these things. "I want o be good, but I can't" :'(

I really don't know what to do - IS there anything I can do?! Is this part of the TS? I found this link yesterday and it does sound like this is disinhibition:
www.tsa-usa.org/Education/UnderstandingTSBehaviors.htm

I am finding it very hard to do anything - the children are incapable of not hurting each other - I can't leave them alone. DS1 is taking it remarkably well most of the time (he also has TS, and ASD traits), but does fight back when pushed.

[mrsbaffled]

Anyone?

[ChampagneAndCrisps]

Is he on medication? I know he's young - but he's clearly severely affected.
Two of mine have Tourettes and the meds do help.

We do get the lashing out and loss of control. The pair of them set each other off sometimes.

Its a very strange illness and difficult to understand - even when you live with it.

Sorry - quite tired just now & can't be bothered writing more. I'll check if you pick this up and for any questions.

[mrsbaffled]

Thanks, Champagne and Polter x

I will read the explosive child when I get the time. Finally finished with holiday club, so feel more relaxed....

Champagne, it is funny, his motor tics are on a lull (just small facial movements), so very few people actually believe he even has TS (they don't see the echolalia etc as anything unusual...just an eccentric child). But the other side of things - behavioural - have increased massively. Perhaps we should go back to the neurologist? He said there was no need to medicate as the tics weren't particularly bothering him. Does the medicine help with the impulses, then, as well as the tics?

[mrsbaffled]

Is he just being six?! Many friends just shrug and say their LO is being difficult too, it is just his age?!

[ChampagneAndCrisps]

The thing about Tourette's is that some of the Doctors don't really understand it. They tend to concentrate on the tics.

In my view & I did used to be a Doctor (!) - Tourettes is diagnosed by the presence of the tics - but the picture is much more complex. The illness presents with tics - but also the comorbid illnesses such as anxiety, obsessional compulsive behaviour, ADHD. It's very difficult to disentangle it all.

I think meds do help the other problems beside the tics. I also think you won't know till you try. My kids have been on Risperidone with good effect, but no side effects. My DD is being switched to Aripriprazole just now - trying to improve her control. It has a better side effect profile long term - but she is older -14. In your son they would probably want to try something that's been around longer.

If he fulfils the diagnostic criteria for Tourettes then I don't think you can say he's just being a six year old. These poor kids are made to behave in ways they don't really want to. The basal ganglia in our brain controls what we do and what we say. Normal people choose what to do and say. In Tourettes the Basal Gamglia just fires spontaneously and the brain makes the body do or say something.

Your son is young. He shouldn't be blamed or judged for his behaviour. I think go back and speak to the Drs. It's very difficult being the parent of a child with Tourettes. You do get very judged. It is a long process. My kids were relatively simple - they're so bad there was no decision to be made re meds- they needed them.

Hope that makes some sense - had wine!

[mrsbaffled]

Thank you x it is nice to be understood :)

He was dx last Easter, with his tics starting before he was 4. His older brother was dx with mild TS 6 months ago. My dad also has it.

How would you deal with the name calling and hitting? Today, for example he told a little girl he hated her. She was really upset. I had to get him to say sorry to make her feel better, but he felt bad. It is so hard.

[ChampagneAndCrisps]

I'm not sure. With my kids I can tell when it's Tourettes and when they're just being mean. I tend to be quite straight with them. Even if it is Tourettes driving their behaviour I feel they have to learn to walk away or apologise. Real life means that people just do not understand the illness.

But my kids are older and maybe that makes it easier. It doesn't always as my DS is too sensitive to people's feelings and he gets bullied because of it. It's too much to go into just now.

The thing to emphasise to the Drs is that your sons life and happiness are being affected. Perhaps a child psychiatrist or psychologist would help more than a neurologist.

Part of the diagnostic process in child psychiatry is the extent to which the child is affected by his symptoms. So if the child is happy even though they tic every day - then that's ok. But if the child is becoming unhappy because they can't control their own behaviour then a solution or help needs to be found.

[mrsbaffled]

Thank you x

[ChampagneAndCrisps]

Sorry, not sure if it was helpful. I find being a mum with children with Tourettes is a real mix of conveying that you understand their pain and helping them cope with reality. Inn the early days I read a lot of books by Drs and also books by sufferers (Nick Van Bloss) to try and understand my children's point of view.

It's hard to keep a diary - but I found that helpful too. I find tics happen so quickly they're hard to remember. It helps to get an over