A Tic, A Tat

Grace was loving third grade and her wonderful teacher.  There was just one problem.  We simply could not get her to stop shouting things out in class.  

The talking out/blurting out had slowly become an issue just this past year.  Grace has always been a good student.  She works hard in class and respects her fellow classmates.  However, this past year I had noticed her having a harder and harder time controlling her vocalizations in class.  She seemed to have literally no control over when she spoke.  The only blessing was that when she blurted things out she was on topic.  Thank goodness she wasn’t shouting out strange words, or talking about flying monkeys...

What upset me the most was that when her teacher and I spoke with her about not talking out Grace felt confused embarrassed and ashamed.  I slowly started to realize that Grace did not know she was talking.  

We tried offering a special reward system where she earned stickers and checkmarks on her desk, but it was totally ineffective.  You can’t reward or discipline a behavior when a child is unaware of it.  

A tic is defined as an involuntary, repetitive movement and/or vocalization.  

According to Wikipedia it is defined as a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups. http://en.wikipedia.org/wiki/Tic 

Many children have tics at one time or another.  Often these consist of eye blinking, throat clearing, or sniffing.  Typically these tics will disappear naturally and don’t last long.  

Grace’s tics started in preschool.  She has a several tics that come and go in a very predictable pattern.  At times they are more present, but they are always there.  They consist of the following...

• grimacing
• this involves squinting and contorting her face 
• throat clearing
• blinking

The newest tic, which I was unaware of, is...

• talking out 
• this involves saying things out loud - Grace says things that are ON TOPIC but has no control over when and how she says them

The thing is that Grace doesn’t just have tics, she has Tourette’s.   It took the talking out to finally get an official diagnosis from her psychiatrist, but it all makes perfect sense.  

Tourette’s is defined as an inherited neuropsychiatric disorder with onset in childhood, characterized by multiple physical (motor) tics and at least one vocal (phonic) tic. These tics characteristically wax and wane, can be suppressed temporarily, and are preceded by a premonitory urge.

http://en.wikipedia.org/wiki/Tourette_syndrome

All it really means is that the tics of childhood contain at least one vocal tic and persist for an extended period of time.  Tourette’s has a stigma attached to it due to the very few people who have it that suffer from a severe form of Tourette’s called coporlalia (uttering foul words).  This is extremely rare.  Most people with Tourette’s manage to live normal lives and control many of their symptoms with medication.  

Tourette’s is extremely common in conjunction with OCD, and we were not at all surprised to receive this diagnosis.  There are often many disorders that coexist with each other.  This phenomenon is called comorbidity (what an awful word!).  

We added another medication to Grace’s current medication.  The med is called Intuniv.  She is currently taking the lowest dosage.  We noticed an immediate improvement with not just the talking out, but all the tics.  Grace didn’t seem to notice either way.  Maybe she seemed a little happier.  It’s hard to tell with her.  I think if you don’t realize you are doing something, it’s hard to tell when you are not.  

I can say that Grace continues to both baffle me and astound me every day.  Sometimes she seems to not notice or care about what anyone else thinks, and every once in a while she will come home sad and tell me she doesn’t feel like she fits in.  The other day she told my husband, in the most monotone, emotionless voice, “ Sometimes kids say I am weird”.  He was about to get fired up and then she said, “I don’t care, I LIKE being weird.”  

And so, there you go.  She’s different, she’s brilliant, she’s her own person, and she really doesn’t care what anyone thinks.  :)