Chronic Motor Tic Disorder Treatment

Chronic Motor Tic Disorder…What is it?

Chronic Tic Disorder

What is it?
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Chronic Motor Tic Disorder, much like Tourette Syndrome, is a condition in which people experience fast, unvoluntary movements in various places on their body or sudden vocal outbursts.  Unlike Tourette Syndrome, they will experience either motor tics or vocal tics, but not both.  When more than one motor tic AND a verbal tics are present, the condition is referred to as Tourette Syndrome.  Transient or Provisional Tic Disorder is when the person experiences the tics for a year or less.  When the tics  breach a full year, it then becomes chronic tic disorder and can be referred to either chronic motor tic disorder or chronic vocal tic disorder, dependent upon which type of tic the person is experiencing.

It is believed that this disorder is caused by physical or chemical abnormalities in the brain such as neurotransmitters misfiring.  Though doctors are not entirely sure what causes this condition as of yet.  Previously, doctors thought that chronic motor tic disorder was being triggered as a side affect of medications that were used to treat Attention Deficit Hyperactivity Disorder.  Though recently, studies have shown that this is not the case.  It seems to be more common in boys and typically lasts 4 to 6 years.

Tics usually start around 5 years old and typically don’t start to improve until the child reaches the age of 12, sometimes carrying on into adulthood.  Chronic tics may be a form of Tourette’s Syndrome, although Chronic Motor Tic Disorder is more common.

People are usually aware of the tics they are experiencing but may not associate them with being tics.  Children especially do not understand why they are happening, they just sort of feel the need to do it.  Tics are unvoluntary, so the person doesn’t have much control over it.  They can sometimes postpone the tic for several moments but will not feel relief until the tic is carried out.  Sometimes people experience abnormal sensations in the area where the tic occurs until it is carried out.

One of the most heartbreaking stories for me to recall for my son is related to his tic disorder.  My son was sitting in church one Sunday and just could not stop clearing his throat.  His tics were worse at the time because he was visiting family out of state and so was out of his normal routine.  My son was told several times during church to stop clearing his throat and when he couldn’t, he was told that he was disturbing everybody.  He was only about 5 years old at the time and could not yet verbalize his feelings to the extent that he could explain a tic.  The family member that told him that did not understand that he couldn’t help it so it left him feeling embarrassed and hurt.

 

Symptoms of Tic Disorder

Much like other developmental conditions, the symptoms of Chronic Motor Tic Disorder vary from person to person.  The type and intensity of tics varies from person to person and each person may experience varying levels of intensity.

Motor Tics:

chronic tic disorder

Another Tic Disorder
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  • Facial grimacing
  • Lip smacking
  • Rapid blinking
  • Jaw popping
  • Nose twitching
  • Head jerking
  • Shrugging
  • Sudden jerking or stretching of the limbs
  • Contractions of the abdomen or diaphragm

Vocal Tics:

  • Throat clearing
  • Groaning
  • Grunting
  • Sudden verbal outbursts

Triggers:

While triggers are not always present, tics may get worse with:
  • Stress
  • Heat
  • Excitement
  • Fatigue
Tics may also occur during various levels of sleep.

Diagnosis of Chronic Motor Tic Disorder

Chronic Motor Tic Disorder Diagnosis

Chronic Motor Tic Disorder Diagnosis
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Doctors and Pediatricians usually diagnose Tic Disorder during a regular examination without the need for any specific tests.  The disorder is diagnosed when the tics have been present for a year or more and when the periods of time where tics haven’t occurred do not last more than 3 months at a time.  They also must have started before the child turned 18.

Chronic Motor Tic Disorder Treatment

Much of the time, tics do not need to be treated as they will eventually be outgrown and don’t have too much of a negative impact on the person.  But sometimes the tics are more severe and can affect daily activities such as social life, work and/or school.  In these cases, doctors may prescribe medications, such as dopamine blockers, to help reduce or prevent tics.  But these medications can have negative side affects like movement problems or stunted thinking, such as confusion or paranoia.

Children may also be referred to a psychotherapist or behavior therapist for treatment.  Comprehensive Behavioral Intervention for Tics (CBIT) has been shown to improve the symptoms in children, according to a 2010 study in the Journal of the American Medical Association.  This approach teaches children to recognize the internal urges of tics and replace the tic with a more acceptable response.

Children who develop this disorder between ages 5 and 8 typically recover on their own within 4 to 6 years.  However, if the disorder develops when they are older and continue into their 20’s, they may or may not outgrow the condition.

One key aspect for proper chronic motor tic disorder treatment is an accurate diagnosis.  Other disabilities can mimic this disorder, such as Tourette’s Syndrome or Epilepsy.  So getting an accurate diagnosis is vital to treating the disorder most effectively.  Medications often tend to have negative side effects so it is always important to ensure that the most effective prescription is ordered when medicinal intervention is necessary.

Also, don’t be too quick to dismiss labels on children.  Remember that there is a huge difference between negative labels and medical labels.  The medical diagnosis that you might consider a label just might be the exact thing a child needs in order to get the help that they deserve.

If you’d like to help me raise some awareness on these “invisible” conditions that are often largely misunderstood, please hit share and get the word out.

Talk soon,

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The Decision to Homeschool My Child

What Happened?!?


My son is in 6th grade this year, his first year of Middle School.  We knew it was going to be a hard year for him as he will now have to transition to changing classes every hour instead of sitting in one classroom most of the day.  He was approved to stay in the Magnet Program with the school he went to for elementary school which meant he got to stay for Middle school as well.  But in order to stay in the Magnet Program, he had to meet certain academic criteria.

At the end of last year, we discussed that in his 504 Plan meeting.  The principal assured me that as long as my son showed effort that he was trying to keep up, then he wouldn’t be kicked out of the program and the school would support him.  While I hadn’t been thrilled with how certain teacher’s had handled my son in the past, overall the school had been better for him than the previous two schools I had him in.  So I was happy to keep him in an environment that he was already familiar with for Middle School.  However, my son and I had discussed this and I made him aware that we’re not going to continue jumping from school to

Shame

Enough is Enough

school.  This was the third school in six years.  If it didn’t work out at this school, I would homeschool him.  He dreaded that though and was absolutely against homeshooling as he did not want to be away from his friends.

However, he got halfway through sixth grade with pretty decent grades.  The very first week back from the winter holiday break, my son was called up to the Dean’s office and told that he had 3 days to pull his GPA up from 1.5 to 2.5 or he would be kicked out of the program.  This devastated him.  He came home crying and feeling like a complete failure, yet again.  His tics immediately started back up indicating that he was overly stressed and he cried off and on the entire weekend.  I was fed up and scared to death at the same time.  I’ve never seen my son that upset, that worthless.

 

Communication…or Lack Thereof


The Dean had tried to call me that same Friday, but I was in a business meeting and couldn’t answer her call right away.  I immediately left my meeting because I knew it was the school calling.  I called the school back but the front office had no idea who had called me.  And, as always, there was no message left on my voicemail at either of the numbers she called.  A few hours later, I received an email from her informing me that she had spoken to my son about his grades and she hoped I would work with him over the weekend on making up assignments he was missing.

Since I was upset, I waited until the following Monday to contact her.  I had spoken to my son over the weekend and determined that he had a few missing assignments and had earned a couple of zeros on group projects where other team members hadn’t done their part so the entire group failed.  There were four assignments that he admitted to not turning in.  So I instructed him to get them done and turn them in Monday.  When I emailed the Dean, I explained what my son had told me about some of the zeros and missing assignments.  I asked what would happen next.  Would they kick him out of the school next week or would he be allowed to finish the year?  Why had the teachers not been communicating with me about work not being turned in until there were only 3 days to do anything about it?  I asked very specific, targeted questions.  I copied the principal on the email because she had pulled me aside at the beginning of this year to tell me that the school was going to stand by my son.  “We’ll get him through it,” she said.School

Wednesday, two days later, I finally received a response from the Dean.  She had forwarded the email to the teachers as they could explain the zeros better than she could.  She told me her team would meet to make a decision and she would bring my concerns to the team at that time.  As for what happens next, they could either kick him out of the program altogether and kick him out of the school immediately, they could place him on academic probation for another quarter and reassess then, or they could release him from probation if his grades were high enough.  I never received a response from his teachers.

My son came home from school that day and told me that he had gone to one of his teachers and asked her if he could turn one of the missing assignments in to her the following day.  Her response to him was, “Why would I take it now?”  This made me angrier.  He did exactly what both the Dean and I instructed him to do, and that was her response.  That same day, the Guidance Counselor called him down and told him that she “doesn’t think” he’d be kicked out of the program just yet and that he’d probably be allowed to stay for the 3rd quarter.  So he gets to spend the next nine weeks worried about whether he’ll be kicked out after that quarter?  I don’t think so.  Not on my watch.

 

Homeschool


I called that very night and enrolled him into an Independent Study Homeschooling program.  I will teach him myself.  He has had his spirit broken down at school year after year.  How is he supposed to succeed at anything if he’s constantly being told he’s not good enough?  During the previous weekend, I had told him he was perfect to me.  That resulted in my son bursting into tears and thanking me.  Then he went to his room to sob…again.  At that point, I put my face in my hands and cried too.  I had never felt so helpless.  I can’t let them continue to destroy my son.  They will lead him to suicide, he’s already high risk just due to his disabilities.  I have to take control of his education and stop this nonsense.

I had him officially enrolled in homeschooling by the end of the day on Thursday and withdrew him from public school on Friday.  I needed to start doing damage control right away and get him built back up, his confidence level is at an all time low.  Since the principal had offered reassurance at the beginning of the year, I wanted to give her a personal explanation of what happened and why I pulled him out.  So I wrote her a letter and sent it to her via email.  It is entirely rhetorical and I am quite certain that I will never hear from that school again.  But I held my head high and explained to her my reasoning while getting everything off my chest at the same time.  This allowed me to close that chapter and move right on to the next.

Focused on Success

Focused on Success

Now, my son and I have just finished our first week of homeschooling.  It went pretty well and he is starting to get back to himself again.  He’s much happier now and is excited to learn again.  I think this was the right decision, at the right time.  That said, this may be right for my child and may not be right for everybody.  As parents, we have to understand that our children are unique and we have to find what will work for them.  I fought the public school system real hard for six years before giving up on them.  But I will not give up on my son.

If you are fighting similar battles with your own children and would like to talk or learn about potential options, please feel free to reach out to me.  I’m happy to share what I know and what I’ve tried in hopes that it will help another unique child.

Happy Parenting!

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