13 YR OLD WITH TOURETTES AND ADHD

MY SON WILL TURN 13 THIS WEEK.  HE IS IN THE 7TH GRADE AND WAS DIAGNOSED WITH ADHD IN 2ND GRADE AND TOURETTES IN 3RD GRADE.  HE TAKES CONCERTA 18MG IN THE AM FOR ADHD AND TENEX 1MG IN THE PM FOR HIS TOURETTES.  HE IS A GOOD CHILD AND REALLY VERY SWEET AND KIND.  HAS A LOT OF COMPASSION FOR PEOPLE(EXAMPLE-KIDS BEING TEASED AT SCHOOL BECAUSE OF SIZE, PERSONALITY, OR SPECIAL NEEDS). MY CONCERN IS THAT WE RECEIVED A NEW PUPPY (SMALL DOG) 8 MONTHS AGO.  MY SON HAS COME TO ME ON A FEW OCCASIONS UPSET BECAUSE HE HAS WANTED TO HURT TO DOG.(CHOKE IT)HE GETS VERY UPSET WITH HIMSELF AT THE THOUGHT OF THIS AND DOES NOT UNDERSTAND WHY HE LOVES IT SO MUCH BUT WILL FEEL THE URGE TO HURT IT SOME TIMES.  MY HUSBAND AND I ARE VERY WORRIED AND CONFUSED.  WE DON'T THINK THIS IS NORMAL BEHVIOR AND THINK WE SHOULD BRING HIM FOR SOME HELP.  PLEASE TELL US WHAT YOU THINK...

[Kevin Kennedy, Ph.D.]

Yes, I think you should bring him for an evaluation. It will help to discern the nature of his worry. One thing the clinician will focus on is whether your son is actually experiencing impulses to hurt the dog (and under what conditions those impulses occur) vs having a worry (but not an impulse) to harm the dog. It goes without saying that he should not be left alone with the dog. One of the possibilities is that your son is displaying a form of Obsessive-Compulsive Disorder (there is a high correlation bewteen TD and OCD).