What is going on with my 4 year old....

[beverly]

For a year now, he has increasingly become hyperactive.  He also has a lot of nervous habits.  He snorts, clears his throat, grunts, does odd things with his mouth, jerks his head back, keeps putting his ear to his shoulder (no ear infection), chews on EVERYTHING (including his lip until it bleeds).  He is a sweet loving boy, everyone loves him, he is very bright and has an engaging personality.  But, all these nervous habits make people around him ask me questions...

My 4 year old also repeats the last 2 words of everything he says... for example, "Mommy, I want to go to the park the park the park." or "May I please have more juice more juice more juice."  I've tried to get him to stop all of these things, he can stop for a while, but the habits return worse if I make him stop or point them out.  It seems that he is aware that he does these things, but, as he says, "I just HAVE to Mommy.  If I don't I feel sick."

I don't know if this is related, but, he will suddenly sreech or bark when he jerks his head back.  

I don't think he is doing this for attention (I thought that until a couple of months ago) because he will retreat to the bathroom and lock the door and go on with these things for several minutes until he comes out.  

He can be fine for a few weeks, but, he always starts all this stuff up again.  Sometimes, he does these things so much that he can't even do his puzzles or carry on a conversation ("Mommy, (snort)I want (grunt)(snort) to go to the (clear throat)(head jerk)park the park (mouth twitch) the park (head to shoulder)(bark)."

Is he losing his mind?  Am I losing my mind!?!?!  The pediatrician says that he is probably just a nervous kid.  There has to be more to it than that!

A

[Kevin Kennedy, Ph.D.]

Dear Beverly,

Your son is not simply a nervous child. Symptoms such as those your son is displaying are typical of Tourette Syndrome (TS). This is a neurological disorder, and it is characterized by multiple motor tics (involuntary , sudden movements) and at least one vocal tic. The tics do not have to occur simultaneously, and must occur over a span of one year to qualify for the TS diagnosis. Sometimes, but not always, the tics are evident many times during a single day, but they can also occur intermittently. They can even disappear for periods of time. The tics can change in type and their number and frequency can also change.

TS always has an onset before the age of 15 years. The average age of onset for motor tics is 7 years, and the average age of onset for vocal tics is approximately 9 years of age. It is estimated that between .1% and 1% of the population display Tourette Syndrome.

Please obtain a second opinion regarding your son's condition. His behavior is well beyond what would be expected of a nervous child along the admittedly broad normal spectrum.

For some easily obtainable information on Tourette Syndrome, click on the Search button for this Forum and you will see both articles and questions/answers pertaining to TS.

Good luck; be persistent. Dr. KDK

The information in this Forum is intended for general education. Always address particular questions about your child's health to your pediatrician or health care providers.

[Pam]

I'm no doctor, but that sure sounds like tic movements.  I think you should get him to a doctor immediately, another pediatrician if yours does not agree that this is abnormal.

I hope it goes well.  I'm sure this must be very hard on you.

[More information from Beverly....]

My little guy also has some odd things like... he lines up his cars by 10's and his animals by 2's and if they get messed up he gets terribly upset.  

The longer these problems go on, and the more servere the problems become, the more hyperactive he becomes.  When his habits decrease for a little while, he is not hyperactive at all...

Thank You....

[Thank you Pam...]

The only thing the pediatrician says about it all is that he is a nervous boy with lots of nervous habits.  He said that he may be ADHD because he has hyperactivity.  He will not take into account that when his odd things lessen, his hyperactivity lessens.  When he is not doing these things, he is not hyperactive or distractable at all... only when he is have a lot of trouble with these things is he hyper and distracted (I would be too, I think, if something weird was happening to me).

Thank you for your reply.  Do you know much about tics?  Where can I find information?  

Beverly

[PamD]

I'm not particularly knowledgeable about tics; that's just what came to mind first.  I think you should get a second opinion, and I'm interested in hearing what the doc here says.

[wes]

Ask your doctor, preferably a different one if your current one won't listen, if this could be Tourette's (sp?) Syndrome.  I know a little boy that has it, and the symptoms your son has and this boy's sypmtoms sound AWFULLY similar.  I'm not a doc, but it doesn't hurt to ask, right?

[PamD]

Tourette's

Beverly, again I want to stress I am NOT a doctor, but I agree with Wes that this sounds like Tourette's syndrome.  For your information on this one syndrome, I've located some information on the Mayo Clinic website.  Here's the address:

http://www.mayohealth.org/mayo/9703/htm/tourette.htm