bald spots in childs hair

I am a child care provider and currently have a 7 year old male child in my care. I am concerned for him for a few reasons. 1) He has 3-4 bald spots in his hair where hair does not grow at all. He does not apprear to be losing hair, 2) He consistantly has facial twitches and a problem clearing his throat. What could be causing his syptoms (symptoms) and is there anything specific that I should try to reduce them?

[Kevin Kennedy, Ph.D.]

Dear Lisa,

The situation requires some professional intervention. Two possibilities, not mutually exclusive, are Trichotillomania and Tourette's Syndrome. The former is an impulse control disorder; the latter is a tic disorder involving both vocal and motor tics. A good place to begin is with the pediatrician and then, probably, proceed to a child mental health professional and/or a pediatric neurologist.