Should I wait it out or see Ped. Neurologist?

[tamu94]

My son will be 6 next month and has suffered from various tics for about a 1/2 year.  About 6 months ago, neck-tic (kinda of a head-bob) lasted a few months.  Took him to our pediatrician and did research, both said actually normal for boys.  Neck-tic stopped for a month.  During Christmas time, neck-tic came back and was a very severe jerking motion.  Severe neck-tic lasted a few weeks and then gradually stopped.  Then in late January we noticed a grunt, like a clearing of the throat.  He still has that tic.  Somedays yes, somedays no.  Sometimes just a low throat-clearing, sometimes a loud grunt.  As of a few weeks ago, he started again with the neck-tic which may go from a small head-bob, to severe neck movement, to a neck and torso jerk now.  Somedays severe and somedays nothing.  He seems to get them more when he is excited or stressed.  (Almost always when concentrating on a video game)  Aside from asking him about it in the beginning, we do not mention it now.  He also suffers from severe low self-esteem.  Always negative.  Always giving up after one try (hitting a ball, catching a ball, etc).  I really don't think his friends have gotten around to teasing his tics, so I don't know about the low self-esteem coming from that.  As far as school, he's a normal boy.  Not at the top, but not slow either.
I'm confused.  Tic Disorder?  Beginning TS?  What does it mean that some days are bad and some nothing?  Can the tics and the self-esteem be related? (aside from people teasing him about it causing low self-esteem)  Ped Neurologist?  Thanks for any and all advice, common stories, or comments.

[Izzi126]

Hi there, I am not a doctor, but I think the pediatric neurologist is a good starting place for you.  There is a clear definition between Tics Disorder and TS.  I believe the TS has to be both vocal and motor, Dx before the age of 21, present for one year with wining and waxing periods.  I believe boys are more prone to it than girls and it does seem to run in the family - you child can be predeposed to condition and something can bring it to the surface.  One thing I want to say with the age, is that my daughter also has for the sake of discussion tic behavior, however it also could be nervous habits she has acquired because she has since birth although does not suffer from low self-esteem have something going on with from sucking her thumb to playing with her belly button.  With that said, it is important that a child get the acquired sleep they need, especially when they have these movement disorders.  Keeping their routine in a good schedule, so that they can antispate how their week is going to go, causing for less stress on them.  Keeping the busy with the things that they like to do and seem to not tic as much when doing.  The spectrum is board based on your child likes and dislikes.  Keeping the intake of high energy foods to a minimum or unlimited completely if that is possible.  Chocolates, high fruitose drinks etc...The low self-esteem issue should also be address.  You should reassure your child daily of your love and praise him for all the good things he does and when he does things you don't like, don't indicate that he is bad in any way, just that he has he could make better judgement.  This will help with low-self esteem and perhaps the ticing could improve with the self esteem issue.  There are many studies out there regarding Video game playing and ADHD, video game should be limited and not every day, especially is the child is ticing more when playing.  Outside play and running around to relieve anxiety can also help, just like excerise helps us as adults manage our anxiety and helps us to sleep better.  Children spend far to much time on computer and watching video and don't spend nearly enough time in the outdoors excercising their anxiety off. Children manifest their anxiety is different ways than us adults.  It is important for your child to feel positive and not negative.  I have read that most neurologist do not like using mediciation especially at such a young age to manage TS or even tic disorder.  It will be a lot of work on your part to move forward into a good managed schedule for your child and positive reinforcement and hope for the manageability for his tics or TS, either way I have read that majority of the children lead normal lives and most children do out grow it.  My strong suggestion also would be definitely to find something more constructive that Video games, I believe our children are not leading healthy lives due to the inactivity that they get from all the inside activities that are available to them in the generation.  Best of luck, I have commented to another post and listed some excellent web-sites I have found on the way that will give your direction and encouragement to get this under control.  
Izzi126