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Is my nephew presenting with OCD/ anxiety?

I'm inquiring about some behaviour that my nephew has been demonstrating lately. He is 8 years old and for the past 3 months or so he has developed a habit of doing a high-pierced screeching noise with his throat. He breaths in hard and does it all through the day. If I have a 5 minute conversation with him, he will do it 4-5 times. When he first started doing it, I asked him what was up and he got very defensive and upset and told me that even his friends at school were noticing and calling him out on it. Whenever he does it and someone takes notice, he gets very upset and says he can't help it. He told his mom that "his brain will be angry if he doesn't make the sound". Then, about two weeks ago, he began a strange eye rolling habit, which he would do randomly throughout the day.

My nephew has always seemed a little anxious and sensitive compared to most. He's an only child and they are in the process of determining if dad has ADHD. For the past year, he has also suffered with cyclical vomiting, where he will get sick every Saturday morning at the exact same time without fail (seems to be separated by weeks or months). Mom is booking an appointment with her doctor soon to inquire about him, but in the mean time, does anyone know if these would be signs of some sort of OCD or anxiety? I'm not sure if these would be considered just minor habits or tics or what the severity of this could be. Any suggestions on how to ease him or help him?

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189897 tn?1441126518
Hi, l also am curious how things are going.  I meant to respond awhile ago...and then life got busy.  I also am over on the adhd forum as the CL and one idea I had for the throat noise is to replace it with something else.  Fidget toys can work very well for adhd kids and I wondered if something like that might just help him to please his brain.   This is a good link to fidgets....
Hope this can be helpful.  Best wishes.
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973741 tn?1342342773
I wanted to check in with you and see how things are going?!  
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973741 tn?1342342773
Ya, you are in a precarious position in regards to wondering about how the issues around the dad impact the situation.  It sounds from an outside perspective that it is related.   I do hope that the therapist keys into what we have.    The problem is, if you say anything, then it could cause you to be pushed out a little bit and that's not good for this little boy.  And he IS a little boy.  Keep loving and safe for him yourself as that is very valuable.  

I think your perceptions about the situation are very good. Your friend is lucky to have you!
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973741 tn?1342342773
I hate to say this but the situation with his parents may impact him subconsciously more than anyone wants to know.  Kids are smart and often know and sense a lot more than we think.  Could this be a reason for the stomach issues?  Were they better while he was not there?  I was trying to read the pattern and thought this is what you indicated. If so, that isn't to say his dad shouldn't be there but that perhaps there is a bit of an element of chaos or tension that impacts him under the surface and now that he is back, the 'idea' of that friction may be enough to trigger him.  

My son, however, does have middle of the night wake ups of vomiting once in a while.  He will say it is what he ate.  But gosh, it coincided with the day before school started last time which is a heck of a coincidence.  

How does he sleep?  How does he eat?  
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And thank you for all of your kind and sweet words.  :>))  
I know I hate to say it too, because it’s a real possibility that his parents relationship could be a reason for his worries and anxiety. To be honest, I was happy for my friend when they were separated because I think she would be better off without him. It’s hard to suggest to someone that you or a significant other could be the trigger or the reason for your kids behaviour, and that’s why I am strongly encouraging them to see a doctor, because that is something I feel a professional can bring to light, rather than me.

I’m also trying to make the connection here. I’m wondering if his vomiting was at peak when his dad was away working? I think perhaps it was. When they were separated for that time, he wasn’t sick at all until we went camping, but sleeping in a tent, waking up in an unfamiliar place could have set him off too.

I feel awful for him, as it’s evident that something is going on. :( It sucks to think that we should have acted sooner or could have done something to prevent this, or perhaps not. It’s tricky, especially with family to suggest something or add opinion because you certainly don’t want to offend! But I feel my friend is on the right track.
His eating habits are pretty good! I would also say that he sleeps well, maybe a little too often in mom’s bed at his age. But I would also like to mention that I am not a mother, so I wouldn’t be able to completely understand motives. Something that may seem so clear and simple to me, might not be for others, especially with children.
973741 tn?1342342773
Hi there.  You are a nice aunt.  :>)  So, I have a son that has both anxiety and a neurological issue called sensory integration disorder.  He started displaying tics early on.  They would change periodically.  He actually has two different kinds of tics and his tics also alternate.  There are simple vocal tics which are just sound like throat clearing or humming, and there are complex vocal tics which are actual words like "ya" or "um hm".  There are motor tics which my son has also had.  He has various ones and they come and go.  He has described it as something he HAS to do and can not control them.  They appear when he is very nervous or anxious.  OR they can appear when he is excited and it would be great if he could calm down. And it happens when he is in a state of 'low registration' in which he is having trouble staying focused on what is going on and he wants to.  So, he may 'hum' which kind of wakes up his nervous system.  You should hear him in church. ha.  

They started around 7 years old.  They have continued but as he got a bit older, since his tics can change, we would try to find ones that were less embarrassing for him or noticeable.  And he did try to stick to those.  A little effort involved but seemed to be able to because HE was motivated not to stand out!  He now, at 15, will hum very softly to himself for the wake up or to calm down.  And he snaps his fingers when nervous say before the gun goes off at one of his track meets.  I see him on the line snapping away but no one seems to really notice that.  

So, I think evaluation would be wise.  OCD could be a possibility but remember that OCD is basically an anxiety disorder.  My son has at times exhibited parts of this from time to time.  My son now mostly has his sensory symptoms to deal with (sensory is adhd's cousin and I'm happy to tell you more about it but these are the kids that are over or under responsive to stimulation, have trouble making eye contact, tags in shirts bother them, are notoriously picky eaters, have trouble maintaining focus, have fine motor issues, etc.) and anxiety.  In high school, there is a lot of anxiety.  

Now, I am careful with how I talk to my son about things.  He is aware that he has anxiety and he and I work on it and he has professional help.  But I don't define him as this or that.  This got really important the older he got.  He wants to be like everyone else.  So, we always talk in terms of making things better for him, giving him coping tools to use, making him feel better.  

What was happening on the Saturdays that he got the tummy aches?  Anything that would bring on anxiety?
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First of all, thank you SO much for reaching out. I really can't thank MedHelp enough for making this site accessible for everyone, it's fantastic!

He definitely seems to do the throat/breathe thing when he is excited. Yesterday, he didn't know that I was coming over and when he saw me and exploded into conversation, it was a little overwhelming at how many times it presented itself. It did, however, ease as he relaxed.

I haven't seen him do the eye rolling bit, but his mom told me that it was just sort of jarring and "creepy" because he would literally roll his eyes right to the back of his head for a few seconds. I am grateful that he is able to realize that "his brain will get mad if he doesn't", just like any habit that any one of us has experienced. I am really thankful for your comment of finding a tic that would be less noticeable. Admittedly at first, none of us handled this properly and we just kind of called him out when he was doing it because it was very distracting. Once I realized that even the kids at school were making fun of him, I realized that it was much deeper than a habit, because no child, especially one as sensitive and emotional as my nephew, wants to be noticed for unwanted behaviour.

We are definitely not jumping to any conclusions, and in my profession I do see and deal with a lot of ADHD and behavioural issues, and I've worked with children who have had tics, but they are always unique to the child and it's always difficult to discern what is what. Because I know my nephew so well, it makes it even a little tricker (personally) because I can usually attribute it to something else, than I would with a child I'm working with. I also work with kids in a more structured environment, so I can gauge their attention and habits that way, rather than informally when I'm just hanging out with the family.

His cyclical vomiting started happening about a year+ ago, but because he has some tummy issues already (as does mom and dad) and the flu seasoned destroyed every school this year, at first mom thought it was just flu or something he was eating - maybe an intolerance of some sort. But then we noticed that this was happening literally every Saturday morning for weeks. At about 6am, he would wake up and start vomiting, like a lot. Then, around noon he would be perfectly fine - literally running outside with his friends. We tried to pinpoint why this was  happening - why this time and why this part of the week. We thought maybe because it was during the school year and he's thrown into a different routine on the weekends? Throughout the week he gets up and goes to school and is able to fulfill that routine, and maybe his subconscious anxiety was worried about what the weekend may look like.

He was perfectly fine for a few months and then we went camping this summer. They arrived Friday evening and then all of  a sudden, Saturday morning he woke up vomiting out of control. He would't even have known (at least I doubt)that it was the weekend because it was mid-summer and neither his mom nor I work in the summer. It was so strange!

My nephew is a very loved boy and is currently the only son/nephew/grandchild in both families right now. Sometimes, he might seem on the border of "spoiled" just because he received so much attention from everyone and is usually pretty busy on the weekends going here and there with everyone. Technically, he's not even really my "nephew", but he's my best friends son who has grown up knowing me as Auntie Caitlin, and I love him as if he were my own. So he is a little torn around, but in a good way haha! I just wonder sometimes if that has any role in what he has been experiencing.

I sometimes question his father, just because he has struggled a little bit with his behaviour since my best friend and him have been together (almost 9 year). The start of their relationship was awful and he treated her poorly, but he made what seemed to be HUGE changes since (even as the skeptical friend, I was impressed by him) until he decided to get goofy earlier this year. My best friend and him were separated for a few months during this summer, and of course that impacted my nephew, but his tics and behaviour surfaced before all this. Mom and dad are since back together.

So the next step is going to see the doctor. He will be starting grade 3 next year and we don't want anything to be harder on him than it already is. I'm just here trying to further my knowledge on it and there is no better way than to talk to people who have experienced similar situations.

I really appreciate you taking the time to comment, I've learned some very valuable things from you today! I will be sure to pass on my knowledge, and hopefully we can figure this out soon! <3
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