Nervous tics in a 4 year old - how concerned should I be?

[GeorginaA]

Don't really know where to start with this (or where to stop).

Ds1 has always been what my mother terms a "sensitive" child. Since starting school he's developed the nervous tic of blinking quite hard regularly - the teachers' have noticed it and informed me, but I'd noticed it independantly. He's had his eyes checked fairly recently and while there's some indication that he's very slightly short-sighted, he's not bad enough to need glasses yet.

It's occurred to me recently that he's done this before - just after he was 2 when we moved house he was doing it for a while. Enough that the Health Visitor noticed it and told me to take him to an optician to get him checked out - so I'm assuming it's a stress reaction of some kind?

I wasn't too worried by this in itself, but then yesterday he started another tic - doing a sort of Brrrr noise with his lips (like a horse breathing) while he's concentrating, or at one point in the day in between his speech almost using it as a pause. Again, he doesn't appear to notice that he's doing it.

How concerned should I be? There's other aspects of his behaviour, while not different to him normally, have become more pronounced since starting school and I'm wondering if he's more stressed than I realised or whether there's something deeper there that I should be concerned about.

On the one hand, with this second nervous tic, I'd like to take him to the GP just to put my mind at rest. On the other, I don't want to draw ds1's attention to the fact he's doing it. But then neither do I want other kids to notice and tease him about it.

Thought I'd ask the court of mumsnet to see if anyone else had similar experiences and whether it just went away on its own...

How sensible is your HV, Georgina?

my ds has this , i cant help much in advice as hes mild asd and weve been told to not suppress it as it will come out elsewhere just to try and help him cope with stress , even try giving him blu tack to keep in his pocket to play with in times of stress..

My ds (now 10) had several tic like habits from about 3 1/2 (starting nursery): strange fist clenchings, wierd noises - that became worrying enough for me to take him to various paeds, educational psychologists etc, as I was getting very concerned and the teachers had also mentioned it.
After various tests and checks all came back clear and I decided the best thing to do was tell him he could "do his hands" (as we called the fist clenching) in private when he needed to (he seemed to get some kind of adrenalin rush and also comfort from it), then that would be ok but he must try to break the habit in public.
That seemed to work, although he still does it very occasionally, and he does have the odd occasional new tic that comes and goes, but basically he's fine now. I think it was stress-related, and like your ds, he's quite sensitive.
The other children did notice the hands at the time, but didn't seem to tease him, though the teacher diverted them by telling them he was 'being Wolverine from X men'!
Sorry this is a rushed answer as he wants the computer - but I would maybe mention it to the gp and have him check him subtly, but not stress too much about it.

Gillian: it's hard to say. She's been helpful in some things and not so helpful in others.

I think part of the thing is that there's a few other things which in isolation don't seem that concerning, but together is making me worried. I don't know whether this is extreme stress reaction or something on a larger scale.

He's always been fairly sensitive to loud noise, but recently it seems to have got worse (the school disco he HATED because it was too loud... we went on the merrygoround at Santaland because he really wanted a go, but while on it he just rested his head on my shoulder and was subdued the entire time around because the music was too loud). He was very distressed at school when the routine changed with the run up to Christmas (enough that the teacher came and told me about it and how they were reassuring him).

I'm just not sure how much of it is normal "easily stressed" four year old behaviour, or if I've completely underestimated how much stress he's under or what, really.

Turg - that sounds interesting (sorry, I cross posted with you!). In retrospect, would you have gone the paed/educational psychologist route again? At what point was it recommended you do that - was it at a certain age/level of disruption in his life?

I would definatly ask for a refferal to a pead, my son has several oddities, coukld be described as tics, and has recently been diagnosed as having aspergers syndrome.

My Ds has a severe disliking of loud music, so discos are a definate no go area.
He can not tolerate the hustle and bustle associated with Discos...kids running around, flashing lights and loud music.
DS2 has a set of full size drums and bashes away at them with no problem at all, because he is in control of the noise and he is making it IYKWIM?

He also has tics, some he has a level of control over.
When he is busy doing something he will "Brrrr"...its called "white noise". He makes a sound to mask out all other sounds around him so he can concentrate better with the task at hand....an excellent coping strategy.
We also have a "tut" tic which he uses during converstaion...he has a significant language disorder which affects his ability to communicate. The "tut" is his way of holding his train of thought and helps him to find the right words he wants to use....the "tut" gives him a couple of seconds to search for the words he wants with out having to just stop his converstaion whilst in mid flow.

Your comments about the meery go round struck a chord with me. Ds2 loves spinning movement. Spinning is a constant source of comfort for Ds2.

If I were you I would make an appointment with your GP and discus your concerns. You dont have to take your Ds with you.

My son has a Dx of SID (sensory intigration dysfunction)as well as a Dx of Autism. Im not saying that your son has either but I really think if the school are expressing some concerns and you are worried, you should seek a professional opinion.

Your DS sounds similar in a lot of ways to my DS.
He is 6 now, but he has had several nervous tics since the age of around 3 & a half.
His tics seem to stick around for so long & then get replaced with another one.
He has had a blinking tic, the Brrr noise with his lips, pulling his sholders up to his ears, licking the tips of his fingers & his most recent one seems to be that he keeps pursing his lips & even talks with pursed lips! I think this one started after a girl kissed him at school!!
The school haven't noticed the tics so much, but they want someone to come in & observe him, as they suspect AS, due to his social & interaction problems & difficulty organising himself.
He is also not keen on loud noises & will cover his ears when watching fireworks etc.

I do know a lot of children (mostly boys, in fact all boys now I think of it...) who have had quite marked nervous mannerisms around this age. Twitches, tics, stammers that resolve spontaneously, little unselfconscious breathing quirks, they are all fading away now.
Starting school, even if overall an enjoyable experience, IS stressful, and I am surprised the Reception teacher didn't suggest that it could well be a response to such a major change for him.

That's reassuring, Marina.

I think I'm going to make an effort to chat to his teacher when term restarts just so they can keep a quiet eye, give him lots of extra TLC and then see how he progresses over this term.

I think its common in this age- I used to blink, and wrinkle my nose aged abot 5 or 6- used to drive my mum mad. I wasn't particularly anxious, and it was long gone before my teens. I don't think there's much point seeing psychs and paeds unless your son is struggling academically/socially at school, or having problems understanding what is expected of him. Tourettes isn't dxed unless complex tics have been present for over a year, so I don't think you'd get anything out of appointments anyway.

Thanks IdaAx & Celia.

Now our Christmas guests have gone home, while he's still got the tics they are much less pronounced and noticeable so does seem to be stress related more than anything. Will just see how we go for a while.

Thank you for all your comments - all were really helpful.

UPDATE

I mentioned this to the teacher yesterday (not in a big way, more in an aside "you know the blinking he's been doing, well at Christmas he also started this... can you keep an eye and let me know if he does it at school too, please?" sort of way).

She asked to have a word this evening. Apparently he'd wet himself during the day and she'd only noticed later on when it was almost dry because of the smell (fortunately they had some spare clothes there for him to change into). She said he seemed totally unaware that he'd done it at all and that as a result she was concerned at him being potentially stressed and nervy and thought he would benefit from seeing a GP.

However, I'm now torn. I'd kind of resigned myself to not doing anything about the tics for a while and seeing if he grew out of it. I don't want to waste the doctor's time. He's always been a bit lax about getting to the toilet on time, although it's very rare for him to have an accident. He's also not as careful at night (although it's extremely rare for him to wet the bed, he quite often has little leaks as he either doesn't get to the loo in time or doesn't shake it off well enough after his sleepy state) - I thought this was fairly normal for a 4.5 year old though?!

Problem is, he seems anything but stressed and nervy at the moment - he's quite happy and chirpy, much more so than he's been for a little while and I'd been concerned how he'd react to the start of term again. I don't want to kick all this off and draw his attention to something he's not aware of in case it makes him more nervous and unconfident which will make it worse. At the same time, I don't want him to lose friends because he's smelly or acting weird :P

ARGH!

Hi Georgina,
I hope you still have access to this post. My son is 4 and recently started blinking for one week. After a week he "replaced" the blinking for a "huh" noise. He does it when he goes to bed and sometimes during the day.
I took him to the dr and she told me to observe him, but i'm very nervous about it and was wondering if you ever find out what was the issue with your son.
Thanks!

My son started twitching his head a few years ago...To cut a long story short..I STOPPED giving him cereal and replaced the cereal with Fresh Fruit Salad and his tic has stopped...I hope it works for others..💝

Hiya how’s your son doing now? My 4yo son just started reception and having terrible eye tics since. He also had it for a while when we had his baby sister last year, then it stopped for a while then has come back now.