Tics in my now 4 year old…

[foreverhopeful1uk]

Hi all,

I’m looking for some advice and maybe some reassurance from anyone who’s been through something similar.

My son is 4½ and started with a blinking tic when he was around 2½. It disappeared for about a year, but then he developed other tics including head jerking, sniffing, blinking, eye rolling, grimacing and mouth stretching. One seems to go away and then another appears. If he gets a cold, he often develops a sniffing tic or a mouth movement that can last for a few weeks.

For a while things seemed to be settling down, but over the last couple of weeks (after another cold) he seems to have developed more tics again. The mouth/nose stretching is back, as well as some grimacing and head bobbing. It’s now been nearly two years since the tics first appeared and I’m starting to feel quite worried about it.

I’ve noticed that his blinking tics are most obvious when he’s watching TV, so we’ve reduced screen time significantly. They also tend to happen when he’s in the car or otherwise sitting idle.

Something else I’ve noticed recently is that he sometimes traces shapes, numbers or letters in the air with his finger. Sometimes he’ll tell me he’s writing a number or copying a shape he’s seen, but other times it seems almost automatic and he doesn’t appear particularly aware he’s doing it. I’m not sure whether it’s just something he’s picked up while learning to write at school or whether it could be another tic.

We have seen a neurologist who wasn’t concerned and basically said childhood tics are common and that we should wait and see whether they improve as his nervous system matures. Intellectually I understand that, but I still find myself worrying, especially as it’s been going on for quite a long time now.

I’d be really interested to hear from anyone whose child had multiple tics from a young age. Did they eventually grow out of them? Did they improve with age? Has anyone seen anything similar with the air writing/tracing?

Thank you.

My son had multiple physical and vocal tics. He ended up being referred to a child psychologist. He was older than your DS and was able to have a say in his treatment and he didn’t like the sounds of habit reversal training but did something else about naming the tics which helped him feel more in control. We never tried to stop him ticcing or used negative language - so we would say they were more “pronounced” rather than “worse”. We were lucky his school were very supportive. Being in “flow” helped him to tic less.

he did outgrow them in his teens (though I sometimes think there’s a trace of a throat clearing one).

it is a dopamine disorder and so is linked to OCD and ADHD.

Thanks for the reply- how long did they last before they eased? Are they always associated with ADHD or OCD?

Your post could also describe my son, who is just 8 now. His tics started at age 2, were very frequent and invasive between ages 4.5-7, but have lessened off a bit over the last year. He also traces/writes things in the air all the time, waves fingers infront of his eyes. He says he sees things like numbers/shapes/colours. He also has a lot of compulsive type movements (tapping, stamping, counting, looking in a certain pattern e.g. left-right-left etc) that sometimes looks like tics. Can be anxious. Can get "stuck" in thought patterns. Sometimes says numbers or letters have colours.

He saw the child mental health team, the nurse said he presents as though he may have OCD, and/or tic disorder. She said tics are really common in kids, often outgrown.

We talk about them, name them, normalise them, validate how they can be annoying, talk about how everyone's body and brain are different. Explore which are voluntary and involuntary. Gently challenge any thoughts that seem a bit troublesome, e.g. the boss in my head says I have to tap in even numbers.

I worried a lot over the years about could it be this or that. At the minute, I just focus on how he's feeling and as long as that seems ok then I try to be laid back about it all!

Not much help because DS is only 9 but he has a blinking tic which is usually more pronounced when hes anxious. He is diagnosed autistic and they also noticed it during his assessment and confirmed they thought it was anxiety. He also sometimes has a vocal tic which is a pretty obvious noise when he's breathing. It bothers him when it happens but as with the blinking it comes and goes, can last weeks but then can go months without either. I've also been told he'll likely grow out of it but obviously he's only 9 so can't tell you if that's true.

When I was a child I did similar to the drawing a shape in the air except I didn't use my finger I sort of imagined it and breathed in and out with each stroke of the shape if that makes sense. E.g drawing a square i would breath in as I imagined drawing the top of the square, out as I drew side, in across the bottom and the out up the other side. I have had a particularly stressful day today and have found myself doing it and suspect the breathing and repeatativeness of it is a form of regulation. When I was a child the breathing was quite pronounced so my mum did notice it, as an adult I do it subtly so no one else notices. It also happens very infrequently as an adult.

I only mention my sons diagnosis as I believe it is linked to his tics, not suggesting your son may also be autistic.

Thanks for your reply- did they ever explain what the air writing is? Sometimes I can see he’s copying something and other times he’s drawing a shape or not really aware he’s doing it, I can’t actually tell. That has only just started in the last week, but doesn’t look to be slowing down. I spoke to school and they said that they do air writing to help learn to write so I keep wondering if it is from this?
Great that your sons tics have lessened over the last year 👍🏻 have the other things also slowed down?

I can see a lot of people refer to Autism- I hope you don’t mind me asking but is this the case with your son?
I really don’t believe my son to be autistic but I guess I also am no expert or know what I would be looking for. He’s just super sociable, has always been advanced in language and communication.

thanks again for replying, it’s really starting to worry me as today and last night the eye rolls have been very consistent. X

DS had tics and was later diagnosed with ASD but tics don't have to mean ASD/ADHD. They are often linked to anxiety too. Watching tv can be very relaxing so it can cause tics to come out more, or it can be overstimulating and cause tics to come out more because of that. It won't cause tics in itself though.

Being super sociable doesn't have to mean you're not autistic, if he will talk to anyone for example or talks at them about his favourite topics or stands too close while talking, they all could be signs.

I like drawing and finding triangles with my eyes, I'm not diagnosed but have various ND conditions running through my family. DS likes to say his thoughts aloud as it makes them feel more real, he has grown out of his tics

My son had verbal and facial tics from the age of 3, they were pretty severe. He grew out of them by high school, he has autism and ADHD

I had a blinking tic when I was about 8, not that we knew what it was. I’m neurotypical. DS started with some facial tics around 3, occasional vocal grunt as he’s got older. We don’t draw attention to it and at nearly 14 it’s rare. Worse if he’s tired or anxious.

My stepson had many between 5-10. Rocking was a main one (he still sometimes does it when standing!) but throat clearing (squeaking), eye blinking etc. His mum took him to a psychologist too and said he would grow out of it. As a personal opinion I do think he's ADHD (never diagnosed) but it's been very well managed now he's older. My daughter does the writing in the air thing (she also started this when she started school) and says she's drawing. I wouldn't worry too much at his age, many many kids have tics x

No explanation as such for the air drawing, but from watching him I think he's just "acting out" what's in his head. He's always in his own head, thinking about numbers or shapes or a picture - he just seems to be tracing it out in the air. Sometimes it does almost seem like a kind of stim, just doing a shape or a movement - it doesn't bother him or cause any problems. Ok then contrary, he's usually relaxed or excited when he's doing it.

He isn't diagnosed as autistic, but it has been mentioned. He does have a lot of behaviours that align with ASD, e.g. special interests like learning 200 digits of pi or the elements of the periodic table, lining up/arranging by colour/size etc when younger. Counting - endless, endless counting! He is very interested in numbers. His social skills were quite slow to come, as was imaginative play. But they have come on, and a lot of the more "ASD" style behaviours have become less intense. I think he's probably just learned to cope with some things better as he's older (like loud noises, busy environments).

He's also friendly and sociable and chatty. Language skills are and have always been very advanced. Was reading very early, doing sums very early. I think those things can actually be an indication of neuro divergence.

What is it that you are most worried about, do you think?

My son had facial and vocal tics which varied in severity over the years. I can't remember when they started, but he had them during primary school and for a while during secondary. He appears to have grown out of them now in his mid-teens. He's diagnosed with autism. A friend suggested we try magnesium and when they were severe he would take a supplement for a few weeks. When he was younger he had a liquid supplement and then tablets when he was able. I don't know whether it was a placebo effect or not with my son but after a short while on magnesium they would pretty much disappear for quite a while. We'd repeat when they returned. It always worked for him. Definitely worth a try.

Please read up on PANS PANDAS if you haven’t already, especially if worse when unwell. In a nutshell, OCD, tics, adhd, anxiety brought on by infection - usually the first trigger is strep / scarlet fever.

I was going to suggest this.
Op my dd had a period of eye rolling and blinking tics. She was five. Hers were triggered by a period of high anxiety at school and they resolved fairly quickly, I think she had them for around six months to a year. She isn’t autistic, and is an adult now, they haven’t returned even in stressful periods. There can be many reasons for tics as pps have said. Sometimes I feel perhaps it’s just a very active brain, this can mean very high intelligence rather than autism or adhd. Most children do just outgrow them so I’ve wondered whether they are a way of processing things, a stage in development where the brain has lots of information to order, and when children are becoming aware of complex systems on all levels. Your ds air drawing made me remember doing that as a little child, I’d forgotten. I think I liked the way sparklers make words in the air and was re-enacting that.

My son had facial, blinking and verbal tics from when he was very young to around 7. His GP also said they were very common and fortunately he grew out of them. No ADHD or autism - I think they were probably anxiety/stress-related.

My ds had tics and a stammer when younger. He outgrew them when about 11. We noticed a MASSIVE improvement/ reduction by giving him a good quality kids magnesium supplement at the time.

Hi which magnesium do you use? I am using Liposomal Magnesium from Mighty Kids and I can’t really say if it’s actually making a difference.

Thanks again for your reply, I think I’m most worried about them just never stopping and him ticking like this forever and it really effecting his life 😩

I understand your worries, I've felt like that as well. The other kids at school started to say things to my DS about his tics and I was so upset for him.

I focussed on building his self-esteem - the nurse recommended that to help with his general anxiety anyway, and it really helped all across the board.

Try not to catastrophise as well - try to focus on how it actually affects him, not how it affects you or what you're worried about. I don't mean that unkindly, I just found that approach helped me. Lots of people have lots of things going on with mental or physical health; even if he did tic all his life, he would be ok and he would handle it. Maybe it would help you to frame it like that in your mind, supporting him to understand himself, his feelings, feel good about himself, feel capable etc.

He's young, as well - this thread shows that a lot of kids grow out of it!

Dd has a throat clearing tic that developed when she was around 3, it went away after a few weeks but returns when she’s anxious. She also has displayed some OCD traits and pica in the past. We saw a paediatrician when she was around 7, and they said that, as it seemed to come and go, we should watch and wait. She’s almost 13 now, the OCD traits and pica have gone, and the tic is becoming much less frequent and doesn’t last more than a day, so I think she’s outgrown it. By all means, seek advice for your ds, but he may grow out of it

Thank you- you are right I really need to change my look on it. I’m just shocked that it’s increased so quickly. How old was your son when it eased? Thanks again x

Probably only in the last few months, maybe since Christmas. So 7.5yrs. And they aren't gone. They've eased before, then come back for a few months, then eased again. But there was a time when it was so constant and they were so big and intrusive, it really stressed me out.

Is your son anxious, has he been unwell, do you think something has triggered them?

If you are interested take a listen to this podcast Episode 20: Dr. Alessio Fasano discusses the gut microbiome and how it affects our health

At about 45 minutes in he discusses a possible mechanism for autism, which affects all developing brains, how inflammation might contribute to physical changes in the brain driving autism.
If the brain plays a role in tics, then brain health is something to consider.

Best wishes.

He’s just getting over a cold and runny nose which seems to have finally settled down. We’re expats living in the Middle East and we’ve had quite a lot going on recently too. We flew back to the UK for a week and have just returned, so he’s had the travel, disrupted routine, and now he’s back in the extreme heat here. It’s also right at the end of the school year, so I don’t know if it’s tiredness, the change in routine, the recent illness, or a combination of all of those things. Part of me wonders whether I’m just looking for reasons to explain it, but I’m honestly not sure.

I knew a boy who did those kinds of tics, he wasn't autistic but he did have tourettes

My son started tics at 3, they went away for a few years, came back, went away again and so on.
When he was 13 they were quite bad, we got him referred to a neurologist.
He was seen and we were told that it was just part of who he was.
They never said he was on the spectrum, but the industry he works in has a higher than average number of people who are.
The relief of knowing it was nothing really serious, helped us to help him to just accept it.
The tics continued, sometimes worse than others, especially if he was tired.
We never drew attention to them and he just told people he had tics if it was mentioned.
Now at 21, he has a fantastic job, earns a huge salary, travels the world, still tics a bit (round his mouth and eyes)
Get your child checked, but if there’s nothing serious, and they are otherwise well, just accept it as part of them, like the colour of their eyes, and focus on supporting the child you love and helping them to negotiate other people’s attitude.