Is this a tic or stimming?

[moosemama]

Ds1 started doing a strange repetitive facial movement (sort of scrunching up his face/eyes with a really exaggerated blink - hard to explain really) when he was getting more and more anxious about going back to school as the end of the summer holidays.

It got worse just after he started back, but then as he's realised that things are much better for him at school this year it diminished, in fact all but disappeared.

He developed a sort of short 'hum' that he does repetitively whilst doing something like reading or watching tv, as well as a sort of throat clearing noise.

Over the past fortnight he has started doing this again and at the weekend I noticed it has really intensified. The facial scrunching in particular has been really bad. Although, oddly I noticed that he didn't do it once during the whole hour he was on his beloved Nintendo DSi.

Am I right in thinking this is a tic and if so, it is probably stress related?

His behaviour has also deteriorated over the past couple of weeks and he is overreacting angrily to almost everything/nothing, being truly vile (particularly to ds2 and I) and ending up in tears a lot of relatively minor stuff.

Thing is, I don't seem to be able to get to what the root of all this is.

Obviously there is the whole, run-up-to-christmas nonsense at school, but that's a lot less now that he is in junior school. He has also started having weekly EP sessions (which he is loving) and is doing the speed-up programme once a week (which he also likes) as well.

Other than that he has had a couple of nasty accidents at school in the last week. Which really upset him.

Not really sure what I'm asking here really. I guess I just want to know how to help him. I'm finding it really hard and have shed a few tears myself in private after noticing him twitching and humming away.

I'm also worried that it might get a lot worse, as he has his WISC IV test coming up a the end of this week, hospital appointment the following week. Christmas, then his ASD Assessment appointment then a week later his Paed appointment regarding his digestion and absences.

On another point, I did his pre-assessment communication questionnaire today and that had me in tears as well. I suppose because to us he is just ds1 and we have got used to how he is and how best to handle him I never really stopped to think how 'different' he is. It was quite an eye opener to realise just how many communication difficulites he has. I think because he is very verbal, it can sort of mask a lot of his problems.

Strangely enough, that's what we (and the EP) have been working on with him recently. That and emotional scaling.

We have been playing face snap with him, but he really struggles to judge the emotion and to think about why someone might be feeling like the person in the picture. Its been a bit of an eye opener really, I had no idea how much he struggles with this on a day to day basis.

I feel like such an awful Mum - I think its just starting to dawn on me how badly affected he really is. I had the whole High Functioning/Aspergers thing firmly stuck in my head, I think as a sort of self-protection ie he's not that badly affected - it'll all be ok type thing.

We already do a feelings diary with school (I am just in the process of redesigning it into a feelings scale) where he chooses any number of a selection of 'smilies' to represent his main feelings about the day and then writes a brief note to say what happened to make him feel that way.

We usually do a debrief after school, when I read his feelings diary and we talk about what happened, why and how he could handle/deal with it if it ever happens again. (We do roleplay sometimes, but he's not keen on it as he likes me to be me and gets upset if I play act or use a silly voice iyswim).

That's what's so weird. I usually know what's going on via this process and so can judge why he's more anxious than usual, but he's not giving anything away, which makes me wonder if either its generalised anxiety or he isn't in touch with/aware of what's bothering him himself, iyswim.

Hope this is making sense, I am very overtired and over-emotional tonight.

Maybe snap is too complicated, as he doesn't recognise the facial expressions, and you could scale it back to just naming them?

You are not an awful Mum. You are a fantastic Mum trying her damndest to help her son. How on earth could you know what he sees through his eyes in his head? No one knows that, even the all-knowing SaLT/Ed Psych/teacher

If you think you're, missing something, simplify. Maybe get him to think of a situation, then help him label the feeling that went with it instead of assuming he knows what the feeling feels like iyswim??

HTH. You are a fantastic Mum and SALT :)

Oh yes. We have had variations of what you describe for quite a long time now with DS.
The throat clearing/soft grunts started shortly before his 4th b/day.
He still does it now he has just turned 5. Some days are bad where he does it almost constantly some days he hardly does it.

The humming we have had since he was a toddler, now he still hums an awful lot every day but he hums tunes too instead of the same humming noise he did when younger.

He also has phases of facial grimacing especially with his eyes, where he scrunches them, rolls them to the corners or opens them very wide then blinks.
A couple of weeks ago, he kept getting hold of his eyelashes and was pulling on them repeatedly, thankfully this has passed quickly.

It's hard to say whether there are tics or stims but he is able to stop when we ask him to, but he often starts again within a couple of minutes. Although at times instead of stopping he does it more.
The asd team said there type of tics were quite common with asd and are not like Tourrettes tics.

Forgot to say imo, these tics/stims DS does are sensory in nature.
I get the feeling he likes the feeling the vibrations in his throat for instance and does it for that purpose.

Incidentally we have noticed he does his tics more when he is either relaxed or when nervous/anxious.

Dd3 hums, throat clears, finger clicks and licks her lips. It is not always when she is stressed in fact humming and finger clicking usually occur when she is relaxed.

I have done some reading around the subject and it does seem that it is not the same as tourrettes as Genie said.

Tony Attwood has included list of stim/tics in "The complete guide to aspergers" book.

It sounds like you are doing loads of great stuff with your lad, don't put yourself down.
We do the faces game in a slightly different way to you, we take it in turns to pick a card and say "I feel ..... when" and then say what might make us feel that way.

We also used a shiny feelings box to record messages about how we felt during each day but Dd3 refused to take part in it for a long time, funnily enough she asked me yesterday if we could do it again.

Hi, sorry to have posted and left. Had to crash last night as was totally wiped out and then had a two hour long anxiety attack in the middle of the night so neither dh or I got much sleep.

I went through a phase of having night-time anxiety attacks when he was really not coping at school last year as well. The only saving grace is that, as they happen in the night, he's not around to pick up on them. I am concerned that my 'worries about and for him' will have a knock on effect if he picks up on them though.

Purple, thanks for your ideas, I will have a ponder and see what we can work out to try and root out any problems we might have missed. I think his EP is intending to start helping him to identify how he feels when different things happen to or around him in their session tomorrow, so I guess our 'homework' will be around that this week. I know she is aiming to get him identifying the physical feelings etc that are associated with different emotions and from there teaching him some coping strategies for those emotions/situations.

Since I posted last night, it transpires that he has been massively disturbed by a wobbly tooth (he got his teeth really late so is only losing his third tooth now and its an upper incisor). He knocked it quite badly in an accident last week, although it was already wobbly and apparently he couldn't stand the feeling or the occasional taste of blood in his mouth. He had an enormous meltdown about it this morning, so bad that we nearly kept him off school, but he settled down after some calprofen, some tlc and a bit of reading time AND halleluja, he has come home with a beautiful gap this afternoon and is much, much happier. He is still tic-ing, but I think perhaps not quite as much.

Genie, thank you for your post, its reassuring to hear that this is common in ASD and different from Tourrettes.

I have learned the hard way not to mention the tics to ds, as I did when he first started the face scrunching thing in the holidays and he got really upset, insisting he wasn't doing it and then when he realised he was that he couldn't help it. I did once say something like "that's a funny little humming noise you are making" when he was reading and he just said "I know, I don't know why, I just seem to do it sometimes." I haven't mentioned it to him since.

Ineed2, I have the Tony Attwood book, but don't recall that section, so will definitely go back and reread it. I really want to do that anyway before his assessment.

We have been doing 'snap' by turning over a card and then when you get a snap you have to say what emotion you think the face is representing and what might make someone feel that way. We've been doing it this way because it ties in with something the EP is working on with him during his in-school sessions. I can see there are lots of different ways to use them, but think it would just cloud things for ds if I did it any differently with him for the moment.

He is currenlty saying either happy or sad for just about every picture and struggles with anything more descriptive eg he couldn't understand what sorrow was or why you would feel it. He simply said "well that is sad then isn't it".

I love the idea of a shiny feelings box. Would you mind if I borrowed that idea. I actually think the whole family would benefit from it, not just ds.

I'm interested in the fact that he doesn't seem to tic while he's playing on his ds, but does A LOT whilst reading (which is his other great love in life). Surely both require a large amount of concentration, so why would he tic when doing one, but not the other?

@ genie - I was looking for a pressie for a friend's 6mo today and you can get a teething ring in Mothercare that vibrates when pushed. Would that be helpful for DS? Also, when I did my first shift in a school for kids with LFA and SLD, I made all the staff with me giggle - one kids pressed up against me holding a cushion, and the cushion vibrated! made me jump - again, maybe something that would help DS with his sensory issues?

@ Moosemama that you are so stressed. The things I suggested are all SALT stuff I've used at work, so hopefully will tie in with what your EP suggests, or at least not conflict iyswim. Can you think of times when the emotion on the card has actually happened to him? Eg: for scared, get him to remember standing at the top of a big slide and being scared of coming down. That way, he might be able to find something to compare?