Hello BabyShrink! I have a six-year-old son and a four-year-old daughter. They are like night and day personality-wise. When my son was between two and four, he had several “tics” including twiddling my thumb with his finger and his own belly button and nipple. He also had a pacifier in his mouth until he was almost four. This wasn’t harmful to him or anyone else so I never really worried about it. My daughter never took a pacifier. She has recently developed some habits that I may be able to overlook like my son’s, which he outgrew eventually – but I feel they are more damaging. She sits and scratches her legs, twists her hair into knots and pulls them out, and not only bites her nails but when she runs out of nail she chews on her fingertips. I thought I might get her a doll with lots of hair to twist and pull on to stop the hair pulling. Any suggestions for the rest of the issues? Some people have said tell her doctor she needs to be medicated but I think that is ridiculous! She is four!~~ Debby, Louisville, KY
The issue of tics is not discussed enough. This is a really common behavior, especially in young children. Studies show that between 20-30% of all school children will show these repetitive movements at some time in their childhoods.
Usually, tics peak at age 10-12. However, tics spontaneously disappear in the majority of all kids who have tics. So for most of us (present company included, though to protect a certain kid I'm not naming names!) who have kids who do weird repetitive movements like eye-blinking, shoulder-shrugging, facial-grimacing or throat-clearing, we simply should ignore it, and it will eventually go away.
The emergence of a tic, however, should initiate some thought and concern by a parent. Is there any undue stress in the child's life? How can we help the child to cope more effectively? The tic is a reflection of something else; some new stress or change in the child's life. Approach the situation in that way, not by trying to control the tic.
It's thought that a tic is a way perhaps of "blowing off steam", and not at all under the child's voluntary control. Shaming them for it, repeatedly pointing it out, or making it a big deal is actually asking for more trouble – it could reinforce the habit, and trigger a power struggle between you and your kid (one you won't win).
There certainly are cases that need professional evaluation and treatment. Since a tic COULD be caused by a medical condition (I know of a case of "shoulder-shrugging" that was triggered by an undiagnosed neck injury), always involve your child's pediatrician in the process. If the tic does not go away over a period of 6-12 months, it starts to interfere with school or social life, or is associated with other problems (obsessive/compulsive behavior, attention problems, etc.), get a thorough evaluation that includes medical/neurology, psychology/psychiatry, and educational consults.
Now, back to your question, Debby. What you describe as "tics" in your son are really more under the category of "weird, annoying, but common toddler behavior". (How's that for a professional diagnosis?) But what you describe in your daughter concerns me. Her behavior doesn't actually sound like tics to me. It sounds more like anxious behavior, and self-destructive anxious behavior, especially in a child this young, is worrisome. Of course medication is not my first thought, since you need a complete evaluation for your daughter to determine the cause of this anxious behavior. Have there been recent stresses or changes in the family? Has she experienced something traumatic? Those would be some of the questions I would ask if I was involved in evaluating your daughter.
Please reach out to your pediatrician, clergy, school system and friends to find a good licensed child therapist who can help you start to solve this problem. If you have more questions, I'm here. Good luck and keep us posted!
Dr. Heather The BabyShrink Mom of Four, Parenting Expert
P.S. Follow this link to a nice article about tics in school children written by a group at NYU.www.aboutourkids.org/files/articles/tics_6_03_e.pdf