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Tics and Stuttering in children with autism
When my high functioning son was seven years old he developed a few tics that lasted for several months. First there was the constant eye blinking that made homework a nightmare. The first grade handouts had suggested that homework time should be about forty-five minutes. At my house it averaged two hours. Besides the eye blinking there was the constant erasing of the work, which caused holes in the paper.
This whole process exasperated my son who would cry over his homework looking sloppy. A short time after this tic started a vocal tic emerged - stuttering. It took my son a long time to get a sentence out, although he was not too frustrated with talking and stuttering - it was hard to understand what he was saying.
This was the year that I had him completely mainstreamed. The previous year he had been in a special day class for mornings and first grade for afternoons. This was a year-round school at the time so when he finished in June I changed him to another track so he would start first grade in July with only a week break. I figured this would keep the momentum going and was the one summer we were not able to get funded for summer camp.
In January of 2003 his first grade teacher wrote a letter on my behalf to get him some assistance with speech therapy. She mentioned that his speech had worsened, with his stuttering becoming significantly more difficult to understand. It was written in his December 2002 IEP that his speech was unintelligible 40% of the time. " He stutters a lot which further interferes with speech clarity". The IEP did mention the motor part of his writing was difficult and caused tears in paper from erasing vigorously. One sentence I made note of, " It was observed that at the beginning of the year, he performed writing tasks better."
His Occupational Therapist (OT) made note of his writing pace decreasing , "primarily due to his tendency to be a perfectionist when he writes. He tends to erase a letter and rewrite it when he does not like the way it looks and this slows his printing pace."
At this time I did some research and learned that some of these issues affecting my son were similar to the traits of Tourette Syndrome (TS). A student in my other son's class had a sibling with TS so I inquired of that parent on TS. I also got some books on stuttering to read up on how to work through it with my son. I did not want to make a big issue out of it with him and needed to know how to approach him about the eye blinking, handwriting troubles and stuttering.
I learned about the types of tics - motor tics, verbal tics, muscular tics. Stuttering could be a form of muscular tics. Eye blinking and head jerking are motor tics. It just so happens that not all tics mean Tourette Syndrome. Many are brought on by emotional stress.
Months went by and we realized the stuttering has ceased to exist with the eye blinking no longer an issue either. Several months went by and one day I ran into the Occupational Therapist who asked me if anything unusual had happened. It turned out she noticed some of these issues again with my son and I immediately made the connection to the time period when the father would reappear into our lives and start his supervised visitation. I went through my paperwork to see when we went to court and what time frame the visits were taking place and it was clear this was the underlying reason for the tics surfacing.
It has become evident over the years that my son does indeed have symptoms of Obsessive Compulsive Disorder (OCD).
When other issues pop up that do not fit the criteria of autism it is best to document them and research them further before assuming it is another diagnosis. Luckily the stuttering, eyeblinking and handwriting issues went away. The additional therapy and reading resources helped us through this period. Many in the professional community are quick to say it is all part of the Autism Spectrum, but a parent is more in tune with their child and can get to the root of the problem.
This is the best website I have perused on the subject of Tourette Syndrome as well as listing other conditions like Sensory Integration Dysfunction and P.A.N.D.A.S.
The best book on the subject of OCD is Freeing Your Child from Obsessive-Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescents. Dr. Chansky is also a member of the OCD and parenting yahoo group.
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