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Help Me Help My Child (May 2007)

Past cases: May 2007

Here are the cases dealt with on Ruth’s page for May 2007.

My daughter is eight and has started doing funny twitches she says she can’t stop.

I wonder if she’s starting with a tic disorder? This is a problem that might run in families and starts at about this age or a bit younger. The best known tic-disorder is Tourette’s but hardly anyone has the swearing and involuntary shouting that you might have seen on television. People with Tourette’s do have to have vocal tics, but these are often grunts or throat clearing, which can sound quite natural.

About one in a hundred children have a tic disorder. Tics start when the children are quite young, often with shoulder shrugs or a head shake. Sometimes it’s hardly noticeable. The tics change and some children have very obvious difficulties with arms that shoot backward, or funny face-pulling, others are much more discreet – one boy had a sort of quiver down his back. Often these tics get worse in adolescence and then stop at about 18, but some find their tics persist into adulthood.

People describe the need to tic building up inside them, a bit like a mini volcanic eruption. Sometimes they can postpone it for a little while, but in the end it bursts out like a sneeze you’ve done your best to hold in. Some children find they have more tics when they relax, some find they have more when they are stressed. Children who have a lot of tics often get very tired just from the physical movement. Interestingly some people find that when they are really concentrating on something, they tic much less, and there is a professional ballerina with Tourette’s, as well as Tim Howard who was the Manchester United goalie for a while.

It’s always worth getting this professionally checked out. Some tics – a very few – are just bad habits. Others are the beginning of something and your daughter will feel much better if she knows that this is really something beyond her control. And there are chat lines and groups in some places so that people can share their experiences. There are also a number of medications that might help if things get bad enough.

Craig is horrible and fourteen. Will it go away?

Teenagers get a bad press but that is because so often the adorable small children and the eager older children seem to have morphed into Kevins [old British programme]. Does it make you feel better to know that this is a physical and physiological change and beyond anyone’s control?

Obviously Craig has “hormones”. Most parents can see their girls going through a funny stage on a monthly basis; girls might be moody and miserable or snappy and if you check it in a calendar you can see that this is happening quite regularly. It happens with boys too, and many boys find their lives and moods are smoother with a daily dose of vitamin B6 or oil of evening primrose. More problematic are those changes you can’t see. The production of melatonin goes out of synch during adolescence. Melatonin is the substance that makes you go to sleep – if it doesn’t kick in until later in the evening, you don’t go to sleep until later. And then you need to sleep in in the morning.

Adolescence is a peculiar stage. It’s the time when children have to change into adults. They have to understand that they are boys or girls – not kids. They have to think about money and how to manage it, about principles and how to support them – should they tell if a friend is taking drugs or having sex or truanting or shoplifting? This is the time when they need to start thinking about a future, jobs, friends, independence. How do you decide what is the right thing to do?

Adults use the executive function, available in the frontal lobe. But recent research has shown that the frontal lobe does not take over this function until about the age of 25. Up till then the amygdala does an awful lot of the decision making – so that decisions are made quickly and acted upon impulsively. They really do not think before they act, and it’s not just naughtiness, it’s physiology. This is also the time when young people practise their independence. Children depend on others for everything, but teenagers practise doing everything for themselves. In an ideal world they grow into inter-dependent adults who like to do things for themselves, but are able to ask for help when they need to.

I think Nature is very careful. The reason why most of us do not kill our teenage children is that we are buffered by a million pictures in our heads of lovely small babies and children hanging on our every word. Craig is probably going to be a wonderful young man. In the end.

After working for other people, we are just starting our own business, but the children don’t understand and won’t leave us alone.

You are up to your eyeballs in planning ,negotiating, sorting, making contacts, borrowing money, all sorts of things and you children want you to be exactly who you were before.

You say the children are eight and 10, and should be able to amuse themselves. Of course you are right, but children inevitably sense when things are changing and try to maintain things the way they were. They are highly conservative creatures and generally like things to stay the same.

I wonder how much you have told them of what is going on. Have you explained some of what you are trying to do and how hard it is? Have you told their school that things are changing for you so they can offer some support too?

I know it will be terribly difficult, but try to guarantee some time for the children every week – and every day if you can. This will be good for all of you – even just going for a walk together can restore a sense of normality. Perhaps you can make sure you are there to take them to bed, or to a club. This will remind all of you how important the children are. It might be possible, if you get on well enough, to invite a granny or aunt across for a little while to keep the children amused while you are busy. If you can, make up an estimated timetable so that you can all see when the end is in sight. And give the whole family a treat if you can afford the time or money at this point.

Good luck with the business. But remember you are doing it for the children ultimately, and try to pull them on board.

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