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Question 20: I listened to the museum of vocal tics. And I have a question because alot of the vocal tics exampled a sense of compulsion, which I know identifies TS. But what about vocalization that is often repeated without the thrusts but just sounds like silliness? And mind you I emphasize "often repeated." Does this qualify as a TS vocal tic. My husband does repeated phrases. And our son does repeated songs, sounds and phrases, continually. I hope to get him a diagnosis by a professional but he is only 5 and I want to see what may change or not. thank you ---- S.H., Texas, USA.

Good Afternoon S.H:

By 'sounds like silliness' do you mean nonsensical noises -- nonwords? Certainly many simple phonic tics in TS fit this pattern yes.

If instead you mean sensical words/phrases that are silly in content and repeated over and over this could also be a tic. Repeating something you have heard over and over again is called echolalia and is a recognized type of complex phonic tic in TS.

Not knowing the specifics of your situation, however, repeating phrases again and again may also be an indication of further diagnoses as well (a number of other disorders commonly occur with TS). If the phrases are always in context for example, just silly and inappropriate, some impulsivity characteristic of Attention-Deficit Hyperactivity Disorder (ADHD) might be present. On the other hand, if the phrases are repeated in response to particular thoughts, or in a very routinized way, or to relieve anxiety, or a certain number of times this may indicate elements of Obsessive Compulsive Disorder (OCD). These questions are not an exhaustive list of what must be asked to tease apart what, if any, diagnoses are warranted -- they are simply an example of the sorts of observations that need to be made by any doctor (Psychologist or M.D.) you approach to assess your son.

Anecdotally, it seems quite common for individuals with these disorders to parrot lines from songs, movies, and television (my own weakness is Monty Python). I've been known to say in my presentations (tongue firmly in cheek) that the easiest way to diagnose a disinhibition disorder (TS, ADHD, OCD) is to simply ask two questions: "What is your favourite show", and "Will you now repeat every funny line from every episode"..................... :-)

 

I should also add that average age of onset has been ascertained using international data to be between 5 and 6. If you have been seeing and hearing tics for at least a year then a diagnosis is warranted.


I hope this helps S.H.
Dr. Dunc.

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