Hi
M.G.W!
Multiple
Tic Syndrome is not a recognized diagnosis by the DSM-IV (Diagnostic
and Statistical Manual, 4th edition) which is the standard book of disorder
that doctors (both MD's and Psychologists) use for diagnosis in North
America, however "Chronic Tic Disorder" is. To be diagnosed
with this, you must have had a tic or tics for more than a year (which
based on your email he has), but they must be all motor or all phonic
(noises). If this is what your son was diagnosed with, then the doctor
must have seen or you must have reported only movements or only sounds.
To be diagnosed with TS you need to have both multiple motor AND one
or more phonic tics for more than a year.
Both groups
at Yale University and in the Tourette Syndrome International Consortium
(TIC -- 24 participating countries) have done major data collection
to find out whether tics get worse with age. Both found that tics tend
to peak just before adolescence -- at around age 10 (Yale) or 11 (TIC).
Remember
that this finding is ON AVERAGE across many individuals; some can
and will peak much older, and some younger. Also remember that many
individuals with TS get quite crafty at suppressing or hiding their
tics -- sometimes an"increase" of tics reflects an increase
in self-esteem (no longer suppressing because of a greater belief in
and comfort with oneself) which is by no means a bad thing. In fact,
in my own experience I've learned that a poor attitude towards myself
did much more damage to myself and my relations with others than the
tics EVER could!
Finally,
while tics may not get any worse (on average) after ages 10-11, whether
they decrease in later life is variable. Not enough study has been done
here yet, but some have found that about 1/3 of TS'ers have tics at
the same level all their lives, about 1/3 have tics all their lives
but they decrease into adulthood, and about 1/3 remit (their tics disappear).
More research needs to be done to confirm these findings, and also to
see if the other associated disorders (such as OCD) may increase as
other tic symptoms decrease. I myself believe that adult TS is underidentified
at this point simply because TS as a diagnosis is young, and TS as a
commonly KNOWN diagnosis is only beginning now. I believe that adults
will more and more "come out of the woodwork" having been
misperceived and misdiagnosed for years. I also think that, now that
the spotlight is on so many TS children, as they grow we will watch
them continue to tic and realize that adult TS is more common than many
suspected.
I hope
this helped!
Dr. Dunc.
