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Question 74: I was.... wondering something about coprolalia. I understand there is an average age where children develop coprolalia - somewhere around 12-14, is that correct? Do children who develop this learn the swear words from what they hear or is it a natural vocal tic that causes them to swear. I guess what I'm wondering is if children who have tourettes hear swearing and develop coprolalia are they more likely to swear? Should a person be cautious about swearing around someone with TS? JS, MB, Canada

Good evening JS:

Coprolalia tends to peak in adolescents........likely the reason why comes back to another one of your questions. Yes this tic develops from swear words they hear. Just as a head tic may develop from purposeful head flicks (say, to get hair out of your face), coprolalia develops from hearing, knowing, thinking about, and saying swear words on purpose. TS neurology simply predisposes an individual to get stuck in particular movements or noises: what those movements or noises ARE are a reflection of the environment you are in. In other words, a child with TS who has never HEARD a swear word could not possibly develop coprolalia even though the potential for it is there because the "software hasn't been loaded". Adolescents in 2002, however, are inundated with swearing and so one might expect this tic to be at its worst at this time.

Of course, this isn't to say that a child with coprolalia therefore comes from a family of potty-mouths. Remember that the more one thinks about a tic, and the more a tic is stressful or physiologically arousing for an individual (through, for example, embarrassment or fear of getting in trouble), the more likely that tic is to present, worsen, and persist. Hence one might expect the Tourettic son of the local minister to have coprolalia simply because the emphasis about NOT engaging in acts such as speaking the lord's name in vain would be so greatly emphasized, and the consequences for doing it so vivid and scary.

My short answer is, then, that yes one should be careful about swearing around a person with TS. To make too big of a deal about any of this to a Touretter though (i.e., "be careful about hearing swear words, because you'll get stuck in them") might only draw attention to this disturbing possibility, raise stress levels, and thereby set this tic into motion anyway (ain't TS sneaky?? :) Hence the best solution is to be careful about swearing a great deal in front of a child with TS (ANY child, for that matter!), but to play things low-key and not make any mountains out of mole-hills if you "slip". And remember -- like it or not, your child will likely be exposed to plenty of 4-letter words regardless. Monumental efforts to shelter them will only draw more unwanted focus on that which you wish them to avoid.

Hope this helps!

Dr. Dunc.

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