Check Study Program

#Tourette_Dx

#Tourette_Tic_related_OCBs_Mx

#Tic_Disorder_Mx

#Tics_Referral

#Tics_Mx

#Tics_Treatment_Goals

#ADHD_Assessment_Tools

#Tics_Comorbidities

#Tics_Tourette_Syndrome_Tic_Disorder

Simon is presenting with multiple rapid jerky movements that are consistent with tics. Further history to elicit the onset, type/ nature of tics, course, etc, would include the following questions: • Has there been any prior history of similar movements (motor tics)? • When was the first tic noticed?(It is important to ascertain whether the tics have been present for more than a year since onset, although they may not have been present all the time.). • Do the movements wax and wane(ie do they come and go with varying intensity and frequency, and are there periods when tics are less pronounced or absent altogether)? • Do they change from one site to another (eg blinking for some time and then shoulder shrug and then facial grimacing, etc)? • Are there any involuntary noises (vocal tics)? • Is there a mental urge to do the tic, or a tightness, stretch/ tickle sensation at the site prior to the tic, and does performing the tic make the sensation better or make it ‘feel right’? • Can Simon voluntarily stop it (even if it is at the expense of an urge to do it)? If yes, for how long? Is there a worsening or rebound after it has been suppressed? • What makes the tics better? What makes them worse (eg are they worse when he is tired or stressed)? • Are there any associated features such as involuntary swearing (coprolalia); involuntary rude gesturing (copropraxia); non-obscene socially inappropriate behaviours; repeating words, phrases or sentences (echolalia) or actions (echopraxia)? • Is there any family history of tics, ADHD, OCD, autism, etc? • Are there any features to suggest myoclonic seizures such as jerky movements that typically occur in the morning on awakening and do not usually recur in the same body part? #Tics_History

Simon, aged 11 years, is brought to your clinic by his mother. She is worried about him, as he has been having severe jerking movement of the neck and head. These movements started two weeks ago, but over the past few days they have become severe and frequent and are causing Simon considerable pain. He had similar head and neck jerks approximately a year ago, but they ceased after some months and were not this severe. While Simon’s mother gives you this history, you notice him shrugging his shoulder and clearing his throat repeatedly. 1.What further history would you seek from Simon and his mother? 2.What is the likely diagnosis? 3.What other conditions are commonly known to co-occur? 4.What other information would you seek from Simon? 5.How will you manage Simon’s diagnosis of Tourette syndrome and comorbid ADHD? 6.What non-pharmacological and/or pharmacological interventions would you recommend? 7.How would you manage Simon if he has a re-emergence of symptoms? #Week10_Case2

#Autism_Drug_Therapy

#Autism_Interventions

#Autism_Comorbid_Psychiatric_Disorders

#Autism_Health_Problems

#Autism_Assessment_Health_Professionals

#Autism_Redflags

#Autism_Referral_Groups