Expert: Trey McGowan - 8/21/2007

Question
My ten year old son has always seemed young for his age. For the last 5 years he has played with small figures{ anything really thats tiny} and while doing this he lets out a variety of noises over which he asppears to hav no control. He has expressed concerns that it is getting harder to control. He often lets out excited squeels and these seem to b increasing in frequency and intensity.  we are very worried about him. Peadeatrician not really interested and under pressure from us has just referred him to mental health team. I dont know whether he could b on autistic spectrum or whether it is an anxiety disorder.

Answer
Hello, Joshua!

The excited sounds that you're describing don't really sound like an 'autistic spectrum' situation. There's a lot more to it than simply making involuntary noises. If there are more symptoms to it, then it may well be something you want to look into since vocalizations are occasionally diagnosed as part of Asperger's Syndrome.

However, what it sounds like you're describing here, if I can walk out on a limb and talk about something I know *very* little about, is one of the 'tic disorders'. Read over http://en.wikipedia.org/wiki/Tic_disorder for more information on these.

The first thing that people think of when they hear this is the people screaming out swear words and full-blown Tourettes. However, these are a VERY small minority of the people who suffer from Tourette's, and Tourette's are only a VERY small minority of people who suffer from Tic Disorders.  I think the best thing that you can do is to speak to the mental health team and see if there is anyone locally who has dealt with Tourette's. I suggest Tourette's in specific because it is going to be the easiest way that you will find a specialist in tic disorders, not because I think your boy has it. In fact, if the vocal tics is the only thing that he's displaying, it's very possible that it's all he *will* display, and the sooner intervention can come in, the better.

Here's some more information for you:

http://www.psychnet-uk.com/dsm_iv/chronic_motor_tic.htm
Notice the mention of 'Asperger's Syndrome' under the other diagnoses. This is why I suggest that you check for other symptoms as well.

http://www.tourettes-disorder.com/symptoms/tics.html
Again: Tourette's Syndrome is *not* what you see on the talk shows. These are a minority. Far more often, what you deal with are a pattern of tics that simply have been going on for a long while. These are some examples of the 'tic terminology'.

http://www.childbrain.com/ticdisorder.shtml
A very good, well-written site that explains tics in an easy-to-digest way.

Feel free to come back if there's more details you want/need to add to this one! But I hopefully was able to reassure a little bit.

Trey