Help for ADHD & Tourettes

Families of children diagnosed with Tourette syndrome and ADHD can find themselves trying to navigate a minefield of unpredictable behaviors, feelings, assumptions and mistaken public attitudes toward the diagnosed child. The child and her family members may be subjected to mistaken, negative attitudes expressed by those who do not know the child is not acting out intentionally. At times, family members themselves may subject the child to mistaken attitudes and beliefs.

Diagnosis of Both Conditions

• When a child presents with symptoms of tics (which are purposeless, non-rhythmic, repetitive and brief sounds or movements), his doctor will review his medical history and make note of the kinds of symptoms the parents are reporting. It will not be necessary for the doctor to witness a tic in action in order to diagnose Tourette syndrome, although seeing one would be helpful. Some parents bring a videotape of their child when he is experiencing tic activity to the doctor's office.

  During the course of the child's diagnostic work, the doctor will discuss how the tics affect the child's school and social life. He may order additional diagnostic tests, such as a psychological evaluation and tests to detect possible learning problems.

  The doctor should evaluate his patient for obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD), as these are considered conditions that can accompany Tourette syndrome.

  While he is working on a diagnosis, the doctor should consider ordering an electroencephalogram (EEG), blood tests and a CT scan to rule out other conditions or causes for the tics.

  The parents of a child who seems to be constantly moving, unable to listen or pay attention or who is easily distracted may wonder if their child is simply "highly active" or if he has ADHD. No physical test exists to diagnose this condition. Instead, the doctor will embark on detective work, talking to the parents of his patient and asking them to fill out a lengthy questionnaire. If the child is already in school, his teacher will also be asked to fill out a questionnaire. The child will probably be referred to a psychologist for a full evaluation and possible diagnosis of ADHD. The parents should ask about learning management and coping skills.

Undertstanding ADHD and Tourette Syndrome

• The child who has been diagnosed with Tourette syndrome and/or ADHD does not experience tics or engage in high levels of activity because she wants to misbehave or "act bad". Until she learns coping and control skills, she cannot control her tics or level of activity. Family members, as well as the general public, mistakenly assume that these children act out because they want attention and because they want to get out of school activities or homework.

  The family of a child diagnosed with ADHD and/or Tourette syndrome should consider seeing a family therapist so they can learn how to understand and work with their child. Before diagnosis, some family members may have developed a negative attitude toward the child, believing that she acts out deliberately. They may have also developed a degree of resentment toward the child because she gets what they believe to be "too much" attention. The child, who is very likely highly intelligent and intuitive, has likely picked up on these negative feelings, which have helped to contribute to a low self-esteem.

Treatment Plans

• If the child has both Tourette syndrome and ADHD, his doctor will need to think carefully about what medications to prescribe. Ritalin can make Tourette syndrome and the tics worse. The parents of a child who suffers from both conditions should also educate themselves so that they can ensure their child is receiving the most appropriate medications and treatments.

  The parents should also seriously consider having their child see a psychologist so he can learn how to control both his tics and his ADHD-related hyperactivity, distractibility and impulsiveness. The psychological therapy should be undertaken in conjunction with any family therapy sessions that have been set up. Psychological sessions and family therapy are intended to help the child address his conditions and learn coping skills while the family looks at their interactions with each other and the child and how this has affected their view of each other.