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Ask the Mental Health Expert Archives 2001-2004

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Nonverbal Tic

Q. My 12-year old son was diagnosed with Tourette's Syndrome two and a half years ago. Have there been any cases of tics coming out in the written form? For example writing dirty words or writing down quotes from movies or songs with inappropriate language? I believe that some of my son's tics are coming out in this way. Can you offer any help?

A. By the usual definition of Tourette's Syndrome (TS), the disorder is characterized by vocal and motor tics starting in childhood. Vocal tics may be either noises or words, and the vocal language tics may consist of obscenities (coprolalia) and repetitions of speech that has been heard (echolalia).

Coprolalia is not always seen in TS, and may be absent in most cases. I am not aware of any published reports of writtin tics. However, there is one report of a deaf individual with TS in whom vocal language tics were replaced by equivalent sign language tics (Morris et al, Mov Disord 2000 Mar;15(2):318-20). So, in theory, I don't see any reason why a TS individual could not have tic-like experiences that are manifest in writing.

However--lots of healthy 12-year-old boys have an interest in inappropriate language from popular movies or songs! Before concluding that these behaviors represent a tic-like phenomenon, I would suggest talking to your son about the matter in a calm, non-judgmental way. Does he experience this as a real problem? Does he feel a kind of inner tension building up inside him that he must release by writing down dirty words? If neither is the case, I'd be skeptical of the tic explanation.

If the answers are "yes" and "yes", then discussing the matter with your son's pediatrician or psychiatrist would be appropriate. But, if no one is adversely affected by this sort of writing, and it represents a harmless outlet for adolescent emotions, maybe it's not something to trouble yourself about.

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May 2003

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