FFS! Stop using that word!
I wrote about Tourette’s syndrome last
year, but I have received a request to run it again. FFS! Someone reads my
Tourette’s generally brings smiles to the people watching (listening) and it
has been shown to the satisfaction of the medical world, that humor and a
good laugh really is good medicine. Some hospitals even employ clowns to
brighten up the days of the inpatients. But not people with Tourette’s.
One of my favorite jokes involves a parrot that was prone to ‘bad’ language,
and consistently used the “F” word. After threatening the talkative bird
with dire consequences, its owner put it in the freezer chest for five
minutes. After being retrieved from the freezer, the parrot was asked if it
would now behave. “Yes,” said the shivering parrot, “I won’t say the “F”
word again, but please tell me what did the effing chicken say?”
Now, the F word in medicine. Inappropriate use of the F word (there are some
appropriate situations, in my mind at least) is part of the interesting
condition known as Tourette’s Syndrome. These are involuntary movements (and
sounds) and can be related to the magic “F” word, and is usually seen in
children (not parrots) around the age of 5-7 years. Boys outnumber girls
three to one!
So is this just a case of little Johnny parroting off (sorry about that,
couldn’t help myself) dirty words he has heard at home? Actually no. This is
a developmental problem that comes under the general heading of ‘Tics’ (as
opposed to ‘ticks’ that are parasitic problems).
Tic disorders can affect up to almost 20 percent of children at some stage
of their development. At one end of the spectrum are children with brief
episodes of single tics, whereas at the other are children with chronic
multiple tics, including our friend Tourette’s syndrome.
Tics are abrupt and recurrent involuntary motor or vocal actions. Motor tics
include eye blinking, grimacing, nose twitching, lip pouting, shoulder
shrugging, arm jerking, head jerking, kicking, finger movements, jaw
snapping, tooth clicking, frowning, tensing parts of the body, and rapid
jerking of any part of the body are simple tics. More complex ones include
hopping, clapping, touching, throwing, arranging, gyrating, bending, biting
the mouth, the lip, or the arm, head-banging, picking scabs, writhing
movements, rolling eyes upwards or side-to-side, making funny expressions,
sticking out the tongue, kissing, pinching, writing the same letter or word
over and over, and tearing paper or books.
However the tic can also be vocal, with simple ones being coughing,
spitting, screeching, barking, grunting, gurgling, clacking, whistling,
hissing, sucking sounds, and syllable sounds such as “uh, uh,” “eee,” and
“bu.” The complex vocal tics can involve complete phrases such as, “Oh boy,”
“you know,” “shut up,” “you’re fat,” “all right,” and “what’s that.” Take
that a little further and you get repetitive bad language which we call
Coprolalia (we love big words) and the best known example of Tourette’s
Children who have these tics can be looked upon as fools by their peers, and
there is a no more predatory group than other children. Parents also can
feel helpless in these situations. From the medical point of view, one has
to treat the entire family, not just little Johnny with the foul mouth!
Most children with tics can lead normal lives, and the tics themselves
usually slow down in teenage years. Parents should be encouraged to get
support for themselves from various organizations such as the Tourette
Syndrome Association ([email protected]). With a good understanding of
tics and related problems, including acceptance from teachers and education
of the child’s peers, most children with tics do not need regular medical
Parents and children need to understand that, although all these symptoms
relate to an underlying brain disorder, breaking the cycle may be extremely
simple - for example, just allowing the child to have a short “tic break” in
a long school lesson may be enough.
Drug treatment can be used, though there are differences in opinion on the
efficacy, with some researchers claiming only 30 percent can be helped;
however, tic severity and frequency can be reduced. Studies of Risperidone
in Tourette’s syndrome has shown that it is efficacious too.