At the beginning of 2020, Luo Hai (pseudonym) left the original company, originally just planned to change jobs, but she did not expect that because of the sudden outbreak of new crown pneumonia, she and her 6-year-old son Hehe were "bound" to spend more than half a year at home.
Luo Hai smiled bitterly and called his combination with his son "unemployed female workers and out-of-school children", school could not be opened, and mother and son looked at each other at home every day.
Thinking that her son will go to primary school in September, Luo Hai feels that she cannot "herd sheep", she signed up for her son to participate in several kinds of online classes, formulated a detailed learning schedule, and ensured that the child took online classes, practiced the piano and wrote homework on time every day, hoping that he could enter the learning state in advance. Even as the epidemic in Beijing eased, she postponed her job search and planned to concentrate on accompanying her until she sent her children to elementary school.
But there are always unplanned things in life that come suddenly, and from the spring onwards, some strange behaviors appear on Hehe's body, which make her more and more anxious.
The child first blinks his eyes and wrinkles his nose frequently. At first, Luo Hai thought that her son's hand rubbing his eyes caused conjunctivitis, and she severely criticized his son for "not rubbing his eyes with dirty hands" and relieving the symptoms with eye drops; but after a week or two, Hehe began to clear his throat frequently, and later gradually evolved into a strange sound from deep in the throat. Luo Hai felt that this was a deliberately mischievous "bad problem" of her son, she tried to persuade each other, and after exhausting patience and intolerable, she also scolded, but it did not work - her son's "bad disease" became more and more severe, and the behavior of blinking his eyes and wrinkled his nose even recurred.
"I get annoyed every day when I see him squeezing his eyebrows, and it's even more annoying to hear him 'squeak' and clear his throat." If you beat him up, you will make more mistakes. Luo Hai also found that Hehe's attention was becoming more and more difficult to concentrate, online classes often deserted, homework was even more casually confused, strokes were particularly heavy when writing, sometimes making the whole page dirty, and even scratching the homework book.
For these things, Luo Hai was so irritable that he couldn't even sleep well, and the child was very well-behaved from an early age, why did he suddenly become like this? I'm about to start elementary school, so what if it goes on?
At that time, the hospital had not yet resumed normal consultation, and she began to check the information on the Internet every day, searching for keywords such as "squeezing eyes" and "making strange noises", and finally associated with an unfamiliar term - tics. For the first time, Luo Hai realized that his son might be sick.
In May, the epidemic eased a lot, and Luo Hai took Hehe to several hospitals and was finally diagnosed with pediatric tics. In order to treat her children, she began to spend more time consulting materials, consulting doctors, and even joining several mutual aid groups of parents of children with tics.
"The disease is not fatal and contagious, but it can cause tremendous psychological stress to children and parents." In case this ticing problem can never be solved, what should the child do if he wants to go to college in the future? What should I do if I am looking for a job interview? What if you want to start a family? "This is a common anxiety problem for Luo Hai and parents of children with tics.
What makes parents more anxious is that there is no specific drug for tics at present, and the Western medicine prescribed by the hospital is mainly to control symptoms. Many parents are reluctant to give their children to eat, afraid that sedative drugs will affect their children's intelligence and growth and development, afraid of drug dependence, afraid of children becoming sluggish and fat...
Therefore, the vast majority of parents have chosen a "multi-pronged approach" to seek medical treatment everywhere: "Traditional Chinese medicine, acupuncture, psychological counseling, sensory system training... If we can try it, we will take our children to try it. Luo Hai said.
Yin Jianmin, a child and adolescent psychological counselor, said that there are many kinds of tics. Like the 6-year-old boy Xiao Hehe mentioned above, his uncontrolled eyebrow squeezing and making strange noises are more typical manifestations of children's tics. "I want to remind parents that childhood tics is a disease, not a child naughty, and not deliberately naughty. Many times children themselves are miserable, but they can't control it, they can't even realize it. ”
Yin Jianmin is exposed to an average of 30 children with tics a year, and among the children he has already received, there are significantly more boys than girls, the oldest is in junior high school, and the youngest is only 4 years old. One of his most impressive tics clients was an 8-year-old Beijing boy who was supposed to be in the third grade but was suspended from school because of tics.
"When he was twitching badly, he couldn't even hold the pen, he couldn't write, and his voice was particularly obvious and frequent." In the classroom, the child will suddenly be unable to control himself and stand up and shout, which will seriously affect the order of the classroom, and the teacher can only talk to the parents to let the child temporarily suspend school, and then go to class after the convulsion phenomenon is alleviated.
Yin Jianmin's counseling room also hosted a 6-year-old girl who had frequent uncontrolled twitching of her arms, squeezed her eyebrows and squeezed her eyes, and made a strange sound similar to a dog bark from her throat. Such a performance made her often ridiculed by children in kindergarten, so the children were silent and introverted, and the tics became more and more serious.
In Yin Jianmin's view, the family relationship and family atmosphere of children with tics are a factor that psychological counselors must pay attention to.
"One kid was very agitated when he first came to the counseling room, and his behavior was very big, making a mess in the house and overturning the sand table." Yin Jianmin sat with him on the ground and played with sand, slowly getting acquainted with him and helping him relax. He was impressed by the child's interaction pattern with his mother: the mother looked more severe, would be very aggressive in reasoning with her son, and the child had a sense of powerlessness that "could not speak to the parents".
Yin Jianmin said that in recent years, the incidence of childhood tics has shown an upward trend, but the clinical mechanism and cause of its pathogenesis are not yet fully clear, and it is related to a variety of factors. Among his clients, the vast majority of children's onset is associated with mental stress. "Our society is fast-paced, and everyone is under a lot of pressure, but people's ability to adjust themselves has not improved much compared to decades ago."
Compared to adults, children have no experience dealing with stress. Faced with a heavier burden of coursework, more changing living environments, and more complex campus interpersonal relationships, they need to make greater efforts to adapt. As a parent, you sometimes need to help your child resist some external pressures, such as when the teacher criticizes or argues between classmates, parents need to help deal with events and emotions. Many children's tics have precursors, such as uncontrolled pencil biting, rubbing corners, pulling hair and other small actions, which is also a release of their stress; "but parents often have to go to the time when the child's academic performance is significantly reduced, they will rush to find the cause, in fact, usually pay more attention to the child's behavior and mental health." ”
1, scientific diagnosis, do not randomly paste the "tics" label
Tics, also known as tic disorders or habitual spasms, begin in childhood and adolescence and are characterized by sudden, rapid, frequently repetitive, or alternating involuntary movements limited to one group of muscles. This activity is purposeless and can be accompanied by inattention, hyperactivity, compulsive movements, and thought or other behavioral symptoms.
The diagnosis of tics lacks specific diagnostic indicators, and clinically descriptive diagnostic methods are mainly used to diagnose children based on tic symptoms and related accompanying psychobehavioral manifestations. Confirmed tics can be done with physical examination and neurological examination, psychiatric examination, EEG examination, intelligence test and related behavioral examination, and if necessary, biochemical examination to rule out chorea. Tics require a scientific diagnosis and cannot be labeled haphazardly.
2. What are the symptoms of tics?
The symptoms of tics are diverse, most of them are mainly manifested as motor and vocal, more from top to bottom, starting from the head, mainly manifested as blinking, frowning, wrinkled nose, opening the mouth, crooked neck, strabismus, shoulder shrugging and other symptoms, some tics patients can appear shoulder and hand movements, including hand shaking, slapping the table, bending, shaking the arm, shaking the arm, kicking and other actions. Some of them are vocal, the movements are clearing, coughing, sniffing, humming in the throat, and some are roaring and shouting. Most of these actions are repetitive, involuntary, uncontrollable, transient, and can occur repeatedly, but mostly during the day and disappear after falling asleep at night.
3. Long-term contact with electronic screens will aggravate tics
Tics are associated with prolonged exposure to televisions and tablets (especially watching martial arts and horror movies), video games, and mobile phones. Children who have been diagnosed with tics can worsen the symptoms of tics if they play games for a long time.
4. Tics need to be "early prevention, early recognition, early treatment"
To prevent tics, we should prevent children's head trauma and drug poisoning, prevent and timely treat encephalitis, meningitis and other diseases, urge children to exercise to enhance physical fitness, and avoid children's imitation of any bad habits. In addition, scientific and reasonable education methods, a healthy and upward education environment and a harmonious and happy family have a very positive preventive effect on diseases such as tics.
On the other hand, parents should pay attention to early identification of whether the child's neurodevelopment is normal, such as finding abnormalities should go to the hospital as soon as possible, and take measures to promote neurodevelopment. In addition, it is necessary to communicate and observe the physical and mental changes of children, and timely relieve stress and bad emotions. For children who have been diagnosed with tics, parents should try to eliminate various tension factors and avoid excessive attention and scolding.
5. The harm of tics cannot be ignored
Childhood tics are more common in boys, with a male-to-female ratio of about 4:1, and most of them start at 4-10 years of age.
As nerve function continues to mature, the tic condition may heal itself. Whether a child with mild tics or not needs treatment depends mainly on whether the people around them know about the child. If the child is ridiculed for this, or even has certain problems in interpersonal and social aspects, it is necessary to intervene as soon as possible. If early detection, early diagnosis, and early treatment cannot be achieved, tics may affect the child's learning and social adaptability and social communication ability, which will have a very significant negative impact on the psychological development of personality.
6. What are the current treatment methods for tics?
Traditional Chinese medicine treatment is an effective treatment in the early stages of tic disorder. Some heavier children often use low-dose sedatives. Such as lumina bromine, remulsine and and so on. Assistive psychotherapy, including behavioral therapy, supportive counseling, family therapy, etc. Medical institutions need to help parents and teachers of children understand the nature and characteristics of the disease, alleviate or eliminate the parents' worries and anxieties, explain that it is a disease, rather than naughtiness or deliberate contrivance, and cooperate and support in many ways to achieve the most positive treatment effect.
Review expert: Cao Lianfu | Deputy Director of the Department of Child Health Care, Children's Diagnosis and Treatment Center, Affiliated Hospital of Changchun University of Traditional Chinese Medicine
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