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Autism

Tics vs Stereotypies

03/12/2010

Question:

Is there a difference between tics and stereotypical behaviors? We are not sure what my son has, possibly Asperger`s, sensory issues, ADD, anxiety, etc. Could be some Tourettes in the mix. Anyway, he is taking ADD meds, despite the warnings about tics and doing much better in school, but the movements are worse. Is there a difference or does is matter?

Answer:

Tics and stereotypical behaviors are different. Tics are involuntary movements, while stereotypical behaviors are more ritualistic or habit-like. They can be hard to tell apart sometimes. Tourettes is a variation of a tic disorder that includes vocal tics or utterances, so again, this can be hard to distinguish from a stereotypical behavior. These symptoms can be seen in ADD, in Asperger's, and by themselves.

While ADD meds may provoke tics, most research has shown that they are safe to use in people with tic disorders. The decision to continue the medicine is a judgment made by the family and physician together: How much better is your child in school, how much worse are the movements, what is the best balance of improving school and tolerating worse movements? There is no single answer for every child.

Does it matter if these movements are tics or stereotypies? To some extent it does. Behavioral treatments may be more effective with stereotypies than with tics. If medication is considered, different medicines may be used for tics than for stereotypies.

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Response by:

Daniel   Coury, MD Daniel Coury, MD
Clinical Professor of Pediatrics and Psychiatry
College of Medicine
The Ohio State University