I may not have been sufficiently clear about tics.
As I understand it, kids with Tourette's have a slightly different problem with tics, although to the casual observer it canbe difficult to tell the problems apart, depending on how the tics are manifesting. And especially with younger kids.
I don't know Tourette's as well, not from personal experience, but because of the often-expressed concerns about difficult child 1 & difficult child 3 and possible Tourette's, I have looked it up.
There are some similarities in terms of the difficulty they have in trying to control tics. With Tourette's it's a form of compulsion, and often the more pressure there is to avoid the tics, the more difficult it is for them to not make the noise. The compulsion can be overwhelming. The tic can be a noise, it can be a facial twitch, it can be a gesture or some other physical movement.
With Pervasive Developmental Disorder (PDD), often they are totally unaware they are making the noise. Watch to see under what circumstances they make the noise (or whatever it is they're doing). Or if they are aware, they aren't always aware of how much they do it.
With both disorders, the more anxiety there is, the worse the tics will generally be. If you try to force them to stop the tics, you can make the problem worse because the anxiety is heightened. Think of that scene in Blues Bros when Elwood & Jake are meeting with the Penguin (the Mother Superior of the orphanage). Jake swears, the Penguin hits him with the ruler and he swears because she's hit him. Elwood tries to stop Jake swearing (and swears himself in the process) and the whole thing escalates until the ruler is swishing back and forth with a blur, hitting them, and they're swearing constantly in response.
If you try to use force or strictness to control tics, this is what is most likely to happen.
We can try all sorts of things to help a child overcome the sort of noises they make. With Pervasive Developmental Disorder (PDD) (which I know more about, from experience) the tic is actually more of a stimulant (self-srimulatory behaviour). It's something they do to help themselves feel calmer. It becomes a habit, the more ingrained a habit then the harder it is for them to change it. The more you pressure them to stop it, the worse they're likely to get with it. It can almost seem like defiance, but it's not.
With Tourette's, the noises can often get louder and more insistent, the more you try to stop them. But with Pervasive Developmental Disorder (PDD), the kid does seem to have a little more control over osme aspects of it. They will try to modify it especially if they are more aware of it. But the younger they are, the less able they are to first be aware before they make the noise, and second to be able to make the change. When they are more able to change it depends on the individual child and how capable they are, as well as how severe the Pervasive Developmental Disorder (PDD) is.
difficult child 3 was probably stimming from birth - he was fascinated with watching the flicker of light through the leaves on the trees, which I now realise was probably very similar to the way some autistic kids will flap their hands in front of their face and watch the gaps between their figers as they do so - it produces a flicker effect which has been described as soothing to the brain, almost like scratching an itch. difficult child 3 never hand-flapped, but another boy we met at age 6 was a hand-flapper. That boy was more high-functioning than difficult child 3 but I noticed that when that boy was especially happy (such as playing in the water at the beach) he began to flap his hands. His parents made no attempt to stop it - there really was no reason. And at age 6, it would have been fairly pointless anyway.The boy would have developed something else to take its place.
And that is pretty much what tends to happen - difficult child 1 at age 6 used to make what we called his World War III noises. It was as if he was doing the sound effects for a Battle of Britain dogfight. And it was constant - we have a videotape of a holiday we took, and all through the video you can hear me complaining to difficult child 1 about the noises he was making. On the tape you can't hear difficult child 1's noises, only me. Ironic.
difficult child 1's "war sound effects" later gave way to quieter sounds and finally that last one which evolved from his attempts to reproduce the emu call. It's a much quieter sound but it got very annoying for a while. He would have been 20 years old at the time, well aware that the noise was annoying but unable to fully control it. He was also aware that it had begun from a habit, but had now become something more.
difficult child 1 no longer lives at home so I'm not so aware of noises he makes. But difficult child 3 has his own noises, the one he's had longest is a quiet growl in the back of the throat, like a constant throat clearing crossed with a groan. If you read Mark Haddon's "The Curious Incident of the Dog in the Night-Time" (a fiction book told from the point of view of a teenage boy with Asperger's) the main character describes a noise he makes as 'groaning". He also descripes a yapping sound he makes when especially upset and stressed. He does seem to have some voluntary control over these, but only some.
difficult child 3 has also had a nose twitch in past years. His good friend (also high-functiioning autistic) has had a similar facial twitch (much to his mother's distress).
Other facets of the autism can come into play - the Obsessive Compulsive Disorder (OCD), for example. A behaviour can become repetitive if the person developes a sort of ritual aorund it. For example, difficult child 1 when anxious and ready to go out will walk around the house checking all windows and doors are locked, making sure he has his wallet and his keys and all power points are switched off. He will go around over and over, until it's time to leave. And as he drives away his mind will be asking him, "Did I shut everyting off? Are all windows/doors locked? Do I have my wallet and keys?" The act of checking his pockets for wallet and keys can become a repetitive gesture which can turn into a stimulant - because feeling for his keys in his pocket and finding them there, reassures him and makes him feel safer and more in control.
It is such an individual thing...
We have been congratulated for raising our boys to feel good about themselves and to not view their autism as a handicap that diminishes them in any way. Autism is simply a facet of who they are and how they function. Autism is simply a different way of brain wiring, not necessarily defective. There are advantages to autism just as there can be problems. The problems of autism are those where society and the individual don't mesh well (for whatever reason) and often there are ways to get around this. There are also many career paths where these problems are not problems at all.
Examples:
1) difficult child 1, after a number of years trying this or that, has finally decided he wants to be a cabinet-maker. HE has a good brain but really likes making things and especially lieks working with wood. He likes the feel of wood under his hands, he likes the smoothness of a well-polished surface. Here, it's the Obsessive Compulsive Disorder (OCD) and the stimming that is being catered to. The Obsessive Compulsive Disorder (OCD) component of the autism helps difficult child 1 do the repetitive tasks and the perfectionism that produces a top quality finish to the sanding and polishing he does. The stimming means he needs to feel a smooth, blemish-free surface when he runs his fingers along it. HE regularly runs his fingers across many surfaces, and if a surface is not smooth and he feels it should be, it worries him until he takes action. As a result at his last job, they put him in charge of sanding all the furniture, he was even supervising more senior staff in this area. So in this case - the autism and stimming is an asset in the workplace.
2) difficult child 3 is obsessed with computers and computer games. There are many aspects to computers and technology that he loves. He likes watching TV home viewer film clips for example, and uses the computer to recordd these TV shows. He then uses computer software to extract the segments he especially likes and turn them into small film clips which he has worked out how to download to his (ancient) Nintendo DS. He plays these clips to his friends or often just watches them himself over and over.
It takes a lot of technological skill to do what he has been doing. His capability is rising exponentially and we can see a number of good career paths for him in technology.
What we're doing with difficult child 3 - there are a number of things he especially loves - film, photography, the technology to hook it all together, computer games, computer trouble-shooting, programming. We found a course we can enrol him in next year, a part-time course which he can do at the same time that he completes his high school studies via our form of home schooling. By the time he has finished all his high school and got his final school graduation qualifications, he could already be halfway to a university degree.
You don't have to give up your dreams for your child. Not at all. But you may have to consider modifying them. difficult child 1, for example - he's really bright, we had hoped we could get him far enough aong the track into a university Science course. For a while it looked like the best place for him, career-wise, would be working in a museum curator department. The organisation, the cataloguing, the meticulous detail - it all fits. difficult child 3 said, in the TV interview, about one of the advantages of having autism, "When you look at two objects that are 99% identical, you have toruble telling them apart. But I zoom in on that 1% difference and can see all the details."
For someone like that, a job that values the ability to recognise that sort of detail is where you want to push your autistic child. Even a hobby - stamp collecting, for example. Or perhaps specialising in recognising counterfeit currency.
What you need Occupational Therapist (OT) do is observe your child, see what he is interested in, support his interests, show you value him as he is but still help him lern to adapt his behaviour to be more successful at blending in where he can.
You don't let him do exactly what he wants without challenge, but neither should you constantly try to mould him into what you feel he should be, some sort of mimic of normality. Because the best he will ever do, is mimic normality. They can get very good at it, but need to have it acknowledged that they are different and that's OK. They need to love themselves as they are and not feel angry or cheated because they are different. But they do need to find ways of not annoying other people too much, when they have to!
If your child can grow to be an adult who holds down a job he enjoys and is good at, who perhaps learns to not annoy people with noises at work, then he also needs to know it will be OK for him to come home from work to a home environment where he can deal with the stresses of his day in a more relaxed manner, knowing that at home he can make noises if he wants because at home he is understood.
Routine helps. Unconditional love helps a lot. Humour is wonderful.
You have tried, but he was younger. You already know how difficult it is to help him change, especially if he's not ready. He may still be not rady, but it is possible that what the teachers have planned, could work. If it does - great! A combination of factors would be why, if it works. But if it doesn't work - also great, because it vindicates you. And who knows? At some stage his brain will be mature enough and he may remember enough of this to help him make the changes more readily.
As long as the teachers do it with love, without judgement and with just enough pressure to keep him thinking.
Keep making your own notes on how he's going, these notes are so valuable when you look back over them. And sometimes they can help you find some answers to problems oyu may not have realised you had.
Marg
