Kids MD - Facial Tic (ER Story)

Emily Halevy | CWK Network

"Advice to parents when children have these tics is really to try to ignore them, don't call the child's attention to them very often, don't talk about them when he's not having them, because again that might make him anxious about it and cause him to think about it and make it even worse."
- Dr. Kathleen Nelson, professor of pediatrics . -

Roy Gilchrist is six-years-old and something is wrong with his eyes. "Has he been complaining that his eyes hurt?" asks Dr. Kathleen Nelson. "No" replies Roy's mom. "Has he been complaining that he can't see very well?" asks the doctor. "No" his mom says again.

His mom noticed he constantly blinking. She brought him to the ER for an examination and as Dr. Nelson discovered, "he could see very well at both close distance and far away. We looked at the back of his eyes, and it looked fine, and the more I watched him, the more it was clear to me that this was just what we call a tic."

A tic, or repetitive muscle twitch often brought on by stress. "It's a very common problem…it can be shoulder shrugging, facial grimacing, wrinkling of the forehead, or very commonly eye blinking," the doctor explains to Roy's mom. "They usually go away on their own, but from everything I can see, it doesn't look like anything serious, so if he should develop anymore bad repetitive habits, I would say you should discuss it with your pediatrician."

Experts say they should go away within a year and the best way to deal with them "is really to try to ignore them, because again that might make him anxious about it and cause him to think about it and make it even worse."

By Larry Eldridge
CWK Network, Inc.
Many parents may not be aware that their children are under a great amount of stress, and your son or daughter may not always be apt to open up about it. Be on the lookout for any of the following behaviors in your child, and know that it may be because of his/her stress level.

Low self-esteem
Little energy
Short attention span
Often sleepy
Extremely hyperactive
Often depressed
Often misbehaves
Angers easily
Fights frequently
Easily frustrated
Says bad things about self
Refuses to do what he or she is told
Walks unsteadily
Makes strange voices, grunts, growls, snorts, etc.
Cries easily
Detached and unresponsive
Change in eating habits
Mood swings
Increased defiance/rejection of authority
Change in appearance and personal hygiene
Change in personality
Abusive to siblings
Grades fall
Talks back

By Larry Eldridge
CWK Network, Inc.
Stress is not limited to adults. Growing up is a very stressful thing, and often times stress affects children more than adults because they have not learned how to properly deal with it and control it. Parents can play a big role in helping their children learn to manage stress, and experts have developed the following suggestions as to how:

Be aware of protective factors. Why is it that some children seem to handle stress well, while other children do not? Research indicates that there are numerous differences between children who do and do not handle stress effectively. Children who manage stress well tend to have good self-esteem, a sense of humor, a perception of control over their lives, a consistent family structure (rules/limits), a cohesive family, open communication in the family, a warm, supporting relationship with their parents, good relationships with friends and teachers, a religious affiliation, and receive recognition for their achievements.
Help your children develop an awareness of the signs of stress. Different children exhibit different symptoms of stress. These symptoms often depend on children's ages, personality and level of development. However, there are many clues that children's bodies provide that indicate when children may be under too much stress. Such clues can include facial tics, a tight throat, sweaty palms, headaches, fatigue, nausea, diarrhea, uneasiness, indigestion, depression, restlessness, frustration and a change in sleeping patterns. Other possible symptoms include withdrawal, irritability, aggression, excessive daydreaming, excessive sensitivity, changes in eating habits and general changes in behavior. Parents and children who learn how to recognize these stress signs have taken the first step to combating stress.
Prepare your children for potentially stressful situations. Parents should take time to prepare their children for potentially stressful situations they might face by rehearsing possible scenarios. For example, if a child is feeling stressed because of a conflict with a friend in school, parents should encourage the child to practice (with him or her) a conversation with this friend to attempt to resolve the conflict.
Avoid overprotecting your children. It is sometimes hard for parents to watch their children deal with stressful situations, since their first instinct is often to protect them from the stresses of life. However, stress is unavoidable in life. Parents will be doing their children a disservice if they always try to protect them from stress. Children learn how to cope with stress only by experiencing it.
Try to build your children's self-esteem. Parents should help their children gain confidence in handling problems by giving them responsibilities and letting them make decisions from an early age. Parents should also help their children develop interests in which they can succeed. Parents should offer their children a lot of encouragement and praise.
Provide support and reassurance. Parents should be available to their children when they are experiencing stress. They should provide lots of hugs, pats on the back and kisses to let their children know that they are there for them. When their children are experiencing stress, parents should let them know they understand that they are having a difficult time. Having a warm and supportive relationship with a parent is one of the single best predictors of how well children cope with stressful situations during childhood.
Provide an environment with open communication. Parents should be available to listen when their children need to talk. They should ask open-ended questions (e.g., questions that can't be answered with just a "yes" or "no") if their children need help discussing the subject. Examples of open-ended questions include "What do you think about ...?" and "How does ... make you feel?" One of the benefits of talking about stressors is that discussing them brings about increased awareness. Also, parents should be willing to share some of their own stresses and feelings to let their children know (without worrying them) that their feelings are normal.
Make sure your children get enough sleep and/or rest. Children who do not get enough sleep will not have the energy required to combat life's stresses. Parents should make sure their children get enough sleep every night. A regular bedtime should be maintained. Getting enough rest is critical to children's mental and physical health.
Model appropriate coping skills. Children learn by watching their parents. If children see their parents using appropriate coping skills when they are under stress, they will be more likely to use appropriate skills when they experience stress, too. Parents should try to demonstrate that stress is normal and can be handled in a calm and effective manner. Parents should try to be optimists who view a stressor as a challenge rather than a catastrophe.
Have your children learn relaxation skills. Relaxation skills can help children release tension caused by stress. There are various specific relaxation techniques that professionals can teach children. Some techniques involve having children use their imagination to recall or develop positive and relaxing images (e.g., playing outside, being at the beach). Other relaxation techniques involve teaching children to systematically tense and relax various muscle groups. These relaxation techniques must be practiced on a daily basis to be most effective. What relaxation technique is chosen is usually not critical. What is important is that it is comfortable for children, that it works and that they stick to it. Parents who think their children might benefit from training in these relaxation techniques should ask their children's healthcare provider for a referral to a professional who is qualified to provide this training.
Teach your children how to handle criticism. All of us are criticized at one time or another. Increased stress can result when a person has difficulty accepting criticism. Children are often exposed to criticism at an early age. This criticism can take the form of peer teasing or constructive feedback from teachers and parents. Parents should try to teach children how to handle criticism from an early age. Children should be taught that no one is perfect and that we all make mistakes from which we can learn. Parents can use role-playing to teach children how to handle teasing and unfair criticism.
Provide proper nutrition. Proper nutrition is a very important part of combating stress, especially for children. The best diet to help children handle stress is one that has few additives, has the right amount of calories to maintain normal development, and is balanced. Children with poor diets (unbalanced, high in junk foods) should be encouraged to decrease their intake of foods high in fats, cholesterol, salt, and refined or processed sugars. Children's consumption of junk foods and caffeine should be limited. They should be encouraged to increase their intake of fruits, vegetables and whole grains. Children should maintain a healthy body weight. Parents whose children are overweight should consult their children's health care provider for recommendations regarding weight loss.
Provide a consistent routine or schedule. Children need predictability in their lives. A consistent schedule of meal times, homework time, bedtime, etc., allows children to know what to expect in their lives. This in turn, helps them feel secure and reduces stress.
Help your children reframe stressful situations. Children have control over the way things affect them. Children's perceptions of a stressful situation help determine how stressful it becomes. Parents should take steps to help their children develop alternative interpretations of the things that cause them stress. For example, if a child is experiencing stress because he thinks his teacher doesn't like him because she didn't say hello to him at the beginning of class, a parent can ask the child to try to come up with other explanations for his teacher's behavior. A parent might suggest that perhaps the teacher was busy thinking about something else and therefore forgot to say hello. This is an example of reframing a stressful situation. The key is for parents to help their children come up with alternative and more positive interpretations of stressful situations. Of course, it's not possible to reframe every stressful situation. There will be times when the stress children perceive in a situation is quite real. At these times, it is necessary for parents to help their children cope with the situation in other ways.
Help your children alter their beliefs about stressful situations. Children's beliefs have a major impact on their behavior – how they behave, whom they choose for friends, what subjects they study in school, etc. Children's beliefs also determine, to a certain extent, what will and will not be stressful for them. Sometimes certain beliefs lead to increased stress. In these instances it's a good idea for parents to make an attempt to help their children change these specific beliefs. For example, children who believe that they must get an A+ on every homework assignment or else they will be a failure will experience stress whenever they don't get an A+. In such a case, it would reduce stress significantly if parents helped their children alter this belief to one that allows for imperfection.
Encourage your children to participate in enjoyable activities. When children are experiencing excessive stress, parents should encourage them to take part in activities they enjoy (e.g., sports, listening to music, playing a game, art, reading). In order to be stress reducing, the activity needs to be enjoyable and should allow them to take their mind off their troubles.
Encourage your children to get regular exercise. Regular exercise is an excellent way to help manage stress. First of all, it helps work out tension that can build up in children's bodies. Secondly, exercise provides for physical fitness, which allows children's bodies to be more efficient at combating stress. Finally, exercise helps clear the mind, making it easier to relax. Exercise, however, will not be effective in combating stress unless it is done regularly. The specific activity that is chosen is not important. What is important is that children find it enjoyable. Also, children will be much more likely to exercise on a regular basis if their parents exercise regularly and are physically fit.
Help your children develop good problem-solving skills. When children face a significant problem parents should take the opportunity to teach effective problem-solving strategies. They should start by helping their children clearly define the exact problem. Then parents should have their children generate a list of possible solutions (not evaluating them at this stage). Once a list of solutions is generated, parents should have their children go through each possibility and evaluate its potential for success. Once all the solutions have been evaluated parents should encourage their children to choose what appears to be the best solution. Parents should encourage and praise their children for the use of effective problem-solving strategies.
Help your children learn how to manage time. Parents should help their children learn how to prioritize activities. If children have a tendency to take on too much responsibility, parents should help them learn to place limits on their commitments. Parents should help teach their children how to schedule their time (e.g., specific time for homework) so they can get things done.
Teach your children to be assertive . Children who are afraid to stand up for themselves tend to have difficulty handling stressful situations. Parents should teach their children to stand up for themselves. Parents can role-play problem situations and teach their children how to stand up for themselves in an appropriate, non-aggressive manner.
Develop your children's sense of humor. Children who can see the humorous side of things and can laugh at themselves tend to handle stressful situations more effectively. Parents should teach their children not to take things too seriously. Laughter is good medicine!
Get professional help if your children have continued difficulty coping with stress. There are times when professional help is necessary to help children deal with excessive stress. Consult with your children's health care provider for assistance and recommendations.

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