Class 7 - Tourette's + OCD

Question 1

What is tourette’s syndrome?

Answer 1

• A complex TIC disorder characterized by multiform, involuntary motor and vocal tics

Question 2

What is the etiology of Tourette’s? (3)

Answer 2

• chronic
• Genetically transferred
• Neurological or neurochemical

Question 3

How is Tourette’s diagnosed? (3)

Answer 3

• no diagnostic test
• Criteria include the presence of more than 2 motor tics and 1 or more “phonic” tics
  ex. limb jerking, frowning, abdominal tensing, lip pouting, sucking sounds, barking, coughing or grunting

Question 4

What is the nurse’s role in caring for children with tourette’s?

Answer 4

• document parents’ description of child’s behaviour, including types of tic(s), duration in months, times per fay demonstrated, as well as other symptoms

Question 5

With tourette’s, what does automatic suppression mean?

Answer 5

When the child goes to the doctor, the behaviour is not expressed
- frustrating for parents, so they should instead take a video

Question 6

What are the next steps in care for early children with tourette’s? (4, 6)

Answer 6

1. Family support
   - normal intelligence, tics are worse during puberty and lessen over time
2. Chronic but not degenerative
3. referrals to neuro, OT, SLP
4. Treatments - meds, cognitive behavioural therapy, psychotherapy

treat symptoms instead of disease

Question 7

What percentage of children are diagnosed with OCD? (2)

Answer 7

• 50% diagnosed in childhood-adolescence
  -2/3 children who have TS also have OCD

Question 8

What is obsessive compulsive disorder?

Answer 8

• includes “rituals” or “compulsions”
  ex. step back and forth three times before crossing a doorway
  obsessions - unwanted, intrusive thoughts

Question 9

What are the characteristics of OCD? (6)

Answer 9

• Checking
• counting
• handwashing
• symmetry or exactness
• “looping” or “being stuck” ( cannot stop thinking about a particular thought)
• can make children appear defensive, negative or “needy” (asking repetitively)

Question 10

Why can families make OCD for a child worse?

Answer 10

• they might have high levels of anxiety, which can create a vicious cycle

Question 11

The nurse’s role is to perform hx and physical on the child with OCD. What does this include? (3)

Answer 11

1. Parent account of concerning behaviour
2. Any other co-morbidities including TS, ASD or MHD in families and child
3. Developmental delays observable or noted by caregivers or teachers