How to respond to 6yo daughter's newly developed throat-clearing tic?

April 10, 2020 8:03 PM

Around three months ago our daughter got a cold and struggled with clearing her throat and the gesture has since developed into a full-blown tic. How should we be responding or supporting her so she can eliminate this behaviour?

The sound itself is really confronting - It's basically the same sound that you would make if trying to hock a loogie if you know what I mean. She does it multiple times per hour, around twice in a row, all day. We can't seem to tie it into any specific food, drink, or situation, so my guess is that this is some sort of anxiety reaction/behaviour.

At first, we tried to offer things like lozenges and tried to show her other ways to clear her throat (like swallowing or gently coughing or blowing her nose) as well as decongestants etc., but none of it worked. We then realised that by talking about it or making a big deal about it it was probably making it worse, so we just tried our best to simply ignore it.

From my initial reading and research I understand that throat clearing can be a Tourette's syndrome or indicate other potential neuro disorders, but apart from being a generally anxious kid, there's no other symptoms or behaviours that she exhibits that indicate this wouldn't be an isolated expression at the moment.

My hope and belief is that like other strange 6yo behaviour, that this will eventually just go away on it's own, but now that we've been housebound for over a month it's really starting to grate, and we can't take her to a therapist or OT etc because of social distancing right now as well, so I'm curious if anyone else has experienced this with their kid and can offer any anecdotal evidence. How long did it last for? Is there anything else we can do? Apart from being really annoying, I can't imagine it must be pleasant for her either and we really want to help her feel good.

(On that note - I should add that even though we have been home for over four weeks, this really started around three months ago pre-coronavirus. We only realised it was a problem around eight weeks ago. The quarantine has not exacerbated things as far as we can tell - it's been a steady level all the way through.

Thank you!

posted by sxtrumpeto to Human Relations (15 answers total)

Is she on any medication? My 11yo developed a similar tic that coincided with starting an SSRI. We're still trying to figure it out.
posted by ellenaim at 8:19 PM on April 10, 2020

You may actually be able to get a telehealth visit with a speech language pathologist, or an occupational therapist who might be able to give you some tips or just advice. Might be worth googling for providers in your area and checking out their websites to see if they're taking new patients for online visits. Ideally you would talk to the provider first about how to explain/frame the interaction, and what you should do otherwise to prepare for a telehealth visit.

Also, worth checking to see if your parent friends have needed interventions for their kids speech or eating because if they liked their provider, you can make the provider extremely happy by being a word of mouth referral.

(What they're going to want to look for is usually structural or functional difficulty, which is obviously easier in person, but a qualified professional will be honest with you about whether this problem is in their wheelhouse.)
posted by bilabial at 8:23 PM on April 10, 2020 [2 favorites]

Best answer: Are you aware of PANDAS?
posted by jocelmeow at 8:23 PM on April 10, 2020 [4 favorites]

Response by poster: Nope, no medication. She's vegetarian, takes a multivitamin and fish oil every day. We have a magnesium supplement we're considering though as I saw it come up on other forums.
posted by sxtrumpeto at 8:36 PM on April 10, 2020

My son has EXACTLY this. Throat tic precipitated by a cold. I talked to pediatrician and he said this is exactly how it starts, as a legitimate physical need to clear the throat that morphs into a psychological habit, and to just ignore it. In our case, it has sort of gone away except when anxious, in which case it pops up again briefly. But the necessant several times an hour throat clearing most definitely has stopped.
posted by St. Peepsburg at 8:40 PM on April 10, 2020 [1 favorite]

So, I was your kid. The second you started describing i knew exactly what you were talking about, and I picked up the ‘tic’ at about her age as well. I can do it on demand... it’s basically a way of using suction in the back of the throat to pull up mucusy phlegm. It’s different than a spit loogie. I can still do it on demand. It’s worse when i have a cold or allergies. It’s like I can feel the phlem in the back of my throat (or think i can feel it, but there’s nothings there) and i need to bring it up but the feeling doesn’t naturally trigger the cough reflex.

The good news? I don’t do it anymore subconsciously. Less good news? I’m in my 40s and I don’t know when it stopped (most likely years/decades ago) but it definitely wasn’t while i was a kid. I also know I learned how to do it without making disgusting noises — it’s more a flexing of my throat muscles now.

I don’t have a lot of advice except to maybe encourage her to cough instead, and even ask her outright if when she does it she brings up phlem she could spit out — if there is she could probably cough it out instead. The only other thing that might be related is I had my tonsils out around that age as well, and needed tubes in my ears — in general my whole ears-nose-throat ecosystem wasn’t super great. Maybe get that aspect checked out as well if you haven’t?
posted by cgg at 8:52 PM on April 10, 2020 [2 favorites]

PANDAS is controversial but I probably had some form of it as a kid, or at least was in a similar tic (for lack of a better word?)-related situation for a brief time due to anxiety. The good news is.....it usually goes away. This is the kind of anxiety-produced behavior kids develop quickly and grow out of quickly and I doubt it's anything more serious than that. So, yeah, it probably has to do with anxiety, and it's a good idea to get a handle on that while she's still at this age. Before you telehealth a therapist, which could end up being a positive thing but is up to you and your kid, try to have a conversation with her one-on-one about anxiety and feelings, in which she has full autonomy, in an environment/atmosphere that's safe and comfortable for her. Focus less on "elimination" of behaviors and more on what she's thinking and feeling around this. Let her lead the way, and no matter what happens that could be a valuable experience for her.

But again, I doubt it's something you need to stress over too much. It's also totally possible it's just allergies.
posted by colorblock sock at 9:22 PM on April 10, 2020 [2 favorites]

Umm. I do this, as an adult, whenever I have a cold or allergies and for quite a long time after. I have quite a bit of postnasal drip that lingers after an infection, plus acid reflux that sometimes causes additional post nasal drip. Are you sure this is a "tic" and not a functional problem?
posted by PhoBWanKenobi at 9:28 PM on April 10, 2020 [14 favorites]

Strongly seconding PhoBWanKenobi. I see no evidence in your post to support the idea that this is a tic and not something like continued post-nasal drip or throat irritation.

As a child, my mother neglected all kinds of legitimate health issues of mine because she decided I was malingering. She would make me go to school even when I was *sick sick sick*. Years later, as an older teen, I had a test that revealed, huh, what do you know, I had had Espstein Barr. I was forced to go to school with fucking mono.

Assuming that your child has an annoying tic rather than a continuing physical issue seems like you are heading down a very ungood road. Please get medical care from a doctor who hasn't already pre-decided that "it's nothing" or that it is psychological.
posted by nirblegee at 1:36 AM on April 11, 2020 [3 favorites]

In addition to what folks have mentioned above, if you’re in the northern hemisphere, allergy season has just kicked up, and she may have some low-level throat junk from that.

Overall though I’d group it under “kids are weird” and not under “symptom of anxiety/OCD” without a whole other group of symptoms. It probably just feels nice and she doesn’t know it annoys you.
posted by tchemgrrl at 4:37 AM on April 11, 2020 [4 favorites]

Best answer: I take care of a fair number of people with tics and Tourette Syndrome as part of my work, and one of my professional grandfathers is the leading tics guy in North America. The sort of throat clearing that happens with a tic is better described as "ahem, I would like to get your attention" than "hock a loogie." Now, these are older teens and adults, so maybe they've learned to modify their tics into something less attention-grabbing, and as with anything, there's a spectrum of severity.

Regardless, this is 100% a telehealth question for her pediatrician, and/or telehealth referral to a pediatric neurologist and therapist. If it's all vocal, over-the-phone may suffice, but a video visit, if that's an option, would let the doc see if there are any other physical signs to be aware of.

If this is a tic, please know there are effective treatments for tics and TS, both medication and non-, pretty much all of which can be done via telemedicine. If it's something functional, there are treatments for that too (some of which are similar to the treatment for tics/TS). Just see her doctor and go from there.
posted by basalganglia at 5:48 AM on April 11, 2020 [4 favorites]

Have you tried an antihistamine? I did this as a kid because my undiagnosed oral allergy syndrome made my throat and Eustachian tubes itchy all the godddamn time. Seasonal allergies do this too sometimes, but foods that trigger my OAS (and there are a LOT of them) make me want to claw my brains out through my ears. The loogie noise was essentially scratching an itch in the back of my throat. My parents hated it but they also kept making me drink orange juice. Eventually I traded it in for a serious Q-tip addiction, and now as an adult I finally sorta have my allergies under control.
posted by yeahlikethat at 5:36 PM on April 11, 2020

Best answer: This sounds a lot like something that affected my pre school aged daughter. She had a cold and then after it passed the cough stuck around and became a throat clearing tic. Her older brother had suffered from OCD and tics in his childhood so we were familiar with some of the presentation. Took her to her pediatrician and she was diagnosed with “ habit cough”. That was the actual name of the illness. I found a surprising amount of information online including quite a few papers rather than just anecdotal stories. The consensus was to ignore it, never comment on it, etc and it would go away on its own. In my daughters case, she caught another cold a couple months later, which provoked a legitimate cough, and when that cough/ cold went away, the tic did too.

A year or two later, the whole process repeated itself, only this time she caught the second cold much sooner so she only manifested the tic or habit cough ( sounded like you described - hocking or clearing throat) for a much shorter time.
posted by Rapunzel1111 at 11:00 PM on April 11, 2020

My kid too. His doctor also diagnosed it as post nasal drip turned into habit. She prescribed a nasal spray, mostly for psychological reasons, which helped a bit. It’s not as bad a few years later, but it’s still annoying.
posted by Valancy Rachel at 8:16 AM on April 12, 2020

This happened with my son and his doctor prescribed a short course of allergy meds. It cleared up during the course of treatment.
posted by poppunkcat at 8:32 AM on April 15, 2020