What is it?

Tourette syndrome is a neurodevelopmental condition characterized by uncontrolled, brief repetitive muscle movements and vocalizations called tics.

What are the symptoms of Tourette syndrome?

The symptoms typically begin at the age of 5. Two types of tics are associated with Tourette syndrome:

1. Motor tics:  sudden, uncontrollable muscle movements such as eye blinking, nose twitching, grimacing, head jerking, clapping, shoulder shrugging or arm/hand movements
2. Vocal tics: throat clearing, coughing, whistling, squeaking, sniffing, humming or repeating sounds or phrases

When a child is under stress, the tics can become more severe, frequent, or extended. The type of tic may also change.

Children who have tics or Tourette may also be diagnosed with anxiety, attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder.

What can be done?

Cognitive behavioural therapy (CBT): CBT is a type of behavioural therapy that teaches a person to recognize behaviour and helps them change how they behave. It can help children with tics learn to identify situations that cause or exacerbate tics and find ways to change them.

Medications are available that can help suppress tics.

What makes some children more vulnerable to Tourette syndrome?

Tourette syndrome is a genetic disorder that happens during fetal development. Environmental factors may contribute to or modulate the severity of symptoms, especially during childhood.

Where can I access support?

Caregivers should always share behavioural observations such as tics with the child’s family doctor or pediatrician. They can further evaluate to determine if the symptom is a tic and if it is caused by a medical condition, medication or drug, or occurring on their own. Tourette syndrome can be diagnosed by family doctors, pediatricians, neurologists, psychiatrists, and psychologists.

Talk to the child’s guardianship worker and share your behavioural observations. Tell them if the tics are causing significant distress, impairment or if you think it is related to other mental health concerns. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

What is it? 

Self-harm is the act of physically hurting oneself without the intent of committing suicide. It is a sign of neurochemical imbalance in the brain and emotional distress, signalling that a child has a lack of healthy emotional regulation skills. Children typically engage in self-harming behaviour to cope with big feelings and/or to express their pain.

What are the signs of self-harm in children? 

Self-harm is not a diagnosis in and of itself but children who engage in self-harm are most often diagnosed with neurodevelopmental challenges such as mood disorders, eating disorders and behavioural disorders.  Some signs of self-harm in children under the age of 6 include hitting their head against the wall, severely biting their skin or cutting the skin with sharp tools.

When is it time to seek professional help? 

You need to seek professional help if the child is injuring themselves and showing signs of physical illness that is affecting their sleep and eating habits as well as their school and family life. If you’ve tried to discourage the behaviour using different strategies and nothing has changed or it’s gotten worse.

What makes some children more vulnerable to self-harming thoughts and behaviours? 

Risk factors for self-harming behaviour include: 

• Trauma, adverse childhood experiences and toxic stress
•  Co-occurring mental health disorders
• Family history of mental health challenges and brain-based disorders 
• Witnessing someone exhibiting the same self-harming behaviour

What can be done? 

Cognitive behavioural therapy (CBT) is a type of behavioural therapy that teaches a person to recognize behaviour and helps them change how they behave. 

Dialectical behavioural therapy (DBT) is a type of therapy that teaches children how to regulate their emotions and respond to emotional distress through skills training.

Interpersonal therapy (IPT) is a brief treatment that focuses on how interpersonal factors affect a child’s emotional state.

Family-based therapy focuses on helping the family act in more positive and supportive ways through education.

Where can I access support?

In an emergency, call 911 or go to the nearest emergency care facility. 

If not an immediate emergency, call 811 to speak with a registered nurse. 

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage. 

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.

What is it?

Post Traumatic Stress Disorder (PTSD) is a disorder that can develop after experiencing or witnessing an intense event. Trauma occurs when a stressful event overwhelms the child’s natural ability to cope. These events cause a “fight, flight, or freeze” response, resulting in changes in the body—such as an increase in heart rate—as well as changes in how the brain perceives and responds to the world. 

Examples of traumatic events include: 

• Psychological, physical or sexual abuse
• Neglect
• Family or community violence
• Serious accidents or life-threatening illness 
• Natural disasters 
•  Loss or separation from a loved one 
• Forced displacement or war experiences 
• Serious and untreated parental mental illness 
• Discrimination
• Persistent extreme poverty

What are the symptoms of PTSD?

Symptoms of PTSD in young children may include:

• reliving or avoiding reminders of the traumatic event 
• feeling alienated 
• delays in reaching physical, language or other developmental milestones
• hypervigilance
• irritability or fussiness
• being difficult to calm
• frequent tantrums
• clingy behaviour
• difficulty paying attention

Learn about the symptoms and strategies for PTSD in children and youth in this video:

When is it time to seek professional help? 

It may be time to seek professional help if the traumatic stress reaction is so intense that it affects the child’s ability to function at school or home and if the symptoms become worse over time.

What can be done? 

Trauma-focused cognitive-behavioural therapy (TF-CBT) is an evidence-based treatment approach for children with PTSD. TF-CBT provides children, parents and caregivers with stress management skills before a direct discussion and processing traumatic experiences. It typically focuses on enhancing safety, psychoeducation and parenting skills, relaxation skills, affective regulation skills, and cognitive coping skills.

Eye movement desensitization and reprocessing (EMDR) is a psychotherapy treatment that uses eye movements to reduce negative physical and mental responses to traumatic memories. 

Play therapy helps children build coping skills, enhance their capacity for self-regulation, and promote positive self-esteem. Play therapists structure activities to target emotions, cognitions, and behaviours rooted in trauma.  

Medications such as antidepressant and anti-anxiety medications (e.g. Selective serotonin reuptake inhibitors or SSRIs) can help some children deal with symptoms of PTSD as well as other brain-based disorders that contribute to the severity of PTSD symptoms such as depression, anxiety, and behavioural disorders.

What makes some children more vulnerable to PTSD? 

Younger children are more vulnerable to PTSD because they have not fully developed cognitive and emotional skills to process a traumatic event. Even infants and toddlers who are too young to remember or talk about the stressful event retain lasting memories of traumatic events that can affect their well-being into adulthood.

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage. 

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges. 

What is it? 

Obsessive-Compulsive Disorder (OCD) is a chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviours (compulsions) that they feel the urge to repeat over and over.

What are the symptoms of OCD?

Children with OCD ­have obsessions which are unwanted thoughts that make them worry and become very anxious. To control these anxious thoughts, they develop rules for themselves which can also be described as compulsions. Children can have obsessions, compulsions or both. 

Common obsessions may involve:

• Excessive worrying about germs or dirt 
• Extreme fears about bad things happening like getting sick or dying
• Extreme fears about doing something wrong
• Excessive attention to detail
• Disturbing and unwanted thoughts about violence or self-harm

Common compulsions may involve:

• Excessive checking and rechecking (e.g. checking to make sure that their snack is in their lunchbox) 
• Excessive washing and/or cleaning
• Hoarding
• Repeating actions like counting and recounting a lot
• Preoccupation with organization, symmetry, or accuracy
• Mental compulsions (e.g. excessive reviewing)
• Repeating sounds or words said by oneself or by others
• Excessive reassurance seeking

When is it time to seek professional help? 

OCD usually begins in children before the age of 10. It may be time to seek professional help when obsessions and compulsions become more intense and frequent, affecting the day-to-day functioning of the child.

What can be done? 

There are two main treatments that can help manage and reduce the symptoms of children with OCD. These treatments may also be used with other therapies or medications when concurrent neurodevelopmental challenges contribute to OCD. 

Exposure and Response Prevention (ERP)

ERP is a type of Cognitive Behavioural Therapy (CBT). It helps children with OCD gradually face their fears and worries without turning to their usual compulsive behaviours. The first step in ERP is to help children try to understand OCD using metaphors, age-appropriate resources and play therapy.  

Serotonin Reuptake Inhibitors (SRIs)

SRIs are a type of medication that helps to reduce the severity of OCD symptoms by altering the balance of chemicals in the child’s brain. It is recommended that SRIs be used along with ERP when a child has severe symptoms.

What makes some children more vulnerable to OCD? 

Genetic factors: family history of mental health challenges and brain-based disorders especially if the child has a first-degree relationship with a family member with OCD (e.g. parent, child or sibling). The risk is higher if the first-degree relative developed OCD as a child or teen.

Environmental factors such as adverse childhood experiences or toxic stress during childhood

Brain structure and functioning: Both genetic and environmental risk factors can alter brain chemistry and development. Scientists believe that the brains of children with bipolar disorder grow and develop differently than those of other children.

Where can I access support?

Talk to the child’s family doctor or pediatrician to help identify if the child’s behaviour is normal for their developmental stage.  

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get an assessment through your local Child and Youth Mental Health team. Your local CYMH office offers a range of free and voluntary mental health services and supports for children from 0-18 years of age and their families. These services include assessments, therapy and treatment, education and referrals to specialized programs and resources. There are 100 intake clinics for children, youth and their families at convenient locations throughout BC. 

You can also contact a private psychologist or counsellor through the BC Association of Clinical Counsellors or the BC Psychological Association. You can use website filters to search for a counsellor in your community that specializes in certain mental health challenges.

What is it?

 Fetal Alcohol Spectrum Disorder (FASD) is used as a diagnostic term to describe the significant impacts that can occur to individuals prenatally exposed to alcohol. FASD’s effects may include physical, mental, behavioural, and/or learning disabilities with lifelong implications. 

Learn about FASD in this video:

What are the symptoms of FASD?

FASD is a lifelong condition but the symptoms may change as the child gets older.

Newborns with FASD may:

• have low birth weights and small heads. They may not grow or gain weight as well as other children
• have slight differences in their faces, such as small eyes, and a thin or flat upper lip
•  be fussy and find it difficult to settle
• have problems sleeping

Babies exposed to large amounts of alcohol before birth may go through withdrawal. Withdrawal often starts before babies leave the hospital.

Symptoms of withdrawal include:

• extreme fussiness,
•  tremors or shaking,
• feeding problems, and diarrhea
• problems with their heart rate, breathing or digestion

Toddlers with FASD may be: 

•  hyperactive,
• unable to follow simple instructions,
• too cheerful and friendly, even to strangers, and
• delayed in their development

What can be done? 

Children with FASD can benefit from:

• early intervention services
• mental health support
• educational supports
• speech and language therapy
• occupational therapy
• physical therapy 
• parent/caregiver training

Medication

There is no medication for the treatment of FASD itself. However, some medications can help with the related challenges that accompany FASD, such as ADHD, depression, and anxiety.

What makes some children more vulnerable to FASD? 

FASD is not inherited. To prevent FASD, a woman should avoid drinking alcohol if she is pregnant or might be pregnant. This is because a woman could get pregnant and not know for up to 4 to 6 weeks. There is no safe amount of alcohol during pregnancy or when trying to get pregnant.

Where can I access support?

Talk to the child’s doctor about getting an assessment. If FASD is suspected, they may refer the child to the Complex Developmental Behavioural Conditions (CDBC) network in your Health Region. They may also refer you to a pediatrician or psychiatrist to rule out other possible medical causes for the difficulties and behaviours that concern you.

Talk to the child’s guardianship worker and share your behavioural observations. Explore what options are available for assessment so their diagnosis and treatment plan can be included in their Care Plan. The guardianship worker will help make appropriate referrals for specialized supports and services.

Get support from an FASD key worker. In BC, there is a free Key Worker and Parent Support Program that provides emotional and practical support for families of children with FASD, even before an assessment. They also refer families to resources like training and support groups. There are FASD key workers located in each Health Region across BC. You can find an FASD key worker or support in your community here.