Need to Know: Pediatric Healthsource

Staff Writer
Columbus Parent

My child has been blinking a lot lately. His pediatrician says these are tics. What are tics and does this mean he could have Tourette syndrome?

Tics are sudden, involuntary, repetitive movements (motor tics) or sounds (vocal tics). The most common motor tics are frequent eye blinking and head shaking. Common vocal tics include humming, grunting or saying actual words.

Three to six million Americans experience tics regularly. Tics are more common in children, where one in four have a tic during the school years. And tics are five times more common in boys than girls.

Nine out of ten children who have tics will experience significant improvements in the symptoms by the time they reach adulthood.

Tics are the most frequent though not the only symptom of Tourette syndrome. For a patient to be diagnosed as having Tourette syndrome, they have to have motor and vocal tics for at least one year, ADD or ADHD and obsessive-compulsive behaviors.

Symptoms wax and wane over time, and Tourette syndrome is not a harbinger of serious neurological disease. Unless symptoms are severe, physicians at Nationwide Children's Hospital usually do not treat patients with tics or Tourette syndrome. Because tics are outside of a child's control, children should not be disciplined if he or she exhibits tics.

For more information on tics and Tourette syndrome as they relate to your son, consult your primary care physician. Nationwide Children's Hospital offers treatment for severe cases, and you can also find more information from the Tourette Syndrome Association of America at

My 8-year-old really wants to do trail riding on his bike, but I'm concerned about his safety. Is he old enough and, if he is, what kind of equipment does he need?

Cycling is a great form of exercise, but not without some risks.A correctly fitted helmet and bicycle are necessary to reduce the risk of serious injury.

There is really no recommended age to start trail riding, but as a parent you must decide if they have the necessary skills to start riding "off-road." Your child should first master some basic cycling skills such as braking, being able to avoid or steer around objects, standing up when riding over bumps and quick stops.A local park with a grass field is a great place to practice.

Pick a trail or path that is suitable for a young beginner. These are typically wide, gently rolling and without any steep hills, high bridges or dangerous obstacles.I recommend an adult lead on the trail, and remember to always wear your helmet as well!If you come upon a section of the trail that is a bit challenging, hop off the bike, walk the section together and discuss your strategy on what is the best path or "line" to take.

There are many organizations in Ohio that provide recreational riding opportunities, so do your homework and find one that is in line with your son's skills and experience. Good luck and safe riding!

The nurse at my daughter's school sent home a note saying that my daughter's BMI (body-mass index) indicates she's overweight for her age and size. I'm at a total loss to know what to do about this because I feel like we eat pretty healthy as a family. Do you have any recommendations?

Take a look at what your daughter is eating and drinking daily in relation to her physical activity.An imbalance between energy in and energy out can cause weight gain, even if she is eating generally healthy foods.

Be sure your daughter eats breakfast, as it helps to jump-start metabolism. Make sure portion sizes are age-appropriate because large portions lead to extra calories and weight gain. Have your daughter cut back on sugary drinks (including juice) and instead drink more water, low-fat milk or other sugar-free options. Encourage her to eat fruits and vegetables daily in a rainbow of colors. Eat dinner as a family and turn off the TV and computer during snack and meal times.

Your daughter should get 60 minutes of moderate to vigorous physical activity every day.Try to limit screen time (TV, computer, etc.) to two hours a day and have her get up and move during commercial breaks or every 30 minutes.

Your daughter's primary care provider will be able to provide more insight and recommendations specific to your daughter's health, as well as screen for more serious medical concerns.

The Center for Healthy Weight and Nutrition at Nationwide Children's Hospital offers comprehensive programs for the prevention and treatment of overweight children.

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Tip of the Month

Before heading outside to enjoy the warmer, longer days, remember that many kids may need some time to get their "outdoor radar" back up. In fact, says Dr. Leslie K. Mihalov, Division Chief of Emergency Medicine at Nationwide Children's Hospital, many emergency departments and urgent cares see an increase in injuries related to common outdoor activities, especially in the beginning of May. Follow these tips to keep your kids safe:

  • Supervise. Children should never be left unattended.
  • Teach. Remind your child how to ride a bike, play with his/her toys, etc.
  • Protect. Be sure kids wear necessary protective equipment (helmet, elbow/knee pads, etc.).
  • Review basic first aid.
  • Establish rules and "out-of-bounds" zones. Many children are injured when they run out into streets and are hit by passing cars.
  • Wear sunscreen.
  • Know where the closest emergency department or urgent care facility is.