I think my little brother has Tourette Syndrome?

I think you're asking a totally reasonable question and you're right to be concerned about this. When I was 10, there was a boy in my class who behaved in a way similar to what you describe, and the teacher did everything she could think of to discipline him, and of course it changed nothing. She went so far as to demote him by two grades, with the express purpose of shaming him into improving - and that's a big deal *especially* in the UK where the concept of "failing" a year or being held back another year in the same grade is totally unheard of - you go on to the next grade the next year no matter what. Looking back it's plainly obvious that that kid had some kind of tic disorder that he couldn't help. I feel terrible thinking about how humiliating and awful it must have been for him. It is also the case, though, that people with these disorders can, through supreme effort, hold them in for periods of time when they consider that they absolutely have to, and then when they get back to a safe space, out it all explodes. So they can have *some* voluntary control for a limited amount of time over *when* and *where* it comes out, but it HAS to come out, same as you can control your bladder and bowels for a certain length of time but you can't control yourself to the extent that you'll never have to go to the bathroom again for the rest of your life. That's what I understand it to be like for people with Tourette's and other tic disorders, though I'm not one of them and I don't personally know any. I definitely don't think you should tell him he has a disorder when you don't know for a fact that he has it, though. I am not a doctor, if I were I certainly couldn't diagnose anyone over the Internet, and you can't either. So when I say it sounds like a kind of tic disorder, that's not a diagnosis, that is my totally nonexpert opinion which is worth exactly as much as you paid for it. Having said that, I don't think your suspicion that he has Tourette's or something similar is just to be dismissed, he is your brother and if you think you see the symptoms of something serious then of course you should try to do something, and if you think it looks like what you understand to be Tourette's there' no point beating about the bush there. Just don't go blurting out to him "hey kid you have a neurological disorder which you can only control with treatment, but you won't get any because I can't take you to a doctor [I assume, since that would be his parents' decision??] and nobody else is motivated to take you to a doctor either." Here is what I would do if I were you: film him while he is [doing what you perceive to be] ticcing and then, look up Tourette's support groups in your area, call them up, and tell them what you've told us. They will hopefully be able to give you some actions to take to convince your parents to push for diagnosis, and they will know who are the best specialists to take him to, so that you really get a fully informed opinion. Good for you for trying to help your brother, and don't give up.

I just want to know whats the most appropriate way to treat a child with Tourette's. This is the wrong question. First, you don't know that he has Tourette's. Second, you are not a mental health professional who can treat a person with a severe disorder (I'm assuming you wanted to know how YOU should treat him). He definitely sounds like he has a disorder that needs to be evaluated, but as others said, you are not the parent so all you can do is implore your parents to take him for an evaluation. You could also try to get the school to put pressure on them to do that. It's great that you are concerned about your sibling and want to do whatever you can to help him.

I've had 9 year old brothers who also yelled a lot, broke things in the back yard, and repeated annoying phrases. I think you really need a professional to see him on a more regular basis if you think that he has problems that are affecting his ability to do what he needs to do at school and to behave appropriately at home. If he has Tourette's for real he wouldn't be able to just turn his behavior off at the therapist's office - the definition of tics is that they are involuntary. It's hard to tell if your expectations are appropriate for him or not. Are you also a child? (serious question)

You know, I've had, over the years, a few people mentioning to me that they, or someone close to them, has problems like these and they've reached the point where they think they need a diagnosis. And they do need a diagnosis, and even though an *accurate* diagnosis is usually difficult to get, I always urged them to follow through until they got an explanation that satisfied them. In every case, they were glad they did. In a couple of cases, it turned out that the cause was a medical condition that could have been serious if left untreated any longer - not learning disabilities at all. If these people had listened to the discouragement they got along the way, like "it doesn't matter what the label is, just be a really nice and caring person to them" or "people like them are just difficult/it's not out of the ordinary" or "diagnosis is too expensive/difficult to get anyway, and nobody's going to treat them even if they do get diagnosed, so just forget about diagnosis" then those people might be dead or seriously ill by now. In other cases, persistence led them to a treatment regime or just a level of self-knowledge that greatly improved their lives, all as a result of accurate diagnosis. Now maybe one of these days, I'll encounter someone whose diagnosis is just "that's their personality, they're just weird" and the day that happens, I'll find out whether it improves their quality of life or not. My guess is that knowing the truth is always the best thing, but we'll see. In the meantime, I have yet to encounter one person whose pursued and received an accurate diagnosis and NOT been better as a result. I do appreciate, OP, that if you get a diagnosis for your brother, and your parents don't take it seriously and don't follow advice about how to handle it, that would be bad too. But that isn't a reason not to try to get a diagnosis in the first place. If your parents react unhelpfully to the diagnosis, that'll be another problem to deal with; but one thing at a time. Full disclosure: my aunt, who is now in her seventies, was considered "mentally ineducable" as a child and was going to be put in an "asylum" as a result. My grandmother could not believe this, and she pushed and pushed until she reached the end of the line, and her final showdown was with the highest medical authority in the land. He asked her something like "what will you do if I tell you that actually, everyone has been right so far and your daughter really is mentally ineducable?" And she replied, "Well, if that's what you say, I will have to accept it, because this is the end of the line. But I'm here because I want you to take this seriously." And he did, and it turned out that my aunt's diagnosis was dyslexia, the very concept of which was virtually unheard of in 1930s/40s, impoverished, working-class Britain. Did that diagnosis matter to my aunt? You bet it did. If she'd gone into "an asylum" she probably would have died long ago and she would never have had any hope of living the life she did, which included becoming a nurse like her sister, and now serving her community as a Franciscan nun (and writing sermons regularly, albeit very slowly!). OP, you have a strong feeling your brother might have some kind of medical condition; you have a Child Neurology centre near you; so if you think investigating this is the right thing to do, go for it, even though some people don't think it's necessary. And if there's nothing diagnosable going on, it's worth knowing that too. Your brother is lucky to have a sister who cares this much about him. Good luck!

Do not tell a 9 year old you think he has Tourette's. He isn't going to have any idea what that even means and there is no sense in alarming him and making him think he has what a child would probably view as a weird and scary disease. I would think the first step would be talking with your parents about it. Do they see that he has an issue and are they interested in getting him some help?

I'm curious about the family dynamics here. You do sound unusually involved for an older sibling, but sometimes siblings are unusually involved. Is there some reason that this is your responsibility? I don't think you should come up with a diagnosis for your brother, and you certainly should n't tell him that he has a disorder when you don't know that he has it. It sounds like something is going on, but you're not in a position to figure out what it is. What you could do is carefully document all his odd behaviors and then encourage whoever is in charge (you, if you're his guardian, or your parents if they're in the picture) to try again with a different mental health professional. If he behaves normally with other people but unusually with his family, you should tell them that. Has someone talked to his teacher to find out whether he has behavioral issues at school? Being a 9-year-old with dyslexia pretty much sucks, and it's possible that he's spending all his emotional energy keeping it together at school and just needs to let go when he gets home.

Thanks a lot guys. I'm concerned about my brother because I genuinely care about him, and he even though he loves to piss me off most of the times I feel really bad for him. My aunts and cousins make him feel bad whenever he misbehaves and blame it on my parents for failing to discipline him. The thing is, I come from Dubai, and my family are not well familiar with these psychological disorders. To them a child is either normal or insane and thats it. I do talk to my brother a lot but he always ends the conversation whenever I bring up his school life or tics. His teachers tell my parents that he's very silent in class but doesnt make the effort to learn or participate in class (mainly because he doesn't know whats going on). I did find a Child Neurology center near by and I hope they would depend on our observations rather than his behavior in the center. I think I'll take videos too

Let his parents parent him? Unless you are his guardian these issues are probably best directed towards his parents. Let them decide his care. If you are his primary caregiver then you need to say so or the advice you get here really won't be relevant.

You are a great - wonderful - big sister. And you're smart enough to realize that your brother's behavior is not the same as that of every other boy his age - and that his behavior threatens his ability to manage a normal adolescence. You know there's a need for some sort of intervention involving an examination by someone whose area of expertise includes Tourette's and similar syndromes. You're right. Just because you have parents doesn't mean they're on top of everything. They may not be at all familiar with neurological disorders, may not understand them, may actually have little interest in doing so - especially if their way of handling your brother is to discipline him and ignore your recommendations that he undergo an evaluation. I wouldn't tell your brother that you have a suspicion of Tourette's because there are so many variations of that condition and other similar disorders and you really don't have the capability to determine exactly which problem he has, if any. Plus it might scare the heck out of him and he doesn't need that right now; for one thing, he probably knows there's something wrong and he's likely scared already. It will be much easier for him if you can manage to get him attention from an expert who can offer the correct diagnosis - and treatment at the same time - it will make it easier for him to deal with. Experts are easier to deal with than parents in situations like this, anyway. My sister had grand-mal epilepsy - and it was severe and uncontrollable by anything they had at the time (the 60s). She had full-blown seizures, the dramatic ones. I had something else - something which turned out to be absence seizures - maybe a hundred of them a day, but I didn't connect my "weird brain" problems with epilepsy at all - it was nothing like my sis's epilepsy. My parents wouldn't take me to a doctor because they had all they could do dealing with her - I guess (haven't completely got past this 45 years later). In those days there wasn't the overload of information from so many sources as we have today and people didn't really know much about conditions like absence seizures so I had to wait until I was 18 and then find my own doctor. When I was diagnosed and put on medication, it was a sweet, sweet blessing to know that I had something with a name, something recognizable and treatable. You're old enough that you can be involved with your brother's care from the sidelines without incurring any butt-out business - just push ahead. Stand with him and love him and do whatever you can to get him some help, but do remember that it's NOT your responsibility - the responsibility lies with your parents - so if you can't get him all fixed up right quick, know that there's only so much you can do. I really like tel3path's idea about filming his tics and behavior and asking a Tourette's group to review your material and see what they think. Document everything. In the meantime, don't punish him, just let him know firmly that breaking things - or violent behavior of any kind - is not okay. And again, if you can't control his behavior, it's up to your parents to handle it. I wish you the best and send you a pat on the back for caring so much.