When the basal ganglia dysfunctions

My oldest son has Tourette Syndrome.  He's 7 and was just diagnosed this summer.  I realized it back in May while reading some continuing education about autism.  We realized early on that our son was bright, but began noticing in 1st grade that he was having difficulty relating to his peers.  He also began having short attacks of anxiety that was bewildering to us, such as being all worked up that he'd never fall asleep if he went to bed after his bedtime.  We began noticing that he was more sensitive to loud noises than other children and that he bristled when he was touched.  He didn't seem to understand or even really have the desire to understand other people, especially other children his age.  He would get obsessive about certain topics or ideas.  For example, one day he got the idea to build a play house out of cardboard, but we didn't really have any boxes laying around.  He was restless and couldn't find anything else to do.  He kept coming back to us asking for us to find him some boxes.  Nothing that he usually enjoyed doing distracted him that day.  His dad finally found a sheet of thick poster board.  Then he settled down, cut it into pieces and used duct tape and pipe cleaners to make his house.  Then he relaxed.  I was reading the continuing education about autism, because all these symptoms seems to implicate it.  Then I read a line that said that there was a correlation between autism and Tourette syndrome and next to Tourette written in parenthesis was the explanation that Tourette Syndrome was a neuro-biological disorder that manifested itself in tics, such as throat clearing, grimacing, eye blinking, nodding, and such.  That's when it hit me.  He'd been clearing his throat obsessively for over 2 years and Tourette Syndrome had never crossed my mind.  Then I realized the neck movements he frequently made weren't from reading too many books, but were another tic.  The more I watched him in the weeks to come, the more tics I noticed.  I was still convinced that he had high functioning autism because I still thought that Tourette Syndrome was just motor and vocal tics.  He was diagnosed with Asperger's syndrome by a developmental pediatrician this summer as well.  However, it wasn't until we met with a neurologist in a Tourette clinic that I began to understand that Tourette Syndrome is so much more than tics.  It is a disorder of the basal ganglia, as is anxiety disorders, obsessive-compulsive disorder, and attention-deficit-hyperactivity disorder.  In simple terms, the basal ganglia is like the brain's brakes system.  It is the area of the brain that allows us to think thoughts and not say them, to control all our movements, to choose not to obsess over something, to focus our thoughts and sit quietly when needed, and to allow us to quite our mind when we start to feel anxious.  People with basal ganglia dysfunctions have leaky brakes.  Sometimes they can control their thoughts or movements, but sometimes they cannot.  Tourette Syndrome manifests itself in my son as periods of bewildering anxiety, obsessive tendencies, impulsivity, sensory integration issues, difficulty controlling his emotions, disinhibition, and social skill deficits.  Despite these setbacks, he reads and does math at a minimum of two grade levels above his peers (I don't actually know how advanced he is because he maxed out the assessment test).  His "giftedness", for lack of another word, compounds his difficulty in school as this is one more area where he cannot relate to his peers.  Adults that don't spend long periods of time with him or observe him around his peers with likely not notice there is anything different about my son.  So I don't think many of our friends or acquaintances understand how tiring it can be to be his parent.  Some days are more a struggle to parent him than others.  Deep inside, he's a kid that aims to please, is thoughtful, creative, funny, smart, and self-assured and I wouldn't change him for the world.  But do me a favor, please?  Don't assume my kid is misbehaving when he is having difficulty controlling his behaviors or emotions.  Imagine being in a car whose brakes only work sometimes and you are never quite sure whether or not they will stop you in time.  He's starting to realize that he doesn't always really mean to say the first thing that comes out of his mouth, but its out before he has a chance to stop it.  I'm constantly having to remind myself that I am privy to his innermost thoughts a lot of the time and I have to give him a little extra grace with what he says and does.  I hope you will too.