Hi, thank you for responding. It is pretty difficult to determine what may be the cause. Some children develop behavioral problems due to inconsistency in discipline styles and consequences such as with divorced parents who try different methods. This should be consistent to help him develop knowledge in what consequences he will suffer if his behavioral issues continue. If he is able to control these appropriately, it may simply be behavioral type, attention seeking behaviors. If not, a more thorough evaluation by a child psychiatrist would help to determine what may be going on .
Children with 'Tourette's can have co occurring disorders such as ADHD and Tourette's and these can be treated with medications, although may not be necessary. You would see symptoms of the "tics" on an almost daily basis if this is tourette's Syndrome. These symptoms will exacerbate in stressful events or with people he may not know well, or if he is tired or feeling sick. Structuring environment and activities can help relieve some of the unpredictable thought process that causes stress, and should relieve his symptoms somewhat.
Children's physical or motor type symptoms of Tourette's can be things such as barking type noises, throat clearing, sniffing, eye twitching, etc. These usually only involve one muscle group, but can become more complicated if not treated.
They also can have the behavioral type symptoms you have mentioned. Most of the time medications are not needed, but a more structured environment, to assist him in learning boundaries. Boundaries provide security and confidence in the child and he can learn to control himself within those confines.
Your daughter might want to try making a chart of certain behaviors she wants to improve. Always list the positive such as: "John will pick up his toys daily" rather than "John did not put away his toys." For each day that this is accomplished "John" will place a sticker on the chart. He will not get a sticker for the days this is not accomplished, but nothing will be said about this either. This will avoid reinforcing negative things he may do or not do. After he receives a specific amount of stickers, he receives a special reward. Work towards positive by setting goals a little small and working upward, and by allowing him to do some extra things to earn stickers he may have missed. This reinforces positive behaviors. Put this chart out so he can check his own progress as well. This idea works well with preschoolers, and helps them take responsibility for their behaviors.
I agree with you. The ADHD thing is tossed around a lot lately, and children may be medicated when they only need a little more structure. I hope this helps, let me know if you have other questions. Gina