Need Information – Concerned preschool teacher

Patient: I am a preschool teacher. I have a female student age 4 who shakes constantly when making and type of fine or gross muscle movement. I have informed her mother. Her mother seemed clueless, but did state that she noticed the shaking since infancy, and referred to it as a motor starting up. I find this odd. I strongly advised her to consult her pediatrician. The child is also very weak, lacks muscle control, her lunches are lacking nutritionally, and she often speaks of helping her Dad (who is a pest control person) apply pesticides, and of not being able to sleep because mommy or Daddy is waking her…. What do you advise??????????????????

Doctor: I do appreciate your concern regarding the health of your students. It is very difficult for me to say what could be cau sing your students movements. Hyperkinetic movements disorders in children are characterized by abnormal involuntary movement. Diagnosis of the specific condition depends primarily upon careful observation of the clinical features. Tics are the most common hyperkinetic disorder in children. Dystonia, stereotypies, choreoathetosis, tremors, and myoclonus also occur but are less common.I would advise that you speak to both the parents regarding your concerns and advise that they take the child for further evaluation to a pediatrician. However in case they do not regard the symptoms as serious, you may consult your school board or an ethics committee as to the next step. I hope this helps.