By Samantha Sherwood, PhD, psychology postdoctoral fellow at CHOC
Although people of all ages can experience tics, they are most common in children. In fact, according to the Tourette Association of America, as many as one in five school-age children may exhibit tics at some point in their lives.
What are tics?
A tic is a sudden, repetitive, involuntary movement or sound. Motor tics can include movements such as eye blinking, shoulder shrugging, and twisting. Vocal tics can include sounds such as throat clearing, coughing, sniffing, and grunting. Tics can occur one at a time (simple tics) or in combination with other tics (complex tics), such as shoulder shrugging while also engaging in throat clearing. For some children, tics may go away on their own.
However, in some cases tics can continue, become more complicated and begin to impact a child’s life. In these cases, a child may be diagnosed with a tic disorder. A child may receive a Tourette’s disorder diagnosis if they experience multiple motor, and one or more vocal tics for a year or longer.
Children who experience either vocal or motor tics (but not both) for a year or longer may be diagnosed with a persistent (chronic) motor or vocal tic disorder. Children who have had motor and/or vocal tics for less than one year may receive a diagnosis of provisional tic disorder.
A single cause of tics has not been found. Rather, tics can result from a combination of neurobiological and genetic factors. It is important to mention that tics are not the result of a person’s behavior or personality, and they cannot be controlled through willpower.
What should I do if I think my child has tics?
Parents who think their child may have tics should talk to their pediatrician. The pediatrician can help diagnose your child and provide information about treatment options or can refer you to a provider who specializes in tic disorders.
Tics can also develop alongside other psychological conditions, such as obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), anxiety and depression. If you are worried your child is experiencing one of these conditions, you should talk to your pediatrician to determine if further evaluation and treatment may be helpful.
How can I help my child manage their tics?
- Create a supportive and accepting environment at home. This includes acknowledging that tics are involuntary and not a result of your child’s behavior.
- Have open and honest conversations with your child about their tics. Let them know that you love and support them and that the tics are not their fault. Encourage your child to share their feelings and experiences with you. Listening and providing empathy and validation can help your child feel more comfortable and less anxious.
- Encourage your child to engage in activities they enjoy, such as sports or hobbies, which can help reduce stress and distract from the tics.
- Some children try to control or “hold in” their tics at school. This takes a lot of energy and can become tiring. Children may have an initial increase in tics when they get home from school and are no longer trying to control the tics. It can be helpful to let your child tic freely when they get home and to help them use stress management and relaxation exercises to decompress.
- Work with your child’s school to create a supportive environment. This may involve educating teachers and classmates about tics and creating a plan for how to manage tics in the classroom.
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Frequently asked questions about tics and tic disorders
What treatments are available for tics?
Treatment options for tics and tic disorders vary depending on symptom severity. In some cases, tics may go away on their own and no treatment is needed.
In other cases, medication or psychotherapy may be recommended to help manage the tics. Behavioral therapies for tics that have been shown to help with symptom management include habit reversal therapy, exposure and response prevention, and comprehensive behavioral intervention for tics (CBIT).
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How long will my child have tics?
For most children, tics usually begin between the ages of 5 to 10 and will change over time. It is common for tics to worsen during the pre-teen years (around ages 10 to 12), and then decrease between the teenage years and young adulthood. It is also common for tics to become more severe when a child experiences increased stress, fatigue, issues with sleep, anxiety or mood difficulties.
Can social media cause tics or make them worse?
There is currently little research exploring the links between social media and tics. However, it is thought that tics are the result of a combination of genetic and neurobiological factors and are likely not caused by a child’s environment.
However, for some children, social media can be a source of stress and anxiety which can impact the frequency and severity of the tics. Parents should consider monitoring their child’s social media use and consider decreasing the amount of time spent on social media if it seems to be causing distress.
Parents may find the following resources helpful to learn more about tics and tic disorders:
- Tourette Association of America (TAA): www.tourette.org
- National Institutes of Health (NIH): www.ninds.nih.gov/health-information/disorders/tourette-syndrome
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The mental health team at CHOC curated the following resources on mental health topics common to kids and teens, such as depression, anxiety, suicide prevention and more.
