Tics are sudden, repetitive movements or sounds that some people make, seemingly without realizing it. Tics are actually more common than you might think. Many people have tics that go away in less than a year or mild tics that don't interfere with their lives.
But in some kids, tics are more severe or long lasting. If a child has tics for more than a year, it is called a chronic tic disorder. In some cases, these tics can be part of a condition called Tourette Syndrome.
The tics associated with Tourette Syndrome tend to get milder or go away entirely as kids grow into adulthood. Until that happens though, there are a lot of steps that you can take to help you and your child cope with the condition.
What Is Tourette Syndrome?
Tourette syndrome (TS) is named for the French doctor Georges Gilles de la Tourette, who first described the condition in 1885. It is thought that in most cases it is a genetic condition that's inherited, or passed on from parent to child. Doctors and scientists don't know the exact cause of TS, but some research suggests that it occurs when there are changes in the brain and problems with how nerve cells communicate. A disturbance in the balance of neurotransmitters — chemicals in the brain that carry nerve signals from cell to cell — may play a role in TS. Tourette syndrome is not contagious.
Symptoms of Tourette syndrome usually emerge in childhood or in the teenage years. TS isn't common — only about 3 in every 1,000 people has the condition. Boys are more likely to have it.
To be diagnosed with Tourette syndrome, a person must have several different types of tics — specifically, multiple motor tics and at least one vocal tic.
Signs and Symptoms
The main symptoms of TS are motor tics (sudden, apparently uncontrollable movements like exaggerated blinking of the eyes) or vocal tics (such as when a person repeatedly clears his or her throat).
At certain times, like when a child is under stress, the tics can become more severe, more frequent, or longer, or the type of tic may change altogether. (This is also true of people who have tics that are not part of Tourette syndrome.) Some kids may be able to suppress their tics for a short time. But tension builds, and it eventually has to be released as a tic. And if a person is concentrating on controlling the tic, it may be hard to focus on anything else. This can make it hard for teens with TS to have a conversation or pay attention in class.
Tics are classified as either simple or complex. Simple motor tics, for example, happen suddenly and separately from other tics and involve just a few muscles. Some examples are eye blinking and grimacing. In contrast, complex motor tics usually involve more muscle groups. For example, a person might touch a body part or another person repeatedly. In rare cases, people with TS might have a tic that makes them harm themselves, such as head banging.
Simple vocal tics can be throat clearing, sniffing, or humming, whereas complex vocal tics can involve repeating other people's words (a condition called echolalia) or involuntary swearing (called coprolalia).
In addition, many kids and teens with TS have other conditions, such as attention deficit hyperactivity disorder (ADHD) or obsessive-compulsive disorder (OCD). Learning disabilities and sleeping problems are also common in people with TS.
Diagnosing and Treating Tourette Syndrome
Pediatricians and family doctors may refer a child with symptoms of TS to a neurologist, a doctor who specializes in problems with the nervous system. Before TS can be diagnosed, a person must have tics for at least a year. Although tics may occur every day or intermittently throughout the year, for TS to be diagnosed, there must not be a tic-free period longer than 3 months. The neurologist may ask you to keep track of the frequency and kinds of tics your child is having.
There isn't a specific diagnostic test for TS — instead, the doctor diagnoses it after taking a medical history and doing a physical exam. Sometimes, doctors use imaging tests like magnetic resonance imaging tests (MRIs), computerized tomography (CT) scans, electroencephalograms (EEGs), or blood tests to rule out other conditions that might have symptoms similar to TS.
Just as TS is different for every person, the treatment for it varies, too. Most tics do not interfere with a child’s life, and do not require any medication. While there isn't a cure for TS, sometimes doctors suggest medications to help control symptoms that begin to interfere with a child’s schoolwork or daily life. Talk to your child's doctor about whether medication would be right for your child.
TS is not a psychological condition, but doctors sometimes refer kids and teens with TS to a psychologist or psychiatrist. Seeing a therapist won't stop tics, but it can help kids and teens to talk to someone about their problems, cope with stress better, and learn relaxation techniques.
Dealing With Tourette Syndrome
Many people don't understand what TS is or what causes it, so they might not know what to make of someone who has TS. And if people stare, kids and teens with TS can feel embarrassed and frustrated. You or your child might have to explain your child's condition to people a lot or have to deal with people gawking at you and your child.
The tics usually get milder as kids grow up, and may go away in adulthood. Although your child may want to stay home from school or avoid other social situations because of the ticks, there are some steps you and your child can take that can help him or her cope with these situations.
- Get involved. Some experts say that when kids and teens are engrossed in an activity, their tics are milder and less frequent. Sports, exercise, or hobbies are great ways for kids to focus mental and physical energy. Some well-known athletes have TS, like Manchester United soccer goalie Tim Howard, who also played for the U.S. Olympic team.
- Give a helping hand. Dealing with TS often makes kids and teens more understanding of other people's feelings, especially other young people with problems. Your child may be able to use that special sensitivity by volunteering. And knowing that he or she helped others might help build your child's confidence, and lessen any self-consciousness that he or she might have about feeling different.
- Embrace creativity. Creative activities such as writing, painting, or making music help focus the mind on other things — and they help it develop. There's speculation that composer Mozart and British writer Samuel Johnson both had TS.
- Find support. The Tourette Syndrome Association sponsors support groups with others who understand the challenges of TS.
- Take control. People with TS can feel more in control of their lives by researching TS, asking their doctors plenty of questions, and taking an active role in their treatment.
Each child with TS will cope differently with its physical, emotional, and social challenges. Because TS doesn't usually restrict activities, though, kids who have the condition should be able to enjoy and participate in the same activities as their peers, and not let it interfere with their everyday lives.
Reviewed by: Larissa Hirsch, MD
Date reviewed: February 2010
