Tourette Syndrome in Children

Overview

What is Tourette Syndrome?

Tourette syndrome is a condition that affects the nervous system by causing tics — movements or sounds that a person repeats over and over, and can’t control. For example, people with Tourette syndrome may keep clearing their throat or blinking their eyes.

Tics often start around ages 5 to 7 and tend to get worse between ages 8 and 12. Tics sometimes are more bothersome in the preteen and early teen years but then may get milder or go away as kids grow into adults. Until that happens, behavioral therapy and support from parents and schools can help kids cope with the condition. Sometimes medicine can help.

Top Things to Know

• Tourette syndrome causes sudden, repeated muscle movements and sounds called tics.
• Kids and teens may do things like shake, stomp, tighten muscles, or make sounds like grunting.
• Treatment includes a certain kind of behavioral therapy and sometimes medicine.
• Tourette syndrome is more common in boys than in girls.

Signs & Symptoms

What Are the Signs & Symptoms of Tourette Syndrome?

The main symptoms of Tourette syndrome are two kinds of tics called motor tics and vocal tics.

Motor Tics

Motor tics are sudden twitches or movements a person makes but can’t control. They can be simple or complex:

• Simple motor tics tend to affect just a few muscles near each other. Kids may blink, frown, shake their head, jerk their shoulder, or shrug.
• Complex motor tics often affect more muscles and might look like a series of movements. For example, someone might touch a body part or another person again and again. In rare cases, people with Tourette syndrome might have a tic that makes them harm themselves, like head banging.

Vocal tics

Vocal tics are repeated sounds a person makes. Like motor tics, vocal tics can be simple or complex:

• Simple vocal tics can include throat clearing, grunting, sniffing, coughing, humming, and animal-like noises.
• Complex vocal tics can include calling out, saying syllables or words, repeating other people’s words (a condition known as echolalia), or swearing without meaning to, which is called coprolalia.

How Long Do Symptoms Last?

People with Tourette syndrome have at least two motor tics and one or more vocal tics for at least a year, starting before age 18. Sometimes more than one kind of tic happens at once.

A person might be able to hold back a tic for a short time. But tension builds and the tic comes out. If someone is focusing on controlling the tic, it may be hard to concentrate on anything else. This can make it hard for kids with Tourette syndrome to have a conversation or pay attention in class.

Tics are often most severe in the preteen years. Most people get much better in their late teens to early adulthood, but some may still have tics as adults.

Do Tourette Syndrome Tics Get Better and Worse?

The kind of tics, how often they happen, and how mild or severe they are tend to change over time. They’re usually worse when a person is tired, under stress (like when studying for a big test), or excited or energized about something — like at a birthday party.

Sometimes, tics happen less often or go away when a person is focused on something else (like working on a computer) or relaxing — like listening to music.

What Causes Tourette Syndrome?

The exact cause of Tourette syndrome isn’t known, but research suggests it’s a mix of:

• Genetics.
• Environmental factors (things in a person’s life or surroundings that might be linked to disease).
• Changes in the brain and problems with how nerve cells talk with each other. A change in neurotransmitters (chemicals in the brain that carry nerve signals between cells) might play a role.

Many kids and teens with Tourette syndrome have other behavioral conditions like ADHD, obsessive-compulsive disorder (OCD), learning problems, anger, or anxiety.

How Is Tourette Syndrome Diagnosed?

If your child has symptoms of Tourette syndrome, your doctor may send you to a neurologist (a doctor who treats problems with the nervous system).

There isn’t a specific test for Tourette syndrome. Instead, the doctor will give your child a physical exam and look at the family history (if any family members have it), medical history, and symptoms. You may be asked to keep track of the kinds of tics your child has and how often they happen. It can help to take a video of the movements or sounds and share it with your doctor, if your child is OK with it.

Your doctor may do blood tests and imaging tests like magnetic resonance imaging tests (MRIs), computerized tomography (CT) scans, or electroencephalograms (EEGs). This can help tell if other conditions are causing the symptoms.

Treatment & Home Care

How is Tourette Syndrome Treated?

There isn’t a cure for Tourette syndrome, but most tics don’t get in the way of day-to-day life. In this case, you and your child simply keep an eye on the tics and no treatment is needed. But if tics bother your child or cause pain, doctors may suggest treatments like therapies or medicines to help manage symptoms.

Behavioral Therapy

The main treatment for kids with tics is a kind of behavioral therapy called comprehensive behavioral intervention for tics (CBIT). It’s important to find a therapist or psychologist who’s trained in it. CBIT focuses on several things:

• getting better at noticing tics
• figuring out what triggers (or causes) tics
• finding ways for parents and schools to help kids feel more supported and comfortable
• learning and practicing actions to “replace” tics (called “habit reversal”)
• doing relaxation exercises

Therapists can also help with other problems that may be linked to Tourette syndrome, like ADHD and anxiety. These conditions should be treated first if they’re more severe than the tics.

Medicine

Sometimes medicine helps reduce tics. Medicine for conditions that can happen with Tourette syndrome, like ADHD and anxiety, may also ease tics.

Speech-Language Therapy

Speech-language therapy is a treatment for kids with speech and/or language disorders. It can also help some children with Tourette Syndrome.

Living With Tourette Syndrome

Many people don’t understand what Tourette syndrome is or what causes it, so they might not know how to act around someone who has tics. Someone who has the condition might have to explain it to others or deal with teasing.

These tips can help kids and teens with Tourette syndrome cope:

Get involved. Sometimes tics are milder and less frequent when kids and teens concentrate on an activity. Sports, exercise, or hobbies are great ways to focus brain and body energy.

Manage stress. Learning coping methods may help. For example, deep breathing, relaxing the body, positive thinking, and fun activities.

Help others. Dealing with Tourette syndrome often lets kids and teens relate to other people better, including other young people with challenges. They might use that special understanding to volunteer. Helping others can make them feel more confident.

Be creative. Activities like writing, painting, or making music help the mind focus on other things.

Take control. People with Tourette syndrome can feel more in control of their lives by learning about the condition, asking their doctors lots of questions, and taking an active role in their treatment. This may mean working with a therapist to manage tics.

What Else Should I Know?

Tourette syndrome is just one kind of tic disorder. Other types include provisional tic disorder, which is the most common kind. People with it have motor or vocal tics for less than a year. Chronic (persistent) tic disorder is when motor or vocal tics — but not both — happen for more than a year. The treatment for all tic disorders is similar.

If your child has Tourette syndrome, it can be hard to know what to do or say. If kids aren’t upset about their tics, just ignore the tics. Avoid telling kids to try to stop “doing” the tics. And encourage them to be with other people, rather than staying alone. If the tics bother your child, explain that you can work with your doctor on a treatment plan.

Try reaching out to the Tourette Association of America for information on support groups, webinars, CBIT therapists, and other resources.

Other Common Questions

How can I help when my child worries?

All kids worry at times, and some may do so more than others. Here’s how to prevent worry from holding kids back.

What are some ways to help my child manage anxiety?

Feeling nervous, worried, or uneasy at times is a normal part of growing up, but there are ways for parents to support kids. Try these tips to help your child deal with stress.

What should I know about taking my child to a therapist?

Many children and teens have problems that affect how they feel, act, or learn. Going to therapy helps them cope better, feel better, and do better. Learn what to expect at a therapist visit.