No. 35; Updated October 2023
A tic is a problem in which a part of the body moves repeatedly, quickly, suddenly, and uncontrollably, often called motor tics. Tics can occur in any body part, such as the face, shoulders, hands, or legs. They can be stopped voluntarily for brief periods. Sounds that are made involuntarily (such as throat clearing or sniffing) are called vocal tics. Most tics are mild and hardly noticeable. However, in some cases they are frequent and severe, and can affect many areas of a child's life. Tics may come and go.
The most common tic disorder is called provisional tic disorder (previously known as transient tic disorder) and may affect up to ten percent of children during the early school years. Teachers or others may notice the tics and wonder if the child is under stress or "nervous." Provisional tics go away by themselves in less than a year. Some may get worse with anxiety, tiredness, and some medications.
Some tics do not go away. Tics which last one year or more are called persistent (chronic) tics. Persistent tics affect less than one percent of children and may be related to a more complex tic disorder called Tourette's disorder.
Children with Tourette's disorder have both body (motor) and vocal tics (such as throat clearing). Some tics disappear by early adulthood, and some continue. Children with Tourette's disorder may also have problems with attention and/or learning disorders. They may act impulsively. Some may develop obsessions and compulsions.
Sometimes people with Tourette's disorder blurt out obscene words, insult others, or make obscene gestures or movements. They cannot control these sounds and movements and should not be blamed for them. Punishment by parents, teasing by classmates, and scolding by teachers will not help the child to control the tics but will hurt the child's self-esteem and increase their distress.
Through a comprehensive evaluation, sometimes involving consultation with a pediatrician or pediatric neurologist, a child and adolescent psychiatrist can determine whether a child or adolescent has Tourette's disorder or another tic disorder. Treatment for the child with a tic disorder may include medication to help control the symptoms and a type of behavioral therapy called habit reversal training, where a child learns to develop greater awareness of the tics and comes up with a different behavior to take its place. The child and adolescent psychiatrist can also advise families about how to provide emotional support and the appropriate educational environment for their child or adolescent.
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