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WHAT YOU NEED TO KNOW:
What is a tic disorder?
A tic is a repeated movement or sound that happens suddenly and cannot be controlled. A tic disorder starts in childhood, usually between 7 and 12 years of age. Your child's tic disorder may be mild or severe. He or she may have a tic for a short time, or he or she may have it for the rest of his or her life. Your child's risk for a tic disorder is higher if he or she has a family history of a tic disorder. Tic disorders are also more common in males.
What are the different types of tic disorders?
- A provisional (or transient) tic disorder means the tics last a short time. Provisional tics can be motor, vocal, or both.
- A persistent (or chronic) tic disorder means the tics last at least 1 year. Persistent tics can be motor or vocal, but not both.
- Tourette syndrome (TS) is a rare type of tic disorder. TS includes both motor and vocal tics and lasts at least 1 year.
What kinds of tics may my child have?
Your child may have motor (movement) or vocal (sound) tics. Motor and vocal tics can happen at the same time or separately. Your child may have many tics in a row, followed by a calm period when he or she has no tics. Your child may have any of the following several times every day:
- Motor tics can be simple or complex. Simple motor tics are short, quick, uncontrolled movements of one body area. Complex motor tics occur when your child has many simple motor tics at one time. Your child may do any of the following:
- Punch, bite, scratch, or poke at himself or herself
- Blink his or her eyes, twitch his or her nose, or twist his or her face
- Bang, shake, or turn his or her head, or shrug his or her shoulders
- Copy other's movements, touch other people, or make inappropriate gestures
- Grind his or her teeth, tense his or her abdomen, or vomit
- Hit, kick, throw things, or do exercises for no known reason
- Slap his or her hand, tap his or her fingers, stamp his or her feet, or shake his or her arms or legs
- Vocal tics can be simple or complex. Simple vocal tics are noises and sounds your child cannot control. Complex vocal tics are words or phrases your child cannot control. Your child may do any of the following:
- Bark, sniff, yelp, squeak, whistle, or make a sucking noise
- Clear his or her throat, cough, make a hiccup noise, or grunt
- Copy the sounds or words of another person
- Curse, shout, scream, or say inappropriate things
- Make the same sound or noise over and over again
- Mumble words or sentences
How is a tic disorder diagnosed?
Your child may not have a tic during an examination. His or her healthcare provider may still be able to diagnose a tic disorder based on information you or your child give him or her. He or she will ask questions about your child's tics and health history. Tell him or her when the tics started, how often they occur, and if they interfere with daily activities. Tell him or her if a family member has a tic disorder. Your child's healthcare provider may do testing to check your child's brain function. He or she may check your child's eyes, strength, memory, and problem solving ability. He or she will also check for other conditions, such as ADHD, OCD, anxiety, and mood disorders. These often occur with some types of tic disorders, such as TS. Treatment for some of the other disorders may also improve tics.
How is a tic disorder treated?
A mild tic disorder may not need to be treated, or may be started later. Your child's healthcare provider may recommend watching and waiting to see if the tics get worse. Your child's tics may become milder or go away during the teen years. Treatment may help make tics less severe but usually does not get rid of them completely. The following can help your child manage his or her symptoms and decrease stress:
- Medicines may be given if your child's tics are painful, harmful, or make it hard for him or her to do daily activities. Medicines may be given to help decrease your child's tics. Some of the medicines may also help control anxiety, mood swings, or aggressive behavior. Some medicines may also help your child sleep. The provider will talk to you about common or severe side effects that each medicine can cause. He or she will also check over time to see if each medicine is still needed or can be stopped.
- Biofeedback training helps your child to control how his or her body reacts to stress or pain. This training can help reduce tics by helping your child manage triggers that can lead to a tic.
- Cognitive behavioral therapy (CBT) helps your child learn to control his or her behavior, thoughts, and emotions. CBT may help your child understand the tic disorder and help him or her cope with symptoms.
- Habit reversal therapy helps your child learn new behaviors to take the place of his or her tics. Your child learns to recognize when the urge to have a tic is building. He or she learns to choose an action that will interrupt the tic. He or she may need to do the action for up to 3 minutes before the tic urge stops.
- Relaxation therapy helps decrease your child's physical and emotional stress. Relaxation therapy may help your child learn to control his or her tics. Deep breathing, muscle relaxation, meditation, and listening to music can help your child cope with stressful events.
What can I do to help support my child?
- Be patient. Remember that your child is not choosing to have tics. He or she is not acting out or trying to cause behavior problems. Punishment will not stop him or her from having tics. A calm and patient approach may help make the tics less severe or happen less often.
- Help your child manage stress. Your child may have fewer tics when he or she is concentrating, doing activities, or sleeping. His or her tics may be worse when he or she is alone, stressed, tired, excited, or worried. It may help to create a regular schedule. For example, set up time during the day for your child to do his or her homework. This can help prevent him or her from trying to finish at the last minute.
- Do not focus on the tic. The tic may get worse the more your child thinks about it. Help him or her focus on his or her strengths and interests. Do not let a tic disorder define your child.
- Create a regular sleep schedule. Have your child go to bed at the same time every night. Make sure he or she will be able to get at least 8 hours of sleep. Lack of sleep can make a tic worse.
- Encourage your child to let the tic out as soon as possible. The longer he or she tries to hold back the tic, the worse it may be when it happens. Your child may have warning signs before his or her tics begin, such as feeling cold, warm, itchy, tingly, or heavy. When the tic occurs, these feelings go away. At times, your child may be able to stop a tic from occurring. This may cause discomfort or a feeling of pressure in his or her body, causing him or her to have many tics afterwards.
Call your local emergency number (911 in the US) for any of the following:
- Your child tells you he or she feels like hurting himself or herself, or others.
- Your child has hurt himself or herself, or someone else.
When should I seek immediate care?
- Your child gets very upset, threatens someone, or is violent.
When should I call my child's doctor?
- Your child is not sleeping well or sleeps more than usual.
- Your child has trouble in school or becomes depressed or anxious.
- Your child is having muscle spasms or trouble walking.
- Your child has new tics, or his or her tics are getting worse or preventing him or her from doing daily activities.
- You have questions or concerns about your child's condition or care.
Care AgreementYou have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's healthcare providers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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