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Tic Disorder


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 may have a tic for a short time, or he may have it for the rest of his life. Your child's risk for a tic disorder is higher if he is male or has a family history of a tic disorder.

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 might happen at the same time, but they might happen separately. Your child may have many tics in a row, followed by a calm period when he 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
    • Blink his eyes, twitch his nose, or twist his face
    • Bang, shake, or turn his head, or shrug his shoulders
    • Copy other's movements, touch other people, or make inappropriate gestures
    • Grind his teeth, tense his abdomen, or vomit
    • Hit, kick, throw things, or do exercises for no known reason
    • Slap his hand, tap his fingers, stamp his feet, or shake his arms or legs
  • Vocal tics can be simple or complex. Simple vocal tics are when your child makes uncontrolled noises and sounds. Complex vocal tics are when your child speaks words or phrases without having control over what he is saying. Your child may do any of the following:
    • Bark, sniff, yelp, squeak, whistle, or make a sucking noise
    • Clear his 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 healthcare provider may still be able to diagnose a tic disorder based on information you or your child give him. He will ask questions about your child's tics and health history. Tell him when the tics started, how often they occur, and if they interfere with daily activities. Tell him if a family member has a tic disorder. Your child's healthcare provider may do testing to check your child's brain function.

How is a tic disorder treated?

A mild tic disorder may not need to be treated. The following can help your child manage his symptoms and decrease stress:

  • Medicines may be given if your child's tics are painful, harmful, or make it hard for him to do his normal 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.
  • Biofeedback training helps your child to control how his 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 behavior, thoughts, and emotions. CBT may help your child understand the tic disorder and help him cope with his symptoms.
  • Habit reversal therapy helps your child learn new behaviors to take the place of his tics. Your child learns to recognize when the urge to have a tic is building. He learns to choose an action he can do that will interrupt the tic. He 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 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 is not acting out or trying to cause behavior problems. Punishment will not stop him from having tics. A calm and patient approach may help make the tics less severe or happen less often.
  • Help your child avoid stress. Your child may have fewer tics when he is concentrating, doing activities, or sleeping. His tics may be worse when he 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 homework. This can help prevent him 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 focus on his 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 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 tries to hold back the tic, the worse it may be when it happens. Your child may have warning signs before his 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 body, causing him to have many tics afterwards.

Call 911 for any of the following:

  • Your child tells you he feels like hurting himself or others.
  • Your child has hurt himself or someone else.

When should I seek immediate care?

  • Your child gets very upset, threatens someone, or is violent.

When should I contact my child's healthcare provider?

  • 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 tics are getting worse or preventing him from doing his normal activities.
  • You have questions or concerns about your child's condition or care.

Care Agreement

You 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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