What Are Tics Anyway?
Tourette's syndrome is a neurological disorder characterized by a combination of involuntary, repetitive movements (motor tics) and vocalizations (vocal tics). These tics must have been present for at least a year for a diagnosis to be made, according to the American Psychiatric Association (2013). It's important to note that motor tics, whether transient or chronic, are relatively common in children, affecting an estimated 1-12% (Chowdhury, 2004).
If your Tics are becoming problematic and interfering with every day life, speak to your GP or make an appointment with us. We have practitioners who have experience helping young people develop strategies to manage tics.
How is Tourette's Diagnosed?
A medical doctor diagnoses Tourette's syndrome, but research suggests most children go undiagnosed unless their tics are severe or occur alongside other mental health issues (Chowdhury, 2004). An estimated 10-15% of school-age children experience tics, but only 1-2% meet the strict criteria for a diagnosis.
How Do Tics Develop?
Motor tics typically start around age 7, while vocal tics often appear later, around age 11. Tics tend to worsen during puberty but stabilise in adulthood. The severity, intensity, and frequency of tics vary throughout a child's life (Robertson & Cavanna, 2008).
The cause of Tourette's remains unclear, but it's thought to be an inherited developmental disorder (Leckman et al., 2001). While stress and anxiety don't cause tics, they can significantly worsen them (Chowdhury, 2004).
How Are Tics Managed?
Most tic disorders, including Tourette's, require minimal intervention. Often, psychoeducation is enough. However, if tics cause pain or social embarrassment, intervention may help alleviate discomfort (Piacentini & Chang, 2006). Medication is the primary treatment in such cases. While some psychological strategies might help, there's limited evidence to support their effectiveness (Robertson, 2000).
Helping the child manage stress through relaxation and exercise can reduce tic frequency. Dr. Chowdhury recommends "massed practice," where children practice their tics before school or events, potentially leading to a natural period of rest for that tic. Habit reversal therapy also has some support. There are no licensed treatments for Tourette's Syndrome in the UK, but sympatholytic drugs such as clonidine and guanfacine have been shown to be effective as treatments (Cureus, 2023).
Advice for Adults Who Care for Young People with Tics
Remember, your child can't control their tics. They're not trying to annoy you. If tics cause pain, gentle massage might help. Children often suppress tics during the day and release them at home. Understanding this need for a safe space to let off steam can be helpful.
Here are some tips for supporting your child:
Don't Punish Tics: Your child can't help it.
Accept and Ignore Tics: Both at home and school.
Inform Teachers: Let them know about the tics so they can ignore them too, potentially setting an example for classmates. The general rule for tics at school is to ignore them.
Advice for Young People with Tics
Remember, you can't control your tics. The more you try to control them, the worse they might get. If you can, try and help people around you understand your tics so you can feel safe to release your tics. While there is no cure for tics, many management options can help. These may include:
Psychoeducation: Learning about tics and understanding that they are involuntary can help reduce anxiety and stress. You may want to read this booklet from Tourettes Action.
Therapy: Behavioural therapies like Habit Reversal Training can teach you to manage your tics more effectively.
Medication: In some cases, medication may be prescribed to reduce the severity of tics.
Relaxation Techniques: Practicing relaxation techniques like deep breathing and meditation can help manage stress and reduce tic severity. Being mindful of when your stress increases, and when your tics start, you can take steps to reduce your stress levels with an aim to reduce or stop your tics.