Short answer: tics are sudden, repeated movements or sounds, such as blinking, throat clearing or shoulder shrugging. Up to one in five children has a tic at some point, and most improve with time. Tourette syndrome means both motor and vocal tics have lasted more than a year. Treatment focuses on comfort, school success and related conditions such as ADHD, OCD and anxiety.
Common tics
- Motor: eye blinking, facial grimacing, head jerking, shoulder shrugging
- Vocal: sniffing, throat clearing, humming, repeating words
Tics typically come and go, change over time, worsen with stress, excitement or fatigue, and often peak around ages 10 to 12.
Conditions that often co-occur
Many children with tics also have ADHD, obsessive-compulsive symptoms, anxiety or learning challenges. These can cause more difficulty than the tics themselves, so a full evaluation looks at the whole child.
Treatment options
- Education and reassurance: for mild tics, understanding is often enough.
- CBIT (comprehensive behavioral intervention for tics): teaches awareness and competing responses; it has strong evidence.
- Medication: considered when tics are painful, disruptive or socially distressing. Some options (such as guanfacine) can also help ADHD symptoms.
- School support: breaks, a private testing space and teacher education.
Tips for families
- Avoid pointing out tics or asking the child to stop; this usually increases them
- Focus on strengths and keep routines predictable
- Protect sleep, since fatigue worsens tics
What tics feel like
Many children describe an uncomfortable urge, like an itch or pressure, before a tic, which is relieved by doing it. Tics can sometimes be held back briefly, which is why children may tic less at school and more at home where they feel safe. This is not deliberate misbehavior, and holding tics in can be tiring.
Helping at school and with peers
Teachers who understand tics can respond calmly and help classmates do the same. Some children and families choose to explain tics to the class. Accommodations may include breaks, a place to step out, alternatives to reading aloud during heavy tic periods, and extended test time when tics interfere.
Looking ahead
For many children, tics decrease significantly in the late teens. Even when tics persist, most people with Tourette syndrome lead full lives. Attending to self-esteem, friendships and co-occurring conditions makes a big difference along the way.
Frequently asked questions
Do ADHD stimulants make tics worse?
For most children, research shows stimulants do not significantly worsen tics, but your psychiatrist will monitor closely.
When should we seek urgent care?
Sudden onset of severe tics with OCD symptoms, or any self-injury, should be evaluated promptly.
Psych Boston’s child psychiatry team evaluates tics, ADHD and anxiety. Request an appointment.
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This article is general information, not medical advice. If you are in crisis, call or text 988 or call 911. Psych Boston is an outpatient psychiatry practice at 35 Bedford St #17, Lexington, MA781-218-9550).