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Tics are involuntary movements or noises that some children make. Tics may be 鈥渟imple鈥� or 鈥渃omplex鈥� depending on what specific movements or noises are made.

鈥淪imple鈥� motor tics are movements that only involve one muscle group. They commonly include eye movements (blinking, darting), facial movements (nose or mouth movements), or simple shoulder or arm movements. 鈥淐omplex鈥� motor tics involve multiple muscle groups and may include head or neck jerking, complicated arm or leg movements, repetitive touching, jumping, pacing, or copying other peoples鈥� movements.

鈥淪imple鈥� vocal tics commonly include throat clearing, sniffling or coughing (frequently confused with seasonal allergies), grunting, and other noises. 鈥淐omplex鈥� vocal tics include repetitive use of phrases and words.

Children with tics fall into multiple diagnostic categories. These include:

• Provisional (transient) tic disorder: motor and/or vocal tics that have been going on for less than one year
• Chronic motor or vocal tic disorder: motor OR vocal tics that have been going on for more than one year
• Tourette Syndrome

The diagnosis of Tourette syndrome is made when the following criteria are met:

• The child has vocal AND motor tics
• The tics have been going on for more than one year
• The onset of tics occurred before the age of 18 years

Tourette syndrome gets a bad reputation in the media and popular culture which commonly depict it only as exceptionally frequent and uncontrollable swearing and cursing. This type of tic is known as coprolalia, and it occurs in less than 10% of children with Tourette syndrome.

Tics are exceptionally common. Approximately 20-25% of children will experience at least one tic at some point during childhood. Approximately 1% of all children will go on to have tics that last for more than one year (chronic motor/vocal tic disorder or Tourette syndrome).

Tics are thought to have a genetic basis based on the fact that many patients with tics have a family history of tics. However, no single gene has been found to cause tics. There is approximately a 50% chance that the child of a parent with tics will go on to have tics as well.

Eighty-six percent of children with tics will also have one or more mental health disorders with attention deficit-hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and anxiety being the most common. In some children, the symptoms of these co-existing conditions may be very mild; however, in some children, these symptoms may be even more severe than the tics themselves. Addressing these psychiatric symptoms for all illnesses is important in comprehensive care of tic disorders.

For many children, tics are very mild and may not warrant treatment. However, tics can sometimes be bothersome and negatively affect a child in many different ways including issues with self-esteem, bullying, and pain in rare cases. In these cases, treatment for tics may be warranted.

There are both pharmacologic (medication) and non-pharmacologic treatments available for tics. The treatment of choice is a type of behavioral therapy called Comprehensive Behavioral Intervention for Tics (CBIT). CBIT is a specialized type of therapy designed to teach a child to recognize an 鈥渦rge鈥� to tic and then channel that urge into a non-tic activity. Greater than 50% of children who complete a course of CBIT go on to have long-term improvement in their tic control.

Medication options also exist to help manage tics. There is no medication that is a 鈥渃ure鈥� for tics, but they can help improve both the frequency and/or severity of a child鈥檚 tics. Multiple medications exist to help tics.