Dr Ana Aguirregabiria
Tics in children
I describe below what tics in children are. I have taken the information from different sources, some of which I have listed at the end of this document, so you can read more regarding presentation and treatment. I hope you find the information of use.
In the list of internet links I have described a little bit what each link describes so you can choose which one to read according to your needs.
I hope you find the information useful.
Tics in Children: What they are
A tic is where a part of the body moves repeatedly, quickly, suddenly and uncontrollably. Tics are painless but involuntary. Tics can occur in any body part, such as the face, shoulders, hands or legs. Most tics are mild and hardly noticeable. However, in some cases they are frequent and severe, and can affect many areas of a child's life.
Types of tics
Tics can be motor tics, or vocal tics and these can be simple or complex.
Simple motor tics involve one muscle group, whereas complex motor tics involve several. Complex motor ticks involve slower, longer, more purposeful movements (biting, whirling and twirling around). Simple verbal tics are usually involuntary noises, as opposed to complex vocal tics, which tend to be more meaningful (often words or phrases).
Children under the age of 10 with simple tics find them to be difficult to suppress, or control. Many older children with more complex tics describe feeling strong sensory urges in their joints, muscles and bones that are relieved by the performance of a motor tic in that particular body part. These patients also report inner conflict over whether and when to yield to these urges. A sensation of relief and reduction of anxiety frequently follows the performance of a tic. Unless the tic disorder is very severe, most people with tics can suppress them for varying periods of time.
Transient Tic Disorder
The most common tic disorder is called "Transient Tic Disorder" and may affect up to 10 percent of children during their early school years (AACAP, 2012). Teachers or others may notice the tics and wonder if the child is under stress or "nervous." Transient Tic Disorder is a temporary condition and the tics will go away by themselves. Some people will have one kind of tic, like a shoulder shrug, that lasts for a while then goes away. Other tics may develop when one goes away. Some tics may get worse with anxiety, tiredness, and some medications.
Tics, which last one year or more and do not go away, are called "chronic tics." Chronic tics affect less than one percent of children and may be related to a more unusual tic disorder called Tourette's Syndrome. Children with Tourette's Syndrome have both body and vocal tics. Some tics disappear by early adulthood, and some continue. Children with Tourette's Disorder may also have problems with attention, and learning disabilities. They may act impulsively, and/or develop obsessions and compulsions.
Sometimes people with Tourette's Disorder may blurt out obscene words, insult others, or make obscene gestures or movements. They cannot control these sounds and movements and should not be blamed for them. Punishment by parents, teasing by classmates, and scolding by teachers will not help the child to control the tics but will hurt the child's self-esteem and increase their distress.
Through a comprehensive evaluation, often involving paediatric and/or neurologic consultation, a psychiatrist can determine whether a youngster has Tourette's Disorder or another tic disorder.
Treatment for the child with a tic disorder may include medication to help control the symptoms and habit reversal training: a behavioural therapy.
Tics with other underlying issues
Tics can also present when a child is beginning to show signs of autism. Autism spectrum disorder is a neuro -developmental disorder and can emerge at different times in childhood. When tics emerge and there is an underlying ASD I recommend we embark in an assessment of the whole child in order to better identify what aspect needs to be addressed first, as medication and / or habit reversal training may not be an effective approach in the long term.
This is a National Health Service site, produced by health professionals to the highest standards. They provide unbiased information regarding the condition. They use research informed evidence to write the information on their site.
This link takes you to the Encyclopaedia of Mental disorders. It is easy to read and again provides complete information regarding what tics are and how best to treat them.
This page describes Tourettes Syndrome, which is a tic disorder. I am adding it to the list because I find that it helps understand better a simple tic when you put it into the context of what it is not, and other similar but not the same presentations.
This link takes you to a magazine article covering in simple terms, for the general public, what a tic is and how to approach treatment.
Dr Ana Aguirregabiria, BA, MA, PhD, CPsychol, AFBPsS
Consultant Chartered Clinical Psychologist (BPS, HPC)
Psychodrama Psychotherapist (UKCP)