Tics are rapid, repetitive, involuntary contractions of a group of muscles. They can occur in the form of either:
- motor tics (bodily movements)
- phonic or vocal tics (sounds)
Most tics are mild and infrequent and they may not even be noticeable to the person experiencing them or to others. However, some tics can be frequent and severe. Tics can also be a symptom of Tourette's syndrome (see below).
Types of tics
Motor tics can affect any part of the body, but they often involve the muscles of the face, eyes, head and neck. These produce movements such as:
- facial twitching
- grimacing
- blinking
- shrugging of the shoulders
Common phonic tics include:
- coughing
- grunting
- clearing the throat
- sniffing
Some people with tics may be able to suppress (control) a tic for a short period of time, although this is said to be like trying to hold back a sneeze. They feel increasing tension until the tic is finally released. See Tics - symptoms for more information.
Progression of tics
Most tics start during childhood. People who have them experience periods when they're better and periods when they're worse. This is often described as ‘waxing and waning’. In most cases, tics improve without treatment during the teenage years or early adulthood.
Some factors can make tics worse, such as:
If you have a mild tic, you may decide that treatment isn't necessary. However, if you want to have treatment, a number of different medicines can be used, although some may cause side effects.
As well as medication, behavioural treatments can also be helpful. However, they're usually only offered in specialist centres. They include:
-
habit reversal therapy (HRT), which aims to teach you how to break the habit of the tic. See Tics - treatment for more information
-
exposure with response prevention (ERP), which aims to help you get used (habituate) to the unpleasant 'premonitory sensations’ associated with tics (the overwhelming feelings that are often experienced just prior to a tic)
Tourette's syndrome
Tourette's syndrome is a condition where frequent and severe motor or phonic tics are experienced. It can also be associated with other difficulties, such as behavioural problems, attention deficit hyperactivity disorder (ADHD), sleep problems and obsessive compulsive disorder (OCD).
Tourette's syndrome affects around 1 in 100 children in the UK. Tics usually begin at around six years of age and, over time, they often become more severe. They're usually at their worst when a child is 10 to 12 years old. Tics usually start to improve during the later teenage years.
Read more about Tourette's syndrome.
If your child develops a tic
The most important thing to remember is that tics are not voluntary. Even if your child can sometimes control a tic by suppressing it, it's highly unlikely that they'll be able to control their tics all of the time.
If your child develops a tic you should:
- not tell them off about their tic
- not try to stop them making repetitive movements or sounds because this may cause them to become stressed, which may make the tic worse
- wherever possible, ignore the tic because if attention is drawn to it, it may get worse
- reassure your child that they are well, that no harm is likely to result from the tics and that there's no reason for them to feel ashamed
- make a point of educating other children about tics so that they're aware of your child’s condition; encourage them to react naturally
- most importantly, try to reduce the levels of stress and anxiety around you and your child