What are tics? 

Tics are involuntary, repetitive movements (motor tics) or sounds (vocal or phonic tics) that often start in early childhood. Tics can be range from simple to more complex movements or sounds.

It is important to know that tics often come and go as well as change over time. Tics tend to increase with stress—good stress (e.g., excitement, anticipation), bad stress, (e.g., anxiety, worry), and physical stress (e.g., fatigue, illness). Tics can sometimes improve when focused on activities. Some people with tics can suppress their tics for short periods of time. Many people with tics do not know why they do the movements or sounds. Some can describe a feeling, need or urge that occurs before the tic.

Tics tend to increase in frequency and severity between the ages of 8-12 years old. Many people with tics can see an improvement in the late teenage years and some will grow out of their tics. There are some people however who continue to have tics as adults. 

Are tics common? 

Tics are fairly common. Tics occur in about 1 in 5 (20%) school-aged children at some point. About 1 in 10 school-aged children with tics will go on to have tics for more than 1 year. Tourette Syndrome and Tic Disorders combined occur in more than 1 in 100 (1%) school aged children. The numbers are likely higher as many go under recognized. Tics happen in all ethnicities, races, ages and gender identities but are 3-4 times more likely in biological boys than girls.

What is Tourette Syndrome?  

The type of tic disorder depends on the types of tic and the length of time the tics have been present. 

Tourette Syndrome (TS), also known as Tourette’s Disorder:

  1. At least 2 movements (motor tics) and at least 1 sound (vocal or phonic tics) have been present, not necessarily at the same time. 
  2. Tics may wax and wane in frequency but have occurred for more than 1 year. 
  3. Tics started to appear before the age of 18 year old. 
  4. Tics are not caused by the use of a substance or other medical condition

What causes tics? 

The cause of Tourette Syndrome and other Tic Disorders is still unknown. Although no single gene has been found to cause tics, many people with tics have a family history of tics or the other common co-occurring conditions. 

Common Co-Occurring Conditions

About 50-70% of people with tics will have one or more mental, behavioral, or developmental conditions that have started prior to the tics. While tics are what you see and hear, these co-occurring conditions may cause more problems and can be more bothersome than the tics themselves. 

The most common co-occurring conditions include the following: 

  • Attention Deficit/Hyperactivity Disorder (ADHD) 
  • Obsessive Compulsive Disorder or Behaviors
  • Behavioral or Conduct Issues
  • Anxiety 
  • Learning Disability
  • Social Skills Deficits and Social Functioning 
  • Sensory Processing Issues
  • Sleep Disorders
  • Handwriting difficulties

How are tics and related disorders treated? 

Most often, tics are mild and treatment is not required. However, if tics are bothersome or getting in the way of school or daily life they may need treatment. Treatments can include behavioral therapy and/or medication. Although medication may help, it does not cure tics. Tics can still wax and wane in frequency and severity, and fluctuations can continue to occur. 

If co-occurring conditions are more bothersome, it may be necessary to treat those more directly with behavioral therapy and/or medication.

Our team has expertise in Tourette Syndrome, Tics and their related disorders. Since every person is different, our team will work together with you to find the best and most effective treatment. 

What if the tics and/or related disorders are interfering with school?

If a person’s tics are interfering in the classroom setting, we will work with you to develop an educational plan (504 Plan or Individualized Education Program – IEP) to maximize success in the all school settings. 

What if the tics and/or related disorders are interfering with work? 

People with Tourette Syndrome and Tic Disorders are part of every field and occupation. Tic Disorders and Tourette Syndrome do not have to be a barrier for what someone wants to do in life. Should tics or the common co-occurring conditions interfere with work, we will work with you and your employer to develop accommodations will help to ensure you are successful at your job. The specific accommodations you will need depend on your symptoms

Why Wake Forest Baptist?

Our team of specialists collaborates to provide comprehensive care and determine the best treatment for every person. Our goal is for the tics and their related disorders not to be bothersome or interfering with daily activities. Your initial visit is performed by Jaclyn Martindale, DO who has clinical expertise in Tourette Syndrome, Tics and their related conditions. Each person’s experience is unique, and so is their treatment.