Tourette’s & tics

People with Tourette syndrome cannot help having tics and are not being disruptive on purpose. Explaining this to others is one of the most helpful kinds of support.

Students with Tourette syndrome generally have the same range of intelligence as other children. Some tics can make reading or writing harder, and trying to hold tics back can be distracting.

There is no cure, but many people with Tourette syndrome don’t need treatment because their tics don’t get in the way of daily life. Help is there when tics cause pain, stress, or problems at school, work or with friends.

Motor tics are movements of the body. Simple motor tics use only a few body parts, like squinting or a shoulder shrug. Complex motor tics use several body parts and can follow a pattern, like head-bobbing, then arm-jerking, then jumping.

Vocal tics are sounds. Simple ones include sniffing or throat-clearing. Complex ones can include saying words or phrases.

Swearing tics are rare. Most people with Tourette syndrome never have them, even though TV and films often suggest otherwise.

Tourette syndrome is diagnosed when a person has had both motor and vocal tics, starting before age 18, for at least a year.

A persistent (chronic) tic disorder means only motor tics or only vocal tics, for at least a year. A provisional tic disorder means tics that have been present for less than a year.

Many children have tics for a short time that fade on their own.

Many people describe a feeling of mounting inner tension or an urge to move just before a tic. Doing the tic eases the feeling for a moment.

For some people, this urge is the most uncomfortable part, more than the tics themselves. Learning to notice it is a key part of behavioral therapy.

Tics can be triggered by stress, excitement or tiredness. A birthday party can bring on tics just as much as a hard test.

Things that may help

• A calm, regular bedtime routine
• Avoiding screens before bed
• Keeping a steady daily routine with plenty of physical activity
• Lowering stress where you can

Some people can hold back tics for a while. But it takes effort and can be distracting, for example in class.

Tics often change over time, and may come and go. They often get less in the teen years and early adulthood, and sometimes disappear. Many people still have tics as adults, and sometimes they can get worse.

Swearing is not needed for a diagnosis, and most people with Tourette syndrome don’t have swearing tics.

Some people can hold tics back for a short time, but they can’t fully stop them. People with Tourette syndrome are not being disruptive on purpose.

There is no cure, but CBIT is an evidence-based behavioral therapy shown to help both children and adults manage tics. In trials, many more people improved with CBIT than with a comparison treatment.

Research suggests Tourette syndrome is an inherited, genetic condition. Parenting does not cause it.

Tics often ease after the teen years, but many adults still have them, and adults can get support too.

ADHD is one of the most common conditions alongside Tourette syndrome. It can make focusing, planning and sitting still harder.

More than 1 in 3 people with Tourette syndrome also have obsessive-compulsive disorder (OCD).

Anxiety is common in people with Tourette syndrome, and mood conditions can occur too. Stress can also make tics worse, which can feel like a loop.

Learning disabilities and sleep problems often occur alongside Tourette syndrome.

Parents, school staff and community adults can help prevent bullying by talking about it, building a safe school, and creating a community-wide plan to prevent bullying.

Teaching others about Tourette syndrome is one of the most helpful kinds of support. Understanding can lead to practical help, like a coach asking teammates to ignore tics instead of teasing.

When people with Tourette syndrome get more support, their tics may lessen. Feeling accepted at home, school and with friends protects mental health.

Teens can join youth programs run by the Tourette Association of America, such as the Youth Ambassador Program (ages 12–17) and Rising Leaders (ages 18–25).

Habit reversal has two parts. In awareness training, a person learns to notice each tic and the early signs it’s coming. In competing response training, they practice a movement that can’t happen at the same time as the tic.

For example, someone who rubs their head might cross their arms instead.

CBIT is an evidence-based therapy for Tourette syndrome and chronic tic disorders. It combines habit reversal with learning about tics and relaxation skills. A therapist works with the person, and parents for children, to find the situations where tics are worst.

In a trial of 122 adults, 38% improved a lot with CBIT, compared with 6% who got support and education only. In an earlier trial with children, 52% improved a lot, compared with 18.5%. In the adult trial, people had eight sessions over 10 weeks.

Parent training helps parents understand their child’s behavior and teaches skills like positive praise. It has helped children with Tourette syndrome and ADHD.

The Tourette Association of America offers free CBIT training to health professionals and works with CDC to teach more clinicians about behavioral approaches.

Children with Tourette syndrome do better when schools use positive rather than punishing discipline, with routines that are predictable and doable. Tics are not bad behavior.

Changes that can help

• A computer for writing
• A different seat
• Extra time for tests

Some children need formal support, such as an IEP (for special education) or a 504 plan, especially when tics come with attention or learning difficulties.

Many adults with Tourette syndrome need few or no changes at work. Others benefit from simple accommodations. The Job Accommodation Network (JAN) gives free, confidential advice.

Examples of accommodations

• A flexible or modified break schedule
• A more private workspace
• Disability awareness training for coworkers
• Noise-canceling headsets or white noise
• Working from home some days

The Tourette Association of America (TAA) offers local chapters for children, families and adults, support groups, information on CBIT, and help finding a provider. Website: tourette.org. Phone: 888-4-TOURET (888-486-8738).

TAA also offers bullying prevention resources for schools and communities, and a toolkit for educators.

Support groups and youth programs let people meet others who understand without explanation. When people with Tourette syndrome get more support, their tics may lessen.