Tics in children usually begin from 3-9 years of age and become more severe from 9-11 years of age. Childhood tics are more common in boys than in girls (1). Tics are quick and difficult-to-control body jolts or sounds caused by fast, repetitive muscle movements or vocalizations. Most people may regard it as an unavoidable submission to an almost irresistible impulse, even though it is occasionally defined as involuntary (2) (3). At least one tic affects about a quarter of all children at some point during childhood (4). Learn about the different types of tics, their causes, symptoms, and treatment options for children.
Types Of Tics In Children
There are generally two types of tics (3) (5). Depending on the involvement of bodily movements or sounds, tics in children can also be either simple or complex (1) (5).
Classification Of Tics In Children
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are three types of tic disorders in children (1) (6) (7).
Causes Of Tics In Children
The exact cause or mechanism of tics in children is unknown; however, various studies suggest different theories (5).
Some studies suggest tics as an inherited genetic condition, i.e., it has been passed through generations.
It may also be related to an abnormal metabolism(breakdown) of the chemical dopamine in the brain.
The neurotransmitter disturbances within the basal ganglia have been observed to be related to tics (8).
Certain factors may increase the risk of developing tics in children.
Tourette’s syndrome is more common in boys than girls.
Certain medications, such as those administered for treating attention deficit hyperactivity disorder (ADHD) or attention deficit disorder(ADD).
Various external and internal factors, such as food allergies, exposure to chemicals, and sensory issues, may also trigger tics in children (9).
Some behaviors or emotions may exacerbate tics in children (1) (3).
Stress or strong emotions Anxiety Excitement Fatigue Happiness Talking about tics or drawing attention to your child’s tic
Symptoms Of Tics In Children
The symptoms of tics in children can be vocal or motor and may differ for different tic disorders (10). Common symptoms of vocal tics include:
Coughing Making animal sounds such as hissing or barking Throat clearing Grunting Sniffing Repeating words and phrases Yelling
Common symptoms of motor tics include:
Nose wrinkling Facial grimacing Head twitching Lip biting
Shoulder shrugging Blinking Mimicking movements by others Kicking Skipping Jumping Smelling objects
Conditions That Commonly Occur With Tics
Many children with tics also have one or more mental health conditions, including (4) (5):
ADHD Obsessive-compulsive disorder(OCD) Anxiety
A combination of all three mental health conditions could also affect your child with tics. While some children experience minor symptoms of these co-existing conditions, others may experience more severe symptoms than the tics themselves. Therefore, assessing and managing these conditions is also important while treating tic disorders in children.
When To See A Doctor
Tics do not usually cause any brain damage and may even disappear as soon as they appear. However, you should consult your child’s doctor if the tics are (3):
Regular and more frequent and severe
Causing your child to experience emotional or social problems, such as humiliation, bullying, or social isolation
Causing pain or discomfort
Interfering with your child’s day-to-day activities, or schoolwork
Triggered by or associated with certain emotions, such as anger, depression, or self-harm
Diagnosis Of Tics In Children
Your child’s healthcare provider can diagnose tics by asking for the signs and the situations when parents observe the tics and their duration. In some cases, the child may have a tic at the clinic, and the doctor may observe it. Neurological exams and tests, such as an electroencephalogram (EEG), may be conducted to rule out brain disorders or diseases. Unless the appearance and clinical findings indicate otherwise, no further studies are required in most children with tics (1) (8).
Treatment For Tics In Children
Treatment of tics in children generally includes reducing or restricting the tics and optimizing the quality of life. Many times, tics are mild and disappear without any intervention as the child grows older. If your child has severe tics affecting their daily activities, the following behavioral therapies may be conducted (1) (3).
1. Comprehensive behavioral intervention for tics (CBiT)
It includes learning a set of behavioral skills to help children with tics. It is a weekly treatment with a therapist that consists of eight sessions stretched out over eight to ten weeks and includes three primary components.
Increase the child’s awareness of tics and the desire to perform tics.
Help the child learn a competing behavior when they feel the impulse to perform a tic. This is also known as habit reversal therapy.
Make modifications to their everyday routine to reduce tics.
2. Exposure with response prevention (ERP)
This technique helps the child adapt to the unpleasant sensations and triggers that often lead to a tic. It makes the child resistant to the sensations or impulses that cause a tic, leading to tic prevention eventually. Your child’s doctor or neurologist may also prescribe medications if the tics’ symptoms are uncontrolled (8). Neuroleptic medications are the most commonly prescribed medications 11.
Ways To Help A Child With Tics
A greater understanding, acceptance, and compassion are the important aspects while caring for a child with tics. The following tips may lessen the severity of tics and prevent them (3) (10).
