You notice it while they’re watching TV or getting ready for bed: a repeated blink, a shoulder shrug, a small sound they don’t even seem aware they’re making. At first, you wonder if it’s just a habit or a phase, but once you see it, you can’t unsee it. Many parents feel a knot of worry in their stomach when something new and unexpected shows up in their child’s behavior. The good news is that sudden tics are a common part of childhood, and in most cases, they’re temporary and harmless.
Tics are quick, repetitive, and involuntary movements or sounds that are common during childhood. Common types of tics include motor and vocal tics, and they can be simple or complex. Tics are more common in boys and are often mild and resolve on their own over time, but if they are frequent, consistent, or severe, they may indicate a tic disorder. If your child is experiencing tics, here’s what you need to know.
What causes tics in children?
We aren’t entirely sure why some people experience tics and others don’t, and there is not a single cause that explains every case of tics.
Tics and tic disorders often run in families, suggesting a potential genetic component. In some cases, tics are likely neurological, related to changes in the part of the brain responsible for controlling movement. Tics commonly accompany other common conditions like ADHD, anxiety, or OCD, and less common conditions like Huntington’s disease or encephalitis.
Tics can be a side effect of some medications and illicit drugs like cocaine or amphetamines. From an individual perspective, tics often begin with an urge or an unpleasant sensation that builds in the body which can be relieved by giving in to the tic. Environmental factors, including stress, can also trigger or exacerbate tics. It’s sometimes possible for a person to suppress or delay tics, but that can cause discomfort and result in increased tics later on.
Why has my child suddenly developed a tic?
When they occur, tics often feel like an impulse or uncomfortable sensation, similar to needing to sneeze. The feeling builds in the affected area of the body, and giving in to the tic provides temporary relief.
Tics may be triggered or worsened by sudden life changes, big emotions, stress, or fatigue. If your child has experienced or is experiencing any of these triggers, they could explain a sudden onset of tics. Tics may worsen when your child is relaxed or alone, and may improve when they are concentrating or focused on a task. Moreover, calling attention to a tic often makes it worse.
Are tics common in children?
Tics are much more common than many people realize, and they are most common in children. Tics often begin between the ages of 5 and 10. They are usually temporary and typically resolve on their own.
The various kinds of tic disorders may appear similar, but they occur at different rates. Transient tics impact about one in 10 kids at some point in their childhood, last less than a year, occur nearly daily, and often resolve on their own without specific treatment. Meanwhile, persistent tics and Tourette syndrome are less common, but together they affect more children than many parents realize. Up to one in five kids may experience some type of tic disorder at some point during childhood.
Can you have tics without Tourette’s?
Not all tics or tic disorders are the same. In fact, tic disorders are a spectrum of neurological conditions with different presentations. Tourette’s is the most well-known of these disorders, but it’s not the only one.
There are three main types of tic disorders, ranging from mild to severe, each characterized by the type of tics involved and how long symptoms last.
Transient Tic Disorder
The most common is known as provisional or transient tic disorder. It is defined by motor and/or vocal tics persisting for less than one year. Transient tic disorder impacts roughly 10 percent of children.
Persistent Tic Disorder
Also known as chronic tic disorder, this is characterized by motor or vocal tics (one or the other, not both) lasting more than a year. This impacts less than one percent of school-aged kids.
Tourette Syndrome
This well-known tic disorder is characterized by two or more motor tics and at least one vocal tic, persisting for more than a year. It is estimated that about one out of every 162 children experiences Tourette’s.
Types of Tics in Children
There are three main types of tics: motor, vocal, and facial. They can be either simple or complex. Simple tics involve fewer muscle groups, are typically brief, and are more common than complex tics. Additionally, in most children with a tic disorder, motor tics usually develop before vocal tics, and simple tics emerge before complex ones.
Motor Tics in Children
- Shoulder shrugging
- Shoulder or head jerking
- Combined motions, like shoulder shrugging and facial grimacing
- Touching or sniffing objects repeatedly
- Hopping or jumping
- Bending
- Twisting
Vocal Tics in Children
- Repetitive throat clearing
- Sniffing
- Barking
- Grunting
- Repeating their own words or phrases
- Echolalia – repeating the words or phrases of others
- Obscene, vulgar, or swear words
Facial Tics in Children
- Facial grimacing
- Eye blinking
- Eye rolling
- Nose twitching
Nervous Tics in Children
While stress and anxiety are known to make tics worse, there aren’t any specific tics associated with nervousness. Nervous tics are characterized by an association with stress or anxiety and can present as any of the above motor, vocal, or facial tics. If your child is facing academic stress, these tips may help.
Supporting Children with Tics
While you may not be able to prevent tics, there are things you can do to support your child, make them feel comfortable, and minimize the frequency and severity of tics.
- Avoid stress and anxiety when possible.
- Provide activities your child enjoys to keep their mind occupied.
- Ensure your child gets enough sleep.
- Ignore tics when they happen (remember they are involuntary, and calling attention to them often makes them worse)
- Don’t scold your child. Your child isn’t being intentionally disruptive, and they need your love and support, not discipline.
- Provide comfort and reassurance. This is especially important if your child feels embarrassed about their tics. Let them know they have nothing to be embarrassed about, that you love them, and that everything will be okay.
- Build a support system. Talk with teachers, family, friends, loved ones, and other people in your child’s life. Let them know what your child is going through and how best to support your child when they need it.
When to Seek Help for Your Child’s Tics
If tics are mild and they don’t disrupt your child’s day-to-day life, then you probably don’t need to do anything. Most cases of tics in children are temporary and resolve on their own without treatment. If tics start happening more regularly, become severe, cause social or emotional problems, or cause pain or discomfort, schedule an appointment with your child’s pediatrician.
Depending on the type and severity, tic disorders can be treated or managed with medication, behavioral therapy, or a combination of both. If you suspect your child has a tic disorder that requires treatment, your pediatric provider can help diagnose, establish a treatment plan, and answer all of your questions.
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