As a caregiver, it can be concerning when your child seems to engage in repetitive movements or sounds that you can’t quite understand. Children can often do things that seem funny or strange, and it can be easy to assume that their vocalizations or movements are a result of a choice that they are making. But if their repetitive movements or sounds persist over time, it is possible that they are tics, and these actions are not a choice.
Tics are quick, repetitive movements or sounds that an individual’s body makes involuntarily, and they are often common in childhood. Most often, tics appear between the ages of five and ten years old. For many kids, tics are mild and seem to go away on their own with time. For other kids, their tics may be more severe and more frequent, which could indicate the presence of a neurological condition called a tic disorder.
When experiencing a tic, it begins with an unpleasant or uncomfortable feeling or urge that builds up in the body. This feeling and urge can sometimes be delayed, if the child is intentional about suppressing the feeling, but ultimately, the discomfort that they feel only feels relieved when they engage with the tic behavior. For those of us who have not experienced tics, people with the disorder have described that it feels similar to the need to sneeze or scratch an itch. You can try to put it off, but most of the time, sneezing or scratching the spot on your skin is the only way to redirect your attention or soothe the discomfort.
There are different kinds of tics, which means that a tic disorder could look different for each kid. The most common kinds of tics are simple motor tics and simple vocal tics, which involve the movement of minimal muscles.
- Common simple motor tics include facial grimacing, eye blinking or rolling, shoulder or head jerking, and shoulder shrugging.
- Common simple vocal tics include throat clearing, sniffing, barking, or grunting.
There are also complex motor and vocal tics, which are less common, but often are portrayed in the media more. These complex tics involve the use of more muscle groups at once, but function in the same way to relieve the feeling of discomfort.
- Complex motor tics include facial grimacing in combination with a shoulder shrug or head twist, touching or sniffing objects, jumping, and bending or twisting the body.
- Complex vocal tics include repeating words or phrases that other people say, which is called echolalia, repeating their own words or phrases again, or repeatedly using inappropriate words or swear words, which is called coprolalia.
It’s important to remember that these actions are only tics if they occur repeatedly and are a result of a feeling of discomfort in the child’s body. Tic disorders encompass a spectrum of tic behaviors and their associated symptoms that stem from a neurological condition. Each child’s experience with tics may be different, because they can range greatly in presentation and severity. There are three main types of tic disorders that are distinguished from each other by mental health professionals by the type of tic and the length of time that symptoms have been present.
Provisional tic disorder, or transient tic disorder, is the most common type of tic disorder which impacts approximately 10% of children in their early school-aged years. These children experience either motor or vocal tics, or both, for less than one year over time.
Persistent (chronic) tic disorder describes children that have either motor or vocal tics, but not both, for more than one year. This disorder impacts less than 1% of children.
Tourette syndrome is the most common form of a tic disorder, because of its frequent presence in media, like movies. It is the most severe form of a tic disorder; however, it is very uncommon for children, with research finding about 0.3% of children between the ages of 3- and 17-years old meet criteria. Kids with Tourette syndrome experience two or more motor tics, and at least one vocal tic, that all last for at least one year. They also will experience tics many times a day, nearly every day.
These kinds of repetitive and unwanted behaviors can be distressing for a child, and at times it may result in functional impairment. Some kids experience bullying or shame around their tics, and it can feel really upsetting because they are uncontrollable. When tics are more severe, pursuing treatment can help the child reclaim control over their body. Learn more about where tics come from, and options for treatment in our next blog.