Does your child experience tics? They need to be soothed, understood, and supported.
Some children blink, wrinkle their nose, or sniffle repeatedly and involuntarily. Although these tics tend to go away on their own, people’s reactions to them can actually make things worse.
What’s a tic?
Tics are involuntary movements or sounds that a child makes suddenly. These movements are fast, repetitive, and don’t have a rhythm. Some children may experience several tics at once and others may have only one.
Depending on the study, 4% to 12% of school-aged children experience tics.
Tics are most commonly located around the face. Facial tics are typically the first to appear (e.g., blinking or squinting, nose wrinkling, grimacing). However, they can affect any part of the body (e.g., head shaking, shoulder shrugging, arm extensions, sudden leg bending). These movements are also known as motor tics.
Tics can also be sound-based (e.g., sniffling, coughing, repeating words). These are called vocal or phonic tics.
Tics may occur several times an hour, and then decrease in frequency or go away for a certain amount of time. They don’t occur during sleep, however. Tics usually appear around the ages of 5 to 7, but they can start earlier, too. In most cases, tics disappear on their own after a few weeks or months with no adverse effects.
What causes tics?
In children, tics are usually caused by excess tension. For this reason, stress, a change in routine, excitement, frustration, or a period of fatigue can cause tics to appear or become more frequent. This is the case, for example, when a child experiences temporary disturbances that distress them, such as the arrival of a new baby, transitioning to kindergarten, going back to school, moving, or the death of a loved one.
Sometimes, tics reflect emotions that a child can’t manage, such as nervousness, frustration, stress, sadness, and boredom. Tics let children release tension, which allows them to calm down and regain their focus.
A child who feels pressured by their environment may also express their tension through tics. Do they have to excel in a sport? Are they often forced to sit still when what they really need is to move around? Do they have to lead by example because they’re the eldest? Do they have trouble keeping up with the pace of learning in class? In such cases, as a parent, it’s important to review what’s expected and required of your child. Doing so will help reduce the amount of pressure they feel.
However, excess tension isn’t necessarily triggered by something negative. For example, going on a trip could cause a child to feel excited, tense, or restless, and thus lead to tics.
Can my child control their tics?
Some children are able to suppress their tics for short periods, which may give the impression that they are semi-voluntary. However, a tic can only be suppressed for so long. In fact, the tic will often come back with a temporary vengeance after the child has tried to control it.
The nature, frequency, and intensity of tics can vary considerably from one child to another depending on the situation. Stressful situations tend to increase the frequency of tics, whereas relaxation, physical activity, and concentration can help reduce them.
How should you react?
How you react to your child’s tics can affect how often they occur and how they develop. Insisting that your child stop ticcing can increase their inner tension and make things worse. Similarly, teasing your child may increase their anxiety and their need to release tension.
If your child tics, they need to be soothed, understood and supported in what they are experiencing.
- Be patient and don’t ask your child to stop ticcing, as they have little control over them.
- Don’t make a big deal of their tics. The subject should not be considered taboo, especially for parents and extended family. Talking to you about their tics will help your child accept them. This will promote their self-esteem and facilitate their relationships with others.
- When your child tics, try to find out what’s causing the tension and don’t scold them. Observe when the tics occur.
- Encourage them to talk about their feelings without judging them, and give them a chance to confide in you.
- Talk to them about what may be causing their discomfort: “I think you might be worried about . . .”
- Propose activities to do to relieve any tension they’re feeling. For example, playing outside (link in French), drawing, painting, singing, dancing to their favourite music, or giving them a massage.
- Do breathing and relaxation exercises (link in French) such as yoga. These generally have a calming effect on tics.
- Encourage your child to participate in individual sports, such as swimming, judo, running, skiing, or cycling. Physical activity promotes self-confidence, releases excess energy and channels aggression in a positive way.
- Ask your child’s teacher if they can use stress balls or other small objects they can handle in class to relieve stress.
In the vast majority of cases, relaxation, fun, exercise, and paying attention to your child’s concerns are the best ways to make the tics gradually disappear.
When should you consult a professional?
Usually, tics go away on their own after a few weeks or months without requiring special intervention.
A tic that lasts longer than a year may become chronic, however.
Consider consulting a doctor or psychologist if the tics persist over time or if they change location, get worse, or if they cause your child pain (e.g., head-shaking or lip-biting), if they are accompanied by another disorder (e.g., difficulty managing emotions, impulsiveness, hyperactivity, obsessive-compulsive or oppositional disorders, and temper tantrums) or if the tics are affecting their self-esteem.
A doctor or psychologist will be able to talk to your child and give you advice on how to support them.
Is it Tourette Syndrome? Tourette Syndrome, which affects boys more often than girls, is a neurological disorder characterized by numerous motor tics accompanied by one or more vocal tics. These tics generally appear around the age of 6 and reach a peak during adolescence, gradually decreasing thereafter in most young people. “Rude” tics (e.g., repetitive and involuntary use of swear words, giving the finger) are the exception to the rule and are present in less than 10% of people with Tourette Syndrome. A Tourette Syndrome diagnosis is solely based on the presence of tics. However, most children with this syndrome will have one or more associated disorders. Among the most common are attention deficit disorder (with or without hyperactivity; 60–80%), obsessive-compulsive disorder (30–60%), learning difficulties (30%), and behavioural problems (30–50%). The associated disorders often have a greater impact on a child’s development and well-being than the tics themselves. |
Things to keep in mind
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Tics usually appear around the age of 5 to 7, but they can also happen earlier.
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Tics may appear or intensify if a child is experiencing stress, frustration, fatigue or pressure from their environment.
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In most cases, the tics will go away on their own after a few weeks or months.
| Scientific review: Marie-Josée Caron, pediatric neuropsychologist Research and copywriting:The Naître et grandir team Updated: April 2021
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Photo: iStock.com/TatyanaGI
Sources and references-
American Psychiatric Association. DSM-5 Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed., Washington D.C., American Psychiatric Association Publishing, 2013, 991 pp.
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Association québécoise du syndrome de la Tourette. “Le syndrome de la Tourette: définition.” aqst.com
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Black, Kevin J, et al. “Provisional Tic Disorder: What to tell parents when their child first starts ticcing.” F1000Research, 2016. f1000research.com
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Chowdhury, Uttom. Tics and Tourette Syndrome: A Handbook for Parents and Professionals. London, Jessica Kingsley Publishers, 2004, 160 pp.
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CHU Sainte-Justine. “Maladie de Gilles de la Tourette: vidéos.” 2018. www.chusj.com
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Dulcan, Mina K. Dulcan’s Textbook of Child and Adolescent Psychiatry. 2nd ed., Washington D.C., American Psychiatric Association Publishing, 2016, 1205 pp.
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Dumas, Jean E. Psychopathologie de l’enfant et de l’adolescent. 4th ed., Louvain-la-Neuve, De Boeck, 2013, 784 pp.
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Leckman, James F., et al. “Course of Tic Severity in Tourette Syndrome: The First Two Decades,” Pediatrics, vol. 102, no. 11, 1998, pp. 14–19.
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Lussier, Francine, et al. Tics?Crises explosives?… Un syndrome de Gilles de la Tourette. Paris, Éditions Tom Pousse, 2018, 172 pp.
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Phelps, LeAdelle and A. Smerbeck. “Pediatric Tic Disorders.” The Handbook of Pediatric Neuropsychology.
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Plessen, Kerstin J. “Tic disorders and Tourette’s syndrome.” European Child & Adolescent Psychiatry, vol. 22, suppl. 1, 2013, pp. 55–60 link.springer.com
For kids -
Verdellen, Cara and Jolande van de Griendt. Se libérer des tics: cahier d’exercices pour les enfants. Malakoff, Éditions Dunod, 2016, 144 pp.
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