Clinical Psychology, School Counseling

Tic Disorder

Diagnosis

Tic disorders are diagnosed based on signs and symptoms. The child must be under 18 at the onset of symptoms for a tic disorder to be diagnosed. Also, the symptoms must not be caused by other medical conditions or drugs.

The criteria used to diagnose transient tic disorder include the presence of one or more tics, occurring for less than 12 months in a row.

Chronic motor or vocal tic disorders are diagnosed if one or more tics have occurred almost daily for 12 months or more. People with a chronic tic disorder that is not TS, will experience either motor tics or vocal tics, but not both.

TS is based on the presence of both motor and vocal tics, occurring almost daily for 12 months or more. Most children are under the age of 11 when they are diagnosed. Other behavioral concerns are often present, as well.

To rule out other causes of tics, a doctor may suggest:

Treatment and coping

Treatment depends on the type of tic disorder and its severity. In many cases, tics resolve on their own without treatment.

Severe tics that interfere with daily life may be treated with therapies, medications, or deep brain stimulation.

Therapies for tic disorders

Some types of cognitive behavioral therapy can help people manage the discomfort of a tic disorder.

Some therapies are available to help people control tics and reduce their occurrence, including:

  • Exposure and response prevention (ERP): A type of cognitive behavioral therapy that helps people become accustomed to the uncomfortable urges preceding a tic, with the aim of preventing the tic.
  • Habit reversal therapy: A treatment that teaches people with tic disorders to use movements to compete with tics, so the tic cannot happen.

Medication

Medication can be used alongside therapies or on its own. Medication typically reduces tic frequency, but does not completely get rid of the symptoms. Available medications include:

  • anti-seizure medications
  • Botox injections
  • muscle relaxants
  • medications that interact with dopamine

Other medications may help symptoms associated with tic disorders. For example, antidepressantscan be prescribed for symptoms of anxiety and OCD.

Deep brain stimulation

Deep brain stimulation (DBS) is an option for people with TS whose tics do not respond to other treatments and impact someone’s quality of life.

DBS involves the implantation of a battery-operated device in the brain. Certain areas of the brain that control movement are stimulated with electrical impulses with the aim of reducing tics.

Coping and self-help tips

Some lifestyle changes can help reduce the frequency of tics. They include:

  • avoiding stress and anxiety
  • getting enough sleep

It can be helpful to:

  • join a support group for people with TS and other tic disorders
  • reach out to friends and others for help and support
  • remember that tics tend to improve or disappear with age

Parents of children with tics may wish to:

  • inform teachers, caregivers, and others who know the child, about the condition
  • help boost the child’s self-esteem by encouraging interests and friendships
  • ignore times when a tic occurs, and avoid pointing it out to the child

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