Tics

Tics are vocal sounds or body movements that are made involuntarily (not on purpose) and are repetitive. The key element to tics is that they are involuntary. The person is not making these noises or movements on purpose, and may at times not even be aware that they are doing them if they happen frequently.

Tics can wax and wane over time and can occur in some environments (eg maths lesson) but not others (eg English lesson).  Some young people may be able to ‘hold them in’ for a while, but  it may be very difficult for them to do this for extended periods of time.

These are very common in children of primary school age, are often harmless and do not require specialist assessment.  Most tics subside as the child grows older.

There are two kinds of tics. One is motor tics, like shoulder shrugging or blinking. The other is vocal tics. The movements or sounds tend to be quick and abrupt.

Examples of motor tics: shoulder shrugs, blinking, touching things, head jerks, facial grimacing, nose twitching, shoulder shrugs.

Examples of vocal tics: repeated sounds, such as throat clearing, sniffing, grunting, or speech.

Tics are not usually serious and normally improve over time. But they can be frustrating and interfere with everyday activities.

Tourette ’s syndrome

Tourette ’s syndrome is a diagnosable is a neurological (brain) condition described as a combination of motor and vocal tics whereby the tics must have been present for at least one year. A diagnosis of Tourette’s syndrome is given by a medically trained doctor

When do tics need treatment?

Usually tics don’t need any treatment and will go away in time. It is important for the child to know about tics, and for people around the child to learn about tics, so that they can respond in a helpful way. This helps to stop behavioural or learning problems developing around the tic.

General practices to help reduce tics

Parents:

• If you find yourself wanting to comfort your child after they tic, say very little. Instead, wait until he’s not ticking as much and ask them how they’re doing.
• If your child’s peers or relatives make comments about the tics, ask them not to react to the tics.
• Sometimes tics can be funny, but don’t laugh when they happen. Pretend as if they did not occur.
• If your child says an inappropriate word as a vocal tic, do not punish or react to what the word or phrase was. Instead, make it an expectation that your child apologize to you and explain to you that it was a tic.
• Share concerns with your child’s school/college, and identify whether additional pastoral support is available
• Establish a good sleep routine and environment

Young people/ children:

Things that might help someone who experiences tics:

• Finding ways to best manage anxiety and stress can be very helpful in reducing tics.  Mindfulness/Meditation techniques are very useful for this.

When to refer to CAMHS

• When they occur very regularly, or become more frequent or severe
• Cause emotional or social problems, such as embarrassment, bullying or social isolation
• Cause pain or discomfort (some tics can cause the person to accidentally hurt themselves)
• Interfere with daily activities, school or work
• Are accompanied by anger, depression or self harm

Resources

What makes us tic? (www.tourettes-action.org.uk)
The good-night guide for children (camhs-resources.co.uk)

Parental Support

https://www.familylives.org.uk/	Previously parent line – online forums and parent courses
www.parentzone.org.uk	Parent Zone
www.psg.org.uk	Parent support group- helpline and advice
https://www.dad.info/	Website with articles, podcasts etc
www.minded.org.uk	Module especially for families – parents and carers who are looking for advice and tips about CYP mental health, alongside existing modules for professionals
mycamhschoices.org/	Explains what young people and families can expect when they visit CAMHS