Tics

Tics are repetitive, rapid, involuntary muscle contractions or vocal outbursts that usually involve muscles of the face, head, neck, shoulders or respiratory tract. They are often exaggerations of normal movements, such as blinking the eyes or shaking the head. Children as young as age one may develop tics, although most cases occur later in childhood, between the ages of nine and 12. Boys are more likely to develop tics than girls.

Tics are generally grouped in three categories. Transient tics last more than two weeks but less than one year; chronic tics last longer than one year; and a third category of tics, classified as manifestations of Tourette's syndrome (a rare, severe disorder that may involve multiple tics, lack of muscle coordination and purposeless muscle movements), may last an entire lifetime or vanish at some point in late adolescence or adulthood.

Most childhood tics are transient. Typical tics in children include involuntary eye winking or head jerking that lasts a few weeks before disappearing or moving to another muscle group.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS A TIC DISORDER?
Several characteristics distinguish tics from voluntary movements, such as head banging, which some children engage in as a form of self soothing. Tics are sudden and spasmodic, and the child is unable to control them (and may not even be aware of them). Tics get worse with strong emotions and disappear during sleep.

WHAT CAUSES TIC DISORDERS?
The cause of most tics is unknown, although there are a number of theories. In a few cases, the development of a tic or tics may reflect an underlying nerve disorder, but tics of this type are usually persistent and they occur in conjunction with other signs and symptoms. Tics may be associated with changes in the body that occur during normal maturation of nerves and muscles. There seems to be a strong association between anxiety or stress and tics, but it isn't clear what, if any, psychological factors may be involved.

IS MEDICAL ATTENTION NECESSARY?
Most mild tics do not require medical attention per se, but the child's physician should be consulted to eliminate the possiblity that the tic is a sign of some underlying neurological problem. Severe tics that disrupt a child's activities should be brought to a doctor's attention immediately.

WHAT TREATMENTS ARE AVAILABLE?
Most mild, transient tics can simply by left alone. If a tic has remained unchanged at the same muscle site for more than a year, the child's physician may consider treatment but usually only if the tic is distressing or disruptive. Behavioral therapy—particularly a technique in which the child is instructed to repeat the tic deliberately many times over—is sometimes effective. Only a behavioral psychologist, however, should try to perform this treatment. Tics that are associated with anxiety or stress may respond to other types of psychotherapy, including family counseling.

Severe tics, such as those occurring in Tourette's syndrome, generally require drug treatment. Although several medications (mainly sedative, antipsychotic and antianxiety drugs) are effective in controlling the tics, they do not cure tic disorders, and they may cause serious side effects.

GETTING HELP
Call your doctor if:

• Your child repeatedly makes movements of the face, neck or shoulders without seeming to be aware of it

• Such movements are repeated regularly over the course of a year

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.