About motor tics and vocal tics

Motor tics

A motor tic is a fast, repetitive series of muscle movements that result in sudden and hard to control body shakes or sounds.

Tics are common in children from the age of 5 years.  It is estimated that 20% of children (1 in 5) experience motor tics at some point. Most motor tics go away independently over time without the need for treatment.

Vocal tics

A vocal tic is when a child shouts or makes a sudden noise. Vocal tics can happen alongside motor tics.

If these continue over a period of time (usually more than a year) a child might be diagnosed with Tourette’s syndrome (see More information section below). This term is used when these tics have lasted more than a year.

Signs of tics

The following are some of the signs of tics:

  • blinking, wrinkling the nose or pulling faces
  • jerking or banging the head
  • clicking the fingers
  • touching other people or things
  • coughing, grunting or sniffing
  • repeating a sound or phrase.  Occasionally this can be something offensive.

How tics happen

Tics often start with an unpleasant sensation that builds up in the body (an urge) until it is relieved by the tic. 

Sometimes these urges can be partly controlled by the child.

Tics can happen randomly and there are different triggers for every child.  Common triggers include stress, anxiety, tiredness, boredom, excitement or happiness.

Tics and other conditions

Tics can occur on their own. Sometimes they are associated with anxiety, stress or panic disorders.

Tics can be more common in children with Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD) or Obsessive Compulsive Disorder (OCD).

How to reduce tics

The following can help to reduce tics:

  • Distracting your child or getting them to concentrate on other activities which they find interesting.
  • Giving your child opportunities for exercise
  • Making sure your child gets enough sleep.

Helping your child to control their tics

You can do the following to help your child manage their tics and reduce their anxiety.

  • Try to ignore your child’s tic.  Do not talk about it too much. Drawing attention to it may make it worse
  • Reassure your child that everything is okay.  Tell them there is no reason for them to feel embarrassed about their tic.
  • Ensure that people who have regular contact with your child are aware of your child’s tics .  Explain to them how to respond if your child displays a tic in front of them. 
  • If your child is finding school difficult, talk to their teacher about ways to help them.  For example, it may help if your child is allowed to leave the classroom if their tics are particularly bad.

Treatment

Tics are not usually serious.  They do not damage the brain. They usually go away independently.  If they are mild and do not cause problems, they might disappear as quickly as they came.

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Contact your GP for advice if any of the following apply to your child’s tics:

  • They happen regularly, or become more frequent or severe.
  • They cause emotional or social problems, such as embarrassment, bullying or social isolation.
  • They cause pain or discomfort.  (Some tics can cause the child to accidentally hurt themselves).
  • They interfere with daily life, school and social activities.
  • They are accompanied by anger, depression or self harm.

It can help your GP if you record a video of your child’s tics, but do not do this if it causes extra distress to your child.   

How your GP can help

If you seek help from your GP, they will ask about your child’s medical history.  They will examine your child and ask about the frequency and symptoms of their tics.

Your GP may find it helpful to see a video of your child’s tics, but do not film your child if this will cause them extra distress.

Your GP may be able to diagnose and manage simple tics and provide support and advice without involving a hospital specialist.

Specialist support

The following types of specialist support are available.

Behavioural therapy

Behavioural therapy involves talking about a problem to help find a coping strategy that suits the patient. This is often recommended as one of the first treatments for children with tics.

Your GP might be able to refer your child for help with this type of therapy.

Medical treatment

If your GP does not have access to a behavioural therapist, they may refer you to a hospital paediatrician (child health specialist) to discuss options. The hospital paediatrician will ask you about your child’s tics and examine them to exclude any other problems which might be causing these tics.

They may be able to offer advice on how best to manage your child’s tics.

Occasionally, children with severe tics can be given a trial of medication called neuroleptics. This is given under specialist hospital supervision and is only used if other strategies have not helped.  If this course of action is recommended, the hospital team will discuss the risks and benefits with you and your child.

Contact information

Paediatric Admin Team, Monday to Friday 9am to 5pm

Telephone:

020 8934 6403