Tics are sudden, rapid, recurrent movements or vocalisations that the child feels a strong urge to perform. Tics often present around 5-7 years of age. They can be associated with OCD and ADHD.
Tourette’s syndrome involves multiple motor and vocal tics, present for at least a year, and starting before age 18.
Tics become more prominent when the child is under pressure or excited. They may describe an overwhelming urge to perform the tic. This urge increases the more they suppress it. They feel the need to complete the tic, often several times, to get relief from that urge. These feelings are called premonitory sensations.
Simple Tics
Examples of simple tics include:
- Clearing throat
- Blinking
- Head jerking
- Sniffing
- Grunting
- Eye rolling
Complex Tics
Examples of complex tics include:
- Physical movements, such as twirling on the spot or touching objects
- Copropraxia involves making obscene gestures
- Coprolalia involves saying obscene words
- Echolalia involves repeating other people’s words
Management
Tics will usually improve over time. Mild cases with no signs of underlying disease may only require reassurance and monitoring. Taking measures to reduce stress, anxiety and triggers can be helpful.
More severe or troublesome tics should be referred to a specialist. They may benefit from:
- Habit reversal therapy (HRT)
- Comprehensive behavioural intervention for tics (CBIT)
- Medications may be tried in very severe cases (e.g., antipsychotics or clonidine)
Co-morbid conditions, such as OCD and ADHD, may benefit from treatment.
Last updated March 2026
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