Tics are sudden, involuntary movements or sounds that can appear in early childhood and may last for weeks, months or even longer. While many tics are temporary and harmless, understanding when they might signal something more serious is important for parents and caregivers. Tics in childhood are common and usually go away on their own, but some cases require a medical evaluation, especially if symptoms worsen or interfere with daily life.

what are tics?

Tics are classified as motor or vocal, and they can be either simple or complex. Most children develop tics between ages 5 and 10, and in many cases, these tics fade with time. However, for some, they persist or evolve into a tic disorder in childhood, which may need clinical attention.

motor tics

Motor tics involve movement of one or more muscle groups.

• Simple motor tics: quick, sudden movements such as eye blinking, nose wrinkling, facial grimacing, shoulder shrugging or head jerking.
• Complex motor tics: more coordinated, purposeful-looking actions such as hopping, spinning, touching objects or mimicking others.

vocal tics

Vocal tics are involuntary sounds made with the voice or throat.

• Simple vocal tics: include coughing, throat clearing, sniffing, grunting or barking.
• Complex vocal tics: involve speech, such as repeating words or phrases, animal sounds or yelling out unexpected words.

Tics can come and go, and they might happen more or feel stronger when someone is stressed, excited or tired.

types of tic disorders

When a child has ongoing tics, it may fall under one of several tic disorders. Each type is defined based on how long the tics last and whether they are motor, vocal or both.

• Provisional tic disorder: This is the most common diagnosis, particularly in preschoolers and younger children. The child has developed tics for less than one year.
• Chronic tic disorder: In this condition, a child experiences either motor or vocal tics (but not both) for more than a year.
• Tourette syndrome: The most well-known tic disorder, Tourette syndrome is diagnosed when a child has both multiple motor tics and at least one vocal tic for over a year.

causes of tics in kids

The causes of tics are not completely understood, but research suggests they result from a combination of genetic, neurological and environmental factors.

• Genetics: Tics often run in families. A child with a family history of tics or Tourette syndrome may be more likely to develop tics themselves.
• Neurological factors: Some experts believe that tics are related to dysfunction in the basal ganglia, the part of the brain that controls movement. This is why tics are considered neurological tics.
• Stress and anxiety: Nervous tics in childhood can sometimes increase during times of emotional distress or big life transitions.
• Developmental conditions: Tic disorders may occur alongside conditions such as ADHD, OCD or anxiety disorders.

symptoms of tics

Symptoms of tics can be hard to identify at first, especially in younger children. They often start as small movements or sounds that appear meaningless but become more noticeable over time.

Watch for:

• Sudden, brief and repetitive movements or sounds
• A pattern of behaviors that may start and stop over time
• Tics that become more frequent or intense when the child is anxious or excited
• Complaints of an urge or sensation that’s relieved by performing the tic
• Disruptions in the child’s ability to concentrate, participate in social activities or sleep

It’s also important to distinguish tics in preschoolers from other movement disorders. Many young children display repetitive behaviors as part of typical development, but persistent or disruptive tics should be evaluated.

treatment for tic disorder in children

There is no universal cure for tics, but many children outgrow them or experience improvement with time. In cases where tics persist or impact quality of life, there are several treatment options available.

behavioral therapy

The most effective non-medical intervention is Comprehensive Behavioral Intervention for Tics (CBIT). This therapy helps children recognize the urge before a tic and substitute the behavior with a competing response.

CBIT is especially helpful in managing nervous tics and provides tools to reduce both motor and vocal tics over time.

medication

In some cases, especially for children with severe tic disorders, medications may be recommended. These may include:

• Dopamine blockers
• Alpha agonists
• Antidepressants (for co-occurring anxiety or OCD)

Medication is typically considered when tics are causing significant physical or emotional distress.

supportive care

• Education and support: Helping the child, family and school staff understand tic disorders can reduce stigma.
• Stress management: Techniques like mindfulness, regular sleep routines and exercise can help manage developed tics.
• Monitoring: In mild cases, no treatment is needed. Regular check-ins with your pediatrician may be all that’s necessary.

when tics might signal something more

Occasionally, tics may be associated with other neurological symptoms such as attention issues, learning difficulties or developmental delays. In these cases, further testing may be necessary to rule out conditions such as autism spectrum disorder, epilepsy or anxiety-related disorders.

are tic disorders neurodivergent? 

Yes, tic disorders fall under the umbrella of neurodivergence, which refers to brain differences that affect how someone thinks, learns and behaves. Children with tic disorders often process motor control differently but can still thrive with the right support.

how common are tic disorders? 

Tic disorders are fairly common in childhood. Research shows that up to 20% of children may develop a tic at some point, with many cases resolving on their own. Tourette syndrome, the most recognized form, affects about 1 in 160 children.

are tic disorders considered a disability?

Tic disorders are not always considered a disability, but in cases where tics cause significant social, academic or physical impairment, they may qualify for accommodations or services under a disability designation in schools or healthcare systems.

when to seek help for a tic disorder

Most tics in kids are harmless and temporary, especially if they appear around ages 5 to 7. However, there are specific signs that suggest the need for a medical evaluation.

Seek expert care if:

• Tics last longer than 12 months
• The child experiences physical pain, social withdrawal or embarrassment
• Tics are interfering with school, play or daily routines
• There are co-occurring issues like obsessive thoughts, anxiety or developmental delays
• The child displays complex or aggressive motor tics, or vocalizations that seem intentional or inappropriate

A pediatric neurologist can assess the severity and recommend appropriate treatment strategies. If your child is showing signs of a tic disorder, don’t hesitate to reach out. Our pediatric neurology team at Dayton Children’s offers specialized care for tics in childhood, including diagnosis, behavioral therapy and treatment planning tailored to your child’s needs. Schedule an appointment online or call 937-641-4000.