Tics and Tourette’s in Children and Teens

Specialized behavioral treatment that gives kids more control over their tics.

What we treat

When tics take over

Tics are sudden, repeated movements or sounds, like blinking, shrugging, throat clearing, or sniffing. Many children have tics at some point. Tourette syndrome is diagnosed when a child has had both motor and vocal tics for more than a year. Tics are not on purpose, and they are not a sign of bad behavior. Specialized behavioral treatment can help.

How commonAbout 1 in 162 children have Tourette syndrome

Typical onsetUsually between ages 5 and 10

First-line treatmentComprehensive Behavioral Intervention for Tics (CBIT)

FormatIn person or telehealth

Understanding tics

What tics look like in kids

Many children feel an uncomfortable urge just before a tic, and doing the tic brings brief relief. Tics often get worse with stress, excitement, or tiredness, and they commonly come and go or change over time.

Motor tics

Eye blinking. Facial grimacing. Head jerking. Shoulder shrugging. More complex movements like touching, hopping, or twisting.

Vocal tics

Throat clearing. Sniffing. Grunting or humming. Repeating words or phrases. Less often, blurting out words.

What parents notice

Tics that increase during stress, screen time, or excitement. Teasing or embarrassment at school. Physical pain from repeated tics. Worry, frustration, or low confidence.

When to reach out

Tics are causing pain, embarrassment, or teasing
Tics interfere with schoolwork, sleep, or activities
Your child feels distressed or frustrated by their tics
Tics have lasted for several months
Anxiety, OCD, or attention problems are also present
You want a treatment option alongside or instead of medication

Tics rarely travel alone

Most children with Tourette syndrome also have at least one other condition, such as ADHD, anxiety, or OCD^[1].

Because we specialize in anxiety and OCD, we can treat tics and co-occurring anxiety or OCD together in one coordinated plan.

How we treat it

Our approach to tics and Tourette's

We use Comprehensive Behavioral Intervention for Tics (CBIT), which the American Academy of Neurology recommends as a first treatment option for tics^[3]. CBIT teaches children skills to manage tics rather than simply trying to stop them.

A thorough evaluation. We learn about your child's tics, what makes them better or worse, and any co-occurring anxiety, OCD, or attention concerns.
Awareness training. Children learn to notice the early urge or warning sign that comes before a tic.
Competing responses. Kids practice a subtle, comfortable action that makes the tic harder to do, such as slow breathing for a vocal tic.
Reducing triggers. We identify situations that make tics worse and adjust routines at home and school.
Coaching parents. Parents learn to support practice, praise effort, and avoid drawing attention to tics.
Relaxation and keeping gains. Children learn calming skills and plan for new or changing tics.

Working with school and doctors: With your permission, we coordinate with teachers on supportive accommodations and with your child's pediatrician or neurologist when medication is part of care.

The evidence

What the research says

Tic disorders are common in childhood, and behavioral treatment has strong evidence as an effective, medication-free option.

1 in 162

children are estimated to have Tourette syndrome, and many cases go undiagnosed.

CDC [1]

52.5% vs 18.5%

of children improved significantly with CBIT, compared with supportive therapy and education, in a trial of 126 children ages 9 to 17.

Piacentini et al., 2010 [2]

83%

of children with Tourette syndrome have at least one other mental, behavioral, or developmental condition.

CDC [1]

The American Academy of Neurology 2019 guideline recommends CBIT as an initial treatment option for tics^[3].
In the landmark CBIT trial, most children who responded still showed benefits six months later^[2].

Research results describe averages across groups of children. Every child is different, and we track your child's progress with standardized measures throughout treatment.

Common questions

Can't my child just stop the tics?

Children may be able to hold back tics briefly, but it takes effort and the urge builds. CBIT teaches practical skills that make tics easier to manage over time.

Will focusing on tics make them worse?

Research on behavioral therapy has not found that it makes tics worse. Children learn skills in a supportive, low-pressure way.

Does my child need medication?

Not always. Many children benefit from CBIT alone. For some, medication is helpful, and CBIT can be used alongside it. We coordinate with your child's doctor.

Does CBIT work by telehealth?

Yes. CBIT has been delivered successfully by video, and telehealth makes it easy for parents to join and support practice.

References

Centers for Disease Control and Prevention. Data and statistics on Tourette syndrome. View source
Piacentini, J., Woods, D. W., Scahill, L., et al. (2010). Behavior therapy for children with Tourette disorder: A randomized controlled trial. JAMA, 303(19), 1929–1937. View study
Pringsheim, T., Okun, M. S., Müller-Vahl, K., et al. (2019). Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology, 92(19), 896–906. View guideline