Tics are purposeless, involuntary, and repetitive movements and vocalizations. Tic disorders are diagnosed by a neurologist specializing in movement disorders. Diagnosis should not be based on videos seen on social media platforms.
Tics are most prevalent in males and begin in early childhood with blinking, neck movement, throat clearing, and other common behaviors. It is believed that roughly 50% of people with tics do not receive a diagnosis or treatment.
Many tics are transient in nature, and cause no distress or difficulty with the completion of daily tasks. Tics become an issue when they increase in intensity, frequency, number, and impairment.
Tics are often preceded by a thought or feeling called a premonitory urge. An urge is a signal that a tic is about to occur. Tics can involve multiple muscle groups and are often chained together, with one tic quickly being followed by another. Tics can cause great frustration, embarrassment, and physical pain. Excessive attention to tics from concened peers, teachers, and family members often exacerbates the tics and makes them harder to manage. It is best not to discuss someone's tics unless they chose to discuss them with you.
Some people just have motor (movement) tics and some people just have vocal (sound) tics. Vocalizations can include words and phrases. Coprolalia is a more rare type of tic that involves saying inappropriate things such as racial slurs. People with Coprolalia tend to feel very remorseful when unwanted words or phrases are said and often try to mask what they are saying. Nonetheless, it is incredibly hard for the words to not slip out without extensive practice using a breathing pattern to overcome the tic. The frequency and intensity of tics varies from person to person, day to day, and over periods of time. Stress, thoughts, emotions, physical activity, and environment all play a role.
Provisional Tic Disorder is common in young children and is defined as motor or vocal tics occurring for less than one year. After one year of motor or vocal tics, neurologists tend to make a diagnosis of Chronic Tic Disorder. People with both motor and vocal tics lasting for more than one year are typically diagnosed with Tourette Syndrome, aka Tourette's, Tourette Disorder, or TS.
Many people with tic disorders also have concerns related to anxiety, depression, Autism, OCD, ADHD, gender dysphoria, handwriting, and executive functioning. Some people with tic disoreders also have Body Focussed Repetitive Behaviors (BFRB) such as skin picking or biting and hair pulling (trichotillomania).
Tic disorders are best managed with a team approach. Family support along with pharmaceuticals and habit reversal therapy are often considered. Accommodations at school and work also make it possible for people with tics to stay engaged and successful. It also helps to stay physically active and to engage in meaningful activities such as music, art, sports, work, and volunteering. It is also useful to get outdoors everyday for a nice walk for both physical and emotional health benefits.
CBIT is the leading intervention strategy for Chronic Tic Disorders and Tourette's. CBIT is provided by licensed and certified health professionals with extensive training in physical dysfunction, sensory integration, and emotional health support. CBIT Therapy services include the following components:
Many children and adults are able to quickly reduce the intensity and frequency of their tics by practicing CBIT therapy strategies. Progress is dependent on their motivation to manage tics, tic severity, and family support. Click here for a brief video about how CBIT helps to manage tics.
This video is about Tourette Syndrome and viewing it may trigger tics in some people.
Neurology Clinic, University Campus
55 Lake Avenue North
Worcester, MA 01655
Marisela Dy-Hollins, E., M.D.
Wang Ambulatory Care Center
15 Parkman Street, 7th Floor, Room 720
Boston, MA 02114
Kinga Tomczak, MD, PhD
Attending Physician in Neurology
Director, Tic Disorders and Tourette Syndrome Program
Department of Neurology
Boston Children’s Hospital
Harvard Medical School
Tel: 781-216-2525 (Waltham) 617-355-2063 (Boston)
University of Vermont
2 Colchester Avenue
Burlington, Vermont 05405
Christy Stine MD, PhD
33 Lyman St, Ste 400
Westborough, MA 01581
Explaining CBIT, tics, and Tourette Syndrome to a child and their friends is easier with the help of a social story.
Educate others about tics and Tourette Syndrome in a quick and effective way. Prepare an elevator pitch, email, text, or put your message on a business card. You can also click here for the TAA "I have TS" card.
Join with others who have Tourette Syndrome and other tic disorders to make connections and new friends. Learn about CBIT, camps, social events and more resources on tics. Click here to contact a local chapter in Boston and other cities across America.
Know your rights. Reach out to the Job Accommodation Network (JAN) for free and confidential guidance on how to manage Tourette Syndrome and other conditions related related to tics while on the job and when seeking new work. Your skills are needed and valuable.
Our name says it all. We specialize in CBIT therapy and are passionate about supporting our patients and their families so that they can better manage Tourette Syndrome and other conditions related to tics. Services are provided by a licensed occupational therapist certified in CBIT.
Some people with Tourette Syndrome experience blocking phenomena, which is an inability to move. Patients tend to get stuck in awkward and painful positions that can be highly debilitating.
Although some people with Tourette Syndrome experience brief times when their bodies are locked in awkward and debilitating positions, prolonged and highly agonizing periods of immobility also occur in some patients. Despite how emotionally and physically disabling this experience can be, research on the cause and treatment is highly limited.
Blocking is thought to be related to tics, OCB/OCD or a Functional Neurological Disorder. People who suffer from blocking may also have more than one of these conditions.
CBIT Therapy is developing strategies to prevent and interrupt freezing postures caused by blocking phenomena. Above all it is important to keep the patient safe. At times this may involve helping them to the floor so they do not fall. Tensing muscles more may help to release the body. Practicing tensing and relaxing during stable times is important. Slowly gazing up and down when the rest of the muscles are stuck may also be useful to break the grip.
The most effective strategy for blocking seems to be managing preceding tics with CBIT.
Please contact us for more information about blocking phenomena, Tourette Syndrome, and tics.