Making Sense of Your Child’s Tics: A Guide for Parents

Written by Dr Lucy Russell DClinPsyc CPsychol AFBPsS

If you’re reading this, you’ve probably noticed some repeated movements or sounds in your child that you think might be tics.

Perhaps you’ve seen your child blinking more than usual, making small movements with their head, or making unexpected noises.

As a clinical psychologist working with children and young people, I know how worried parents can feel when they first notice these behaviours.

In my clinic, parents often ask me: “Will they get worse?” “Can we stop them happening?” “What should I do about them?” These are all natural questions, and I’m here to help you understand what’s happening and how you can best support your child.

In this guide, you’ll learn how to recognise tics, understand what’s happening in your child’s nervous system, and discover practical ways to create a supportive environment. Most importantly, you’ll learn why modern approaches focus less on ‘stopping’ tics and more on understanding and supporting your child’s needs.

What Are Tics?

Tics are sudden, rapid, repetitive movements or sounds that your child may feel they need to do.

Think of them as a bit like a sneeze – there’s often a building sensation or urge, then the tic happens, followed by a feeling of temporary relief. Just as you might be able to hold in a sneeze for a while but find it uncomfortable to do so, children can sometimes suppress their tics, but this takes energy and can be stressful for them.

Your child’s nervous system plays a crucial role here. When I explain this to families in my practice, I often describe it as their child’s nervous system being a bit more sensitive, overloaded or reactive than usual. This sensitivity can increase when they’re excited, anxious, tired, or even just at the end of a busy day at school.

Tics are actually quite common in childhood. According to the NHS, they affect up to 1 in 5 schoolchildren at some point during their development. They often first appear between ages 5-10, and you might notice they come and go, varying in type and intensity. Some days might have lots of tics, other days very few. This ‘waxing and waning’ pattern is completely normal and isn’t something to worry about.

What’s particularly important to understand – and something I emphasise with all the families I work with – is that tics aren’t a sign of bad behaviour or poor parenting. They’re a natural variation in how some children’s nervous systems work, and with the right understanding and support, they can be managed effectively.

How to Spot Tics in Your Child

Parents often tell me they’re unsure whether what they’re seeing is actually a tic. This uncertainty is completely understandable – tics can sometimes look similar to other behaviours like fidgeting or habits. Here’s what to look out for:

Common Signs of Tics in Children

• The movement or sound happens suddenly and usually includes the same action each time
• Your child might say they feel an urge or sensation before it happens
• The tics may increase when your child is tired, excited, anxious, or stressed
• You might notice them more after school or at bedtime
• Your child might be able to suppress them for short periods, but this takes effort
• The movements or sounds may change over time – this week’s eye blink might become next month’s shoulder shrug

Your Child’s Tics: When and Where to Watch

In my clinical work, I’ve noticed that tics often become more noticeable in certain situations:

• During transitions (like between activities or lessons)
• When concentrating (like doing homework)
• During relaxing activities (like watching TV)
• When tired or coming down with an illness
• In new or stressful situations
• After holding them in all day at school

It’s important to note that trying to spot every tic isn’t helpful and can make your child more self-conscious.

Instead, focus on understanding how your child’s nervous system responds to different situations and environments.

Types of Tics

In my practice, I find it helpful to explain to families that tics generally fall into two main categories: motor tics (movements) and vocal tics (sounds). Each of these can be either simple or complex.

Motor Tics

Simple motor tics involve sudden, brief movements like:

• Eye blinking
• Head jerking
• Nose twitching
• Shoulder shrugging
• Facial grimacing
• Finger movements

Complex motor tics might include:

• Combined movements
• Touching objects or people
• Mirroring someone else’s movement
• Jumping
• Twirling
• Specific patterns of movement

Vocal Tics

Simple vocal tics often involve:

• Throat clearing
• Coughing
• Sniffing
• Grunting
• Making specific vowel sounds

Complex vocal tics might include:

• Words or phrases
• Changes in volume or pitch
• Repeating heard words or phrases
• Making specific patterns of sounds

Remember, these tics can change over time – something I often explain to worried parents in my clinic. Your child might have one type of tic for a while, then it might change to something else, or they might experience several different tics at once. This changeability is entirely normal.

What’s particularly important to understand is that tics are neurological in nature – they’re not something your child is doing on purpose.

When I work with families, I emphasise that focusing too much attention on the tics themselves can sometimes make them more pronounced.

Instead, we want to understand what might be triggering increases in tics and how we can support your child’s overall nervous system regulation.

Tic Disorders vs Tourette’s

One of the most common concerns parents bring to my clinic is worry about whether their child’s tics mean they have Tourette’s syndrome. Let me help clarify the differences between various tic presentations.

Tic disorders exist on a spectrum, and the distinctions are mainly based on:

• How long the tics have been present
• Whether they’re motor tics, vocal tics, or both
• Their impact on daily life

A diagnosis of Tourette’s syndrome typically requires:

• Both motor and vocal tics
• Tics that have been present for at least a year
• Onset before age 18

However, I want to emphasise something crucial here: these diagnostic labels are primarily useful for helping professionals communicate and for accessing support when needed. In my experience, what matters most isn’t the specific diagnosis, but understanding your child’s individual experience and needs.

Many children I work with have what we call provisional or transient tic disorder, where tics are present for less than a year. Others might have persistent (chronic) tic disorder, where they experience either motor or vocal tics (but not both) for more than a year.

The Neurodivergent Connection

In my clinical practice, I often see that tics are just one part of a child’s unique neurological makeup. Many children with tics also have other neurodivergent traits or diagnoses, particularly ADHD or autism. This isn’t a coincidence – it reflects how these different aspects of neurodiversity share common ground in how the nervous system works.

Tics and Neurodivergence: Understanding the Nervous System Connection

Think of your child’s nervous system like a highly sophisticated monitoring system. In many neurodivergent children, this system is more sensitive and responsive to both internal and external stimuli. This can mean:

• Greater sensitivity to sensory input
• More intense emotional responses
• Higher baseline levels of internal energy or tension
• Different ways of processing and responding to the world around them

When I explain this to families, I often describe how these different aspects of neurodiversity can interact. For example:

• A child with ADHD might experience more tics when they’re trying to concentrate
• An autistic child might find their tics increase in sensory-rich environments
• Anxiety, which is common in neurodivergent children, can temporarily increase tic frequency

The Latest Understanding

Recent research has shifted away from seeing tics as something to ‘fix’ and towards understanding them as part of natural neurodiversity. This aligns with what I see in my clinical work – children tend to thrive best when we:

• Accept and understand their unique neurological makeup
• Support their sensory and emotional needs
• Create environments that work with, rather than against, their natural patterns
• Help them understand and advocate for their own needs

Some children will have a single diagnosis, while others might have several. What’s most important is understanding how your child’s individual nervous system works and what helps them feel regulated and supported.

A Child’s Experience of Tics: Oliver’s Story

Let me share a story that illustrates how understanding and accepting tics can transform a family’s experience. Oliver (not his real name) was 9 when his parents first brought him to the clinic. He had developed several motor tics including head jerking and shoulder shrugging, along with a throat-clearing vocal tic.

Oliver’s parents were worried because the tics seemed to be getting worse, especially during homework time. They had tried asking him to stop, which only made him more anxious and increased the tics.

What became clear as we worked together was that Oliver’s nervous system was particularly sensitive to academic pressure. He was bright and capable but found the expectations he placed on himself overwhelming.

His tics would increase dramatically when he was trying to concentrate or feeling pressured to perform well.

Instead of focusing on stopping the tics, we worked on:

• Understanding his nervous system’s signals
• Creating a calmer homework environment with regular movement breaks
• Helping his teachers understand his needs
• Teaching him simple breathing techniques for when he felt overwhelmed
• Supporting his parents to respond with acceptance rather than concern

The outcome wasn’t that Oliver’s tics disappeared – though they did naturally reduce as his stress levels decreased.

The real success was that he became more confident and comfortable with himself. His parents learned to see his tics as useful signals about his stress levels, and the whole family developed a more relaxed approach to managing them.

Supporting Your Child

When parents first come to my clinic, they often ask for strategies to help their child ‘control’ their tics. However, I’ve found that the most effective support usually comes from understanding and adapting to your child’s needs.

Here’s what really helps:

Creating a Supportive Home Environment

• Accept tics as a natural part of your child’s experience
• Avoid drawing attention to new or different tics
• Create calm spaces where your child can release suppressed tics
• Maintain regular routines while being flexible when needed
• Ensure all family members understand and support this approach

Understanding Triggers and Patterns

Help your child recognise what affects their tics:

• Keep a simple diary of high-stress times
• Notice patterns around tired periods
• Be aware of sensory challenges in different environments
• Understand that some days will naturally have more tics than others

School Support

I often work with families to help schools understand tics better:

• Share information about tics with teachers
• Request simple accommodations like:
  • Movement breaks
  • Extra time for tests if needed
  • A quiet space for releasing suppressed tics
  • Understanding about tics during concentration tasks
• Help peers understand (if your child wants this)

Practical Strategies for Different Situations

Each child’s needs are unique, but these approaches often help:

• Build in regular movement breaks during homework
• Create a bedtime routine that helps calm the nervous system
• Have a ‘wind-down’ period after busy activities
• Use relaxation techniques that your child enjoys
• Maintain open communication about what helps and what doesn’t

Supporting Self-Advocacy

As children grow older, I encourage them to:

• Understand their own patterns and needs
• Feel confident explaining tics to others if they choose to
• Know what helps them feel more comfortable
• Recognise that tics are just one part of who they are

Remember, your child is still the same wonderful person they’ve always been. Supporting them means helping them navigate their world with confidence, not trying to make the tics disappear.

Treatment and Support Approaches

Our understanding of how to support children with tics has evolved significantly over the years. In my clinical practice, I’ve seen a marked shift away from trying to ‘cure’ or eliminate tics, towards a more holistic approach focused on understanding and supporting the whole child.

How Treatment Approaches Have Changed

Traditionally, treatments like habit reversal therapy or exposure and response prevention were the main approaches offered. While these can still be helpful for some children who are finding their tics particularly distressing or disruptive, they’re no longer seen as the automatic first step.

Instead, modern approaches typically focus on:

• Understanding the child’s unique nervous system patterns
• Identifying and reducing unnecessary stressors
• Supporting better nervous system regulation
• Building confidence and self-acceptance
• Creating supportive environments at home and school

When Additional Support Might Help

Consider seeking professional support if:

• Your child is finding their tics very distressing
• Tics are significantly impacting daily activities
• Your child is developing unhelpful anxiety around their tics
• You need help managing specific situations
• School is becoming challenging
• You’d like guidance on supporting your child’s needs

Available Professional Support

Different types of support are available through:

• Your GP – who can refer to specialist services when needed
• CAMHS (Child and Adolescent Mental Health Services)
• Clinical Psychologists with experience in tics and neurodevelopmental conditions
• Occupational Therapists (particularly helpful for sensory regulation)

Remember, seeking support doesn’t mean there’s something ‘wrong’ – it’s about getting the right understanding and strategies to help your child thrive.

Further Resources and Support

NHS Resources

• Your GP is usually the first point of contact
• NHS Choices provides reliable information about tics and Tourette’s
• Some areas have specialist neurodevelopmental clinics

UK Support Organisations

• Tourettes Action (www.tourettes-action.org.uk)
  • Provides information, support, and advocacy
  • Offers parent support groups
  • Has resources for schools
• ADHD Foundation (www.adhdfoundation.org.uk)
  • Helpful for understanding neurodiversity
  • Resources about managing tics in educational settings

Books and Reading Materials

Here are some books I often recommend to families:

For Parents:

• “Can I tell you about Tourette Syndrome?” by Mal Leicester – An excellent introduction for families
• “Understanding Tourette Syndrome: A guide to symptoms, management and treatment” by Carlotta Zanaboni Dina and Mauro Porta – Evidence-based information written in accessible language

For Children:

• “Tic Talk: Living with Tourette Syndrome” by Dylan Peters – Written by a young person with tics, for young people
• “ADHD, Tics & Me! A Story to Explain ADHD and Tic Disorders/Tourette Syndrome” by Susan Ozer and Inyang Takon – an interactive story about a boy called Jamie

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Dr Lucy Russell is a UK clinical psychologist who works with children and families. Her work involves both therapeutic support and autism assessments. She is the Clinical Director of Everlief Child Psychology, and also worked in the National Health Service for many years. In 2019 Lucy launched They Are The Future, a support website for parents of school-aged children.

Through TATF Lucy is passionate about giving practical, manageable strategies to parents and children who may otherwise struggle to find the support they need.

Lucy is a mum to two teenage children. She lives in Buckinghamshire with her husband, children, rescue dog and three rescue cats. She enjoys caravanning and outdoor living, singing and musical theatre.

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