TOURETTE’S DISORDER AND TICS
• Tics are uncontrolled body movements or vocal utterances
• Tics are most common in children with an estimated 20% of kids experiencing transient tics that clear up on their own. Tics that last less than a year fall under the category of “Provisional Tic Disorder.”
• Tics often improve with age and experts suspect brain maturation plays a role.
• About 10 to 15% of people with Tourette’s Disorder display inappropriate utterances of obscenities or slurs.
• A parent who becomes upset or distressed over their child having tics and might cut them slack by saying “You don’t have to do your homework tonight” only reinforces the tics.
• Reassuring parents and kids that tics are not dangerous medical condition and they will see improvement with age gives parents and children hope.
Behavioral Treatment for Tics
• Behavioral Treatment called Cognitive Behavioral Intervention for Tics (CBIT) is the gold standard of treatment. There are three components: 1. Learn to become more self-aware of tics and the preceding urge that sometimes arises before the tics; 2. Help learn a competing response, which makes the tic more difficult. For example, if the tic involves jerking your head back, a competing response would be to tuck your chin, straighten your neck, and hold that position; 3. Figure out what situations tend to make tics worse or to reinforce them and change the circumstances.
• TicHelper is an on-line self-help version of CBIT that walks kids and families through the intervention
• About half of kids and most adults who try CBIT do not respond or partially respond, therefore an alternative approach is Exposure and Response Prevention (ERP). This involves learning to tolerate the urge to tic-exposing yourself to situations that may trigger tics and learning to relax with deep breathing and progressive muscle relation.
• Mindfulness exercises and distress tolerance practices are part of mindfulness. Using images such as the urge to tic as an ocean wave and let the wave crest and collapse on the shore. Tics increase with excitement and stress and improve with calm, focused activities.
• People with chronic tics have an overconnected corticostriatal sensorimotor circuit that links the cortex to deep motor structures in the brain. They also have underactive inhibitory circuits and overactive limbic circuits. Interventions like CBIT helps strengthen the prefrontal inhibitory circuits.
• Tics can appear alongside other disorders such as obsessive-compulsive disorder (OCD) or Attention Deficit Hyperactivity Disorder (ADHD). A thorough diagnostic session is necessary to identify other coexisting diagnoses. Anxiety disorders can worsen tics, as well as depression. Life stressors can worsen tics, for example, a difficult Calculus Class, transitioning to college or a job, a divorce, being bullied.
• Lifestyle: exercise, good sleep habits, daily routines—things that you can control.
Source: Monitor on Psychology. June 2026. Stephanie Pappas. Pages: 33-37.
Another source: Nix your tics! Eliminate Unwanted tic symptoms” A how-to-guide for young people (2nd ed.) B. Duncan McKinlay.
One last comment. We may suggest a referral for medication, but will leave specific medication recommendations to the expertise of the Prescriber.
Frank R. Ezzo, Ph.D., ABPP, LLC
The Behavioral Wellness Group
8224 Mentor Ave #208 Mentor OH 44060
P: 440 392 2222 #852 F: 440 565 2349
fezzo@behavioralwellnessgroup.com
www.behavioralwellnessgroup.com