Tourette Syndrome and Tic Disorders

What To Do

Tourette Syndrome is the most severe tic disorder, but there are other types. A comprehensive and detailed clinical assessment of your or your child’s symptoms will help to clarify if the tics are transient tics, or tourette's syndrome.

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Tic Diagnoses May Include:

Provisional Tic Disorder: Motor or Vocal Tics (one or both) present for less than one year.
Persistent (chronic) Tic Disorder: Motor or Vocal Tics (not both) for more than one year.
Tourette's Syndrome: Motor and Vocal Tics (both) present and changing over time, for more than one year.

What Is Tourettes?

What You Need To Know

Tourette’ Syndrome (TS) is a neurodevelopmental disorder initially presenting in childhood, characterized by unwanted, repetitive, recurring involuntary motor and vocal tics, which persist in a waxing and waning pattern, changing over time in type, severity and frequency.

The onset of TS has been reported to be as early as two years of age, with the average age of diagnosis about 8-9 years of age, or about the time a child is in early elementary school.

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What causes Tourette Syndrome?

The exact cause of Tourette Syndrome (TS) is unknown. The condition tends to run in families, and genetic predisposition is supported by ongoing international family genetic research studies.

What are Tics vs. normal movements?

More About the Condition

Tics are generally classified as simple or complex. Simple motor tics may include repetitive motor movements, such as eye blinking, facial grimaces, jaw extensions, bending at the waist, and repetitive tossing of the head or neck and shoulder jerks.

Motor tics involving multiple muscle groups often result in more purposeful, complex, and often physically disruptive patterns of movement, and may present as: patterns of eye deviations, sequences of facial movements, touching and tapping, jumping, and sequential motor movements.

Motor tics usually occur concurrently with a wide spectrum of vocal tics. Vocal tics can range from simple sounds (grunting, sniffing, snorting, barking, yelping, humming, repetitive clearing of the throat) to more complex vocalizations such as palilalia (repetition of one’s own utterances and phrases) and echolalia (repetition of someone else’s words or phrases).

The occurrence of profanity utterances (swearing/coprolalia) is considered very rare in typical Tourette populations, although this unique vocal tic tends to be the one most often represented on television and in movies.

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How We Approach It

We Understand Tourette's across the Lifespan

At the Toronto Neurodevelopmental Centre we offer child/adolescent, parental/family and adult therapy for individuals with TS, including CBIT (Comprehensive Behavioural Intervention for Tics), to help your child or adolescent learn techniques and strategies to reduce their tics.

With the benefit of a Clinical Neuropsychological perspective and Dr. Stephens' 17+ years of working with Neurodevelopmental Disorders, our clinicians look beyond the presenting symptoms to discover each individual's unique strengths, creativity, and intellectual potential while determining if there are any commonly associated concerns, such as ADHD, OCD, Learning Disabilities/Giftedness and Obsessive/Compulsive behaviours interfering with daily functioning and achievement.

We offer diagnostic assessments in addition to supportive, cognitive behavioural and solution based therapy for social and performance anxieties, depression, low self-esteem, learning differences, sleep problems, social development and behavioural problems.

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The Reality

No one should not be defined by their Tics

The majority of Motor and Vocal Tics do not reach a level of concern to require treatment of medication, however if the Tics are causing significant disruption to the child’s daily life, or pain and discomfort, recommendations will be made to involve a Pediatric Psychiatrist or Neuropsychiatrist in your child’s care for a potential medication trial.

On average, the majority of Tics abate significantly by early adulthood, although adults with a childhood history of Tics or TS may wish to explore therapy to help better understand their childhood and adolescent behaviours and learning difficulties, as well as to work on constructive strategies to help manage any residual attention, perfectionistic, anger control, or obsessive compulsive behaviours that continue to be problematic in everyday functioning.

As noted, ADD/ADHD and Autism Spectrum Disorder [ASD] are sometimes identified within Tourette populations, and therapy focussing on strategies for improving social interactions, peer and co-worker relationships, academic and work/vocational planning, as well as social anxiety and awkwardness, can be arranged at the Toronto Neurodevelopmental Centre.

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