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Tic Disorders

Summary

Tics are sudden, repetitive movements or sounds that children may make involuntarily. These can include blinking, shoulder shrugging, throat clearing, or sniffing. Tics often become more noticeable during times of stress, excitement, or change.

Tics are most common in children and adolescents and tend to be more frequent in boys. Many children experience mild tics that come and go and do not require treatment. However, if tics interfere with daily life, social interactions, or cause discomfort, medical advice may be needed.
Tics can sometimes occur alongside other conditions such as ADHD, anxiety, or obsessive-compulsive disorder (OCD). 

Diagnosis and When to Seek Help

Most tics are harmless and do not require medical treatment. However, parents should consider consulting a doctor if:

  • Tics become severe or cause physical pain.
  • The child feels embarrassed or struggles socially due to tics.
  • Tics worsen significantly or continue for more than a year.
  • The child has other symptoms, such as difficulty focusing, anxiety, or compulsive behaviors.

Management

Many tics improve on their own without treatment. If intervention is needed, options include:

  • Education & Reassurance: Understanding that tics are common and often temporary can help reduce concern.
  • Behavioral Therapy: Habit reversal therapy (HRT) can help children become more aware of their tics and learn strategies to manage them.
  • Reducing Stress & Anxiety: Encouraging relaxation techniques, structured routines, and stress management can help lessen tics.
  • Medication: In rare cases, when tics are severe or significantly impact daily life, a doctor may discuss medication options.

Follow-Up and Monitoring

  • Monitor the frequency and intensity of tics over time.
  • Help your child manage stress and create a supportive environment.
  • If tics persist or worsen, follow up with a healthcare provider to explore additional support.

Most children with tics continue to lead normal, happy lives, and many see improvement as they grow older. 

History and Exam

Key diagnostic factor

  • presence of risk factors
  • observed tics
  • premonitory sensation
  • ability to suppress tics

Other diagnostic factors

  • symptoms worse with stress, anxiety, excitement, or transitions
  • variable severity over time
  • symptoms of comorbid psychiatric disorder

Risk factors

  • onset at age <18 years
  • male sex
  • family history of tics
  • family history of obsessive-compulsive disorder (OCD), ADHD, or depression

Diagnostic Investigations

1st investigations to order

  • clinical diagnosis

Investigations to consider

  • MRI brain with and without contrast
  • electroencephalogram
  • cerebrospinal fluid analysis (lumbar puncture)

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    Other Related Conditions

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    weakness

    cerebral palsy

    neurogenetic disorders

    neurometabolic disorder

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com