What are guidelines?

Guidelines are summaries of what we know about different tests and treatments for health problems. They are based on research and include recommendations that help guide doctors and other health care providers when they are working with patients, or with patients and families, to make decisions about their health care.

Is tic disorder the same as Tourette syndrome?   

Tourette syndrome is one type of chronic tic disorder. Tics are purposeless, repetitive body movements or sounds. There are two types of tics that people with Tourette syndrome or other disorders might exhibit—motor tics and vocal tics.

Motor tics are repetitive body movements that can include:

• Forceful or frequent blinking
• Eye movements
• Facial grimacing
• Movements of the head or limbs

Vocal tics are repetitive sounds made through the mouth or nose. Vocal tics include:

• Sniffing
• Coughing
• Clearing your throat
• Words
• Phrases

All of the above are examples of simple tics. Tics can be more complex. Tic symptoms also differ from person to person. Sometimes the tics come and go for days, weeks, or months. For most children with tics, tics are at their peak severity between the ages of 10 and 12 years.

Can education help?

The guideline states that improving the attitudes of peers and the knowledge of teachers about Tourette syndrome can have a positive effect. The guideline recommends that doctors refer people with Tourette syndrome to resources, such as the Tourette Association of America for educational materials.

Can tic disorder go away?

For people with Tourette syndrome or chronic tic disorders, the guideline states that over time, tics often resolve or greatly improve in many children. Watching and waiting may be all that is needed and may be considered an acceptable form of management.

Doctors may prescribe a treatment called comprehensive behavioral intervention for tics (often referred to as CBIT) to patients whose tics are not causing problems in daily life but who want to try a treatment.

What is comprehensive behavioral intervention for tics?

Comprehensive behavioral intervention for tics (CBIT) is a treatment that combines relaxation training, habit-reversal training, and behavioral therapy to help reduce tic symptoms. The guideline states that CBIT has been proved to be effective in both children and adults and has no major side effects. Recommendations about many other treatments used for tics are also discussed in the guideline.

Are Tourette’s and ADHD related?

Children with Tourette syndrome and other chronic tic disorders may also have attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) or other anxiety, mood, and disruptive behavior disorders. Having these conditions in addition to tics may affect treatment options. The guideline recommends that people with tics are screened for ADHD and OCD and make sure treatment for both disorders is provided when it is needed.

It is important that people with tics are screened for anxiety, mood, and disruptive behavior disorders. People with Tourette syndrome should be asked whether they have thoughts about harming themselves. If they do, it is recommended that doctors refer them to appropriate health care providers. 

Read the full practice guideline recommendations summary.

Read the full summary of the guideline for patients and their families.