Tics are rapid and repetitive movements (motor tics) or sounds (phonic or vocal tics) that are difficult to control. Up to 1 in 5 children experience tics during childhood. Tics tend to change over time, and usually start with simple motor tics (e.g., eye blinking, shoulder shrugging) or simple vocal tics (e.g., sniffing, throat clearing), and can evolve to be more complex with multiple muscle groups or combinations of movements (e.g., hopping, jumping) and/or sounds (words or phrases).
Parents are often worried when their child has tics, but the good news is that they often decline naturally on their own. When tics persist, are painful, cause distress, or impact a child’s life, treatment may be helpful.
Interventions for tics that have demonstrated the strongest evidence base is a type of behavioral treatment called Comprehensive Behavioral Intervention for Tics (CBIT) or Habit Reversal Training (HRT).
The treatment is composed primarily of two components - awareness training and competing response training:
Awareness training involves recognizing the urge that arises just before a tic. This urge is a signal that a tic is about to occur.
Once you are able to notice this urge, you can then use a competing response (an action that is less noticeable and physically incompatible with the tic) whenever you feel an urge to counteract the tic.
Tics are targeted one at a time as both of the above two components are introduced in sessions and then practiced in between sessions to promote generalizability in your life. Treatment will also likely involve parent or caregiver support to help and encourage the use of competing responses.
Other coping skills (e.g., relaxation strategies, distress tolerance skills) and function-based interventions to address environmental influences, are incorporated to enhance treatment.