A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization. Tics are common in childhood but most often transient. Onset of tics is typically between ages 4 and 6 years with peak severity occurring between ages 10 and 12 years, declining in severity during adolescence. An individual may have various tic symptoms over time. Tics are generally experienced as involuntary but can sometimes be vol­untarily suppressed for varying lengths of time. Tics can be simple (e.g., eye blinking, shoulder shrugging, clearing throat, sniffing) or complex (e.g., combination of simple tics simultaneously, such as head turning and shoulder shrugging). Tic disorders may be diagnosed as persistent (chronic) motor or vocal tic disorder, provisional tic disorder, unspecified or other tic disorder, or Tourette’s Disorder.
Tourette’s Syndrome is a specific type of tic disorder defined by both multiple motor tics (2+) and at least one vocal tic. The tics may wax and wane in frequency but have persisted for more than 1 year since first tic onset.
Habit reversal training (HRT) and Cognitive Behavioral Intervention for Tics (CBIT) is used for the treatment of Tics. HRT for tics also includes awareness training, helping the person learn to identify the earliest warning that a tic or is about to take place. These warning signs can be urges, sensations, or thoughts, and may not coincide with the part of the body where a tic occurs. The therapist and individual then work to create competing responses. For example, if someone has tic of tilting their head to the left, a competing response may be to tilt their head to the right when they feel an urge. CBIT incorporates HRT, and helps the person identify situations that may cause tics to be worse than they might otherwise be (e.g., stressful/anxiety-producing situations such as giving a presentation). Components of CBT are used to help manage and alleviate feelings of anxiety which in turn, helps decrease the severity of tics.