Maybe this sounds familiar. Your child is watching television and you notice their eyes scrunching shut, again and again. A few weeks later there is a small sniff or a throat-clearing sound that will not go away. The teacher has mentioned it, a classmate has copied it, and your child has started to look embarrassed.
Tics can be alarming to watch when you do not know what they are. They are also more common in childhood than most parents expect, and for many children they are a passing phase.
What tics are, and what they are not
A tic is a sudden, repeated movement or sound that a person does not choose to make. Motor tics involve the body: blinking, grimacing, head jerks, shoulder shrugs. Vocal tics involve sound: sniffing, throat clearing, humming, small squeaks or words.
Tics typically come and go. They tend to increase when a child is stressed, excited or tired, and fade when the child is absorbed in something they enjoy. Many children have tics for a few months and then lose them. When both motor and vocal tics have been present for more than a year, doctors may diagnose Tourette syndrome. For many young people, tics become milder through the teenage years.
Tics are not a bad habit, a bid for attention or a sign of poor parenting. They also do not mean your child is anxious because of something you did. They are thought to arise from the way certain movement circuits in the brain are developing.
See your doctor first
Any new tic should be assessed by your GP or paediatrician, who may refer you to a paediatric neurologist. Most tics are harmless, but other conditions can look similar, and a doctor needs to make that call. Go promptly if the movements began very suddenly, are severe or painful, involve any loss of awareness, or came together with a marked change in mood or behaviour.
Your doctor can also discuss established treatments, including a behavioural therapy designed for tics and, for some children, medication. Neurofeedback works alongside that medical care, never instead of it, and any medication should only be changed by the prescribing doctor.
Inside the brain: a gate that may let too much through
Deep in the brain sits a group of structures called the basal ganglia. One of their jobs is thought to be acting as a gate for movement, letting wanted movements through while holding others back.
One leading idea is that in children with tics this gate is a little leaky, so that a movement that would normally be held back slips through. The exact cause of tics is not fully understood.
Older children can often describe what comes before it: a build-up of pressure, an itch or a "not right" feeling in one part of the body. Doing the tic brings relief for a moment, and then the feeling builds again.
Asking a child to stop a tic is like asking them not to blink. They can manage it for a moment, and it costs them everything they have.
The hidden cost of holding tics in
Many children learn to suppress their tics at school. From the outside it looks as if the tics are improving. On the inside, your child is spending much of their concentration on staying still.
You may notice the after-effects:
- A burst of tics in the car or at home after school
- Exhaustion and irritability in the afternoon
- Trouble following lessons, because attention is used up elsewhere
The kindest response is usually the quietest. Try not to point tics out or ask your child to stop, since attention and pressure tend to increase them. Let home be the place where they can tic freely. It also helps to give the teacher a simple explanation and ask that the tics be ignored in class. Many children with tics have attention difficulties too, which we discuss in our article on childhood ADHD and school focus.
How neurofeedback may help
Neurofeedback is a non-invasive form of brain training. Small sensors on the scalp read your child's brain activity, and nothing is sent into the brain. Your child watches a video or game that responds when their brain produces a particular pattern.
For tics, some practitioners train SMR, or sensorimotor rhythm. This is a steady brainwave linked with a still body and a quietly alert mind. The idea is that strengthening it may help the brain hold back unwanted movement and settle overall arousal, which matters because stress and fatigue tend to make tics worse.
The research on neurofeedback for tics is limited and preliminary. Results vary, and no outcome can be promised. If you are new to the idea, what is neurofeedback explains the basics.
At Fix Your Brain every child starts with a 19-channel brain map, which takes about an hour and a half. Training sessions are 45 to 60 minutes and begin with a short check-in. Our what to expect page describes a visit step by step.
Common questions
Should I tell my child to stop when I notice a tic?
It is better not to. Tics are involuntary, and drawing attention to them usually makes them more frequent. Holding them in takes a great deal of effort and often leads to a burst later. Ignoring the tic, staying relaxed and letting home be a safe place to tic freely tends to help most.
Do we need to see a doctor before starting neurofeedback?
Yes. Any new tic should first be assessed by a GP, paediatrician or paediatric neurologist, to confirm what it is and to rule out other causes. They can also advise on established treatments. Neurofeedback is a complementary approach that may be used alongside medical care, not in place of it.
Will my child's tics go away?
Nobody can say for certain. Many childhood tics fade within months, and for many young people with longer-lasting tics they become milder during the teenage years. Some people continue to have tics as adults. Your doctor is the best person to advise on your child's particular situation and what to expect.
Your child is so much more than their tics. If your doctor has assessed them and you would like to explore brain training as extra support, please get in touch with Irine to talk it through.
- motor tics
- tourettes
- vocal tics
- kids health
- basal ganglia
