Tourette’s disorder

Tourette’s disorder is a neurological condition characterized by involuntary movements and sounds called “tics.” Different children have different tics, such as blinking, twitching, barking, throat clearing, coughing, or repeating certain words. Some people with the disorder experience outbursts of profanity, although this particular tic is actually quite rare.

Children with Tourette’s disorder usually begin exhibiting tics around seven to ten years of age, and they reach their peak during adolescence. Facial tics, such as blinking and twitching of the face, head, neck, and/or shoulders, often occur before vocal tics like barking and repeating words. Not all tics indicate Tourette’s; unless your child has both motor and vocal tics, he doesn’t have the disorder. Children with the disorder can sometimes experience rage attacks and poor impulse control as well.

No specific gene causing Tourette’s disorder has been isolated, but there is strong evidence of a genetic component and that people with Tourette’s have brain abnormalities. Children with a family history of the disorder are more likely to develop it. Boys are also more likely to be diagnosed than girls.

To be diagnosed with Tourette’s disorder, your child will exhibit multiple motor tics and at least one vocal tic for an extended period—more than a year. These tics occur regularly, and your child doesn’t have tic-free period that lasts longer a few months. Only people under the age of 18 are diagnosed with Tourette’s, and for a diagnosis the tics can’t be the result of a separate medical condition or be a reaction to substances.

Tourette’s disorder cannot be cured, but it can be treated through a combination of behavioral therapy and medication.

Psychotherapeutic: While tics are involuntary, children can sometimes learn to suppress their tics through a kind of behavioral therapy called “habit reversal.” Habit reversal teaches children to recognize their individual tics and perform actions that are incompatible to them each time the tic impulse is anticipated. Other psychotherapies, including cognitive behavioral therapy, can help children learn to cope with their Tourette’s syndrome as well as any co-existing disorders. In addition, peers and teachers can be educated about the condition so that they can provide caring support for a young person with the disorder.

Pharmacological: There are a variety of medications commonly prescribed to help control the symptoms of Tourette’s disorder, and an experienced professional should closely monitor any course. Your child’s doctor may prescribe neuroleptic medications, which appear to help control tics by blocking the brain’s dopamine neurotransmitters. Co-occurring behaviors such as rage attacks and poor impulse control are sometimes treated with a class of medications called antihypertensives.

Many children diagnosed with Tourette’s disorder also have other psychiatric disorders. Some 64% of them have also been diagnosed with ADHD, and OCD and depression are also associated with Tourette’s.

Doesn’t Tourette’s involve outbursts of profanity? Can a child who doesn’t do that still have Tourette’s?
Involuntary obscene language (called coprolalia) is actually a rare symptom of Tourette’s. Fewer than 15% of people diagnosed with Tourette’s disorder will ever experience it.
Can tics be controlled?
Tics are involuntary. With effort and concentration children can sometimes suppress some of their tics. The goal of behavioral therapy is to help children anticipate their tic impulse and perform an action incompatible to the tic until the impulse has passed.
Will my child outgrow his tics?
Tics usually do improve with age. Some children outgrow their Tourette’s disorder after adolescence, although many don’t—it’s highly variable and unpredictable. In any case, Tourette’s can be extremely distressing for the child, so it’s a good idea to seek treatment as early as possible.
What causes it?
Researchers still aren’t sure exactly what causes Tourette’s, although [[abnormal]] brain function appears to be a factor. Children with a family history of the disorder are more susceptible.