What are the signs of Tourette syndrome in toddlers? How is Pediatric Tourette Syndrome diagnosed and treated? Find the answers to these questions and more in this comprehensive article.

Understanding Tourette Syndrome in Children

Tourette syndrome is a neurological disorder that affects more boys than girls. The condition is characterized by repeated tics, which are sudden, uncontrolled vocal sounds or muscle jerks. Symptoms of Tourette syndrome often begin between the ages of 5 and 10, starting with mild, simple tics of the face, head, or arms. Over time, the tics may become more diverse, involving more parts of the body and becoming more disruptive to daily life.

Causes of Tourette Syndrome

Most cases of Tourette syndrome are caused by genes. It is an autosomal dominant disorder, meaning that only one copy of the gene is needed to have the condition. If a parent has Tourette syndrome or the gene for it, there is a one in two chance that they will pass it on to each of their children.

In up to one in 20 children with Tourette syndrome, the disorder is not caused by genes. Possible causes in these cases may include problems during pregnancy, low birth weight, head injury, carbon monoxide poisoning, or inflammation of the brain (encephalitis).

Symptoms of Tourette Syndrome

The most common symptoms of Tourette syndrome are uncontrolled muscle movements, known as tics. These tics can occur in the face, neck, shoulders, torso, or hands, and may include head jerking, squinting, blinking, shrugging, grimacing, nose-twitching, and repeated foot tapping, leg jerking, scratching, or other movements.

Tourette syndrome also includes one or more vocal tics, such as grunting, moaning, barking, tongue clicking, sniffing, hooting, saying rude things, throat clearing, snorting, coughing, squeaking noises, hissing, spitting, whistling, gurgling, or echoing sounds or phrases repeatedly.

Tic behaviors can change over time and vary in how often they occur. Tourette syndrome can also occur differently in boys and girls, with boys being more likely to have long-term (chronic) tics and girls being more likely to have obsessive-compulsive disorder (OCD).

Diagnosing Tourette Syndrome

A child with Tourette syndrome is usually diagnosed around the age of 7. The healthcare provider will ask about the child’s symptoms and health history, as well as the family’s health history, and will observe the child’s behavior. They may also ask for a history of the child’s behavior from teachers and assess the child’s psychological, social, and educational status.

Treatment Options for Tourette Syndrome

Treatment for Tourette syndrome will depend on the child’s symptoms, age, and general health, as well as the severity of the condition. Some children may not need treatment, as they can typically function well at home and in a regular classroom.

In some cases, a child may need special classes, psychotherapy, or medication, particularly if the tics cause problems with daily function or school, or if the child has additional conditions such as OCD or attention deficit/hyperactivity disorder (ADHD).

Genetic Considerations

Not everyone with the gene for Tourette syndrome will have symptoms of the disorder. If a parent passes the gene to a child, the child may not have any symptoms. However, if a daughter inherits the gene, there is a 7 in 10 chance that she will have at least one sign of Tourette syndrome, and if a son inherits the gene, there is an almost sure chance (99%) that he will have at least one sign.

Families with a history of Tourette syndrome should speak with a geneticist or a genetic counselor to understand the inheritance patterns and potential implications for their children.

Conclusion

Tourette syndrome is a complex neurological disorder that can have a significant impact on a child’s life. By understanding the signs, causes, and treatment options, families can work with healthcare providers to manage the condition and support the child’s overall well-being. Regular monitoring and a comprehensive approach to care are essential for ensuring the best possible outcomes for children with Tourette syndrome.

Pediatric Tourette Syndrome – Conditions and Treatments

Key Points About Tourette Syndrome in Children

• Tourette syndrome is a neurological disorder. It affects more boys than girls.
• The disease causes repeated tics. These are sudden, uncontrolled vocal sounds or muscle jerks.
• Symptoms of Tourette syndrome often begin between ages 5 and 10.
• Tourette syndrome can occur differently in boys and girls. Boys are more likely to have long-term (chronic) tics. Girls are more likely to have obsessive-compulsive disorder (OCD).
• Some children may not need treatment. A child with Tourette syndrome can usually function well at home and in a regular classroom. In some cases, a child may need special classes, psychotherapy or medicine.
• A family with a history of Tourette syndrome should speak with a geneticist or a genetic counselor.

• 
  

  Tourette syndrome is a neurological disorder. It is also called Tourette disorder. The disorder causes repeated tics. Tics are sudden, uncontrolled vocal sounds or muscle jerks. Symptoms of Tourette syndrome often start between ages 5 and 10. They usually start with mild, simple tics of the face, head or arms. Over time, a child may have different kinds of tics that may happen more often. They may also involve more parts of the body, such as the trunk or legs. And they may be more disruptive to daily life.

   

• 
  

  Most cases of Tourette syndrome are caused by genes. It is an autosomal dominant disorder. Autosomal means that the gene is not on a sex (X or Y) chromosome. Dominant means that only one copy of the gene is needed to have the condition. A parent with Tourette syndrome or the gene for Tourette syndrome has a one in two chance to pass the gene on to each child.

  In up to one in 20 children with Tourette syndrome, the disorder is not caused by genes. Possible causes in these cases may be problems during pregnancy, low birth weight, head injury, carbon monoxide poisoning or inflammation of the brain (encephalitis).

• 
  

  Tourette syndrome affects more boys than girls.

   

• 
  

  The most common symptoms are uncontrolled muscle movements. They may occur in the face, neck, shoulders, torso or hands. Examples include:

  • Head jerking
  • Squinting
  • Blinking
  • Shrugging
  • Grimacing
  • Nose-twitching
  • Repeated foot tapping, leg jerking, scratching or other movements

  Complex tics include:

  • Kissing
  • Pinching
  • Sticking out the tongue or lip-smacking
  • Touching behaviors
  • Making rude gestures

  Tourette syndrome also includes one or more vocal tics such as:

  • Grunting or moaning sounds
  • Barking
  • Tongue clicking
  • Sniffing
  • Hooting
  • Saying rude things
  • Throat clearing, snorting, or coughing
  • Squeaking noises
  • Hissing
  • Spitting
  • Whistling
  • Gurgling
  • Echoing sounds or phrases repeatedly

  Tic behaviors change over time. They also vary in how often they occur.

  Tourette syndrome can occur differently in boys and girls. Boys are more likely to have long-term (chronic) tics. Girls are more likely to have obsessive-compulsive disorder (OCD). This is an anxiety disorder. With OCD, a child has a repeated thought, fear, or worry (obsession) that they try to manage through a certain behavior (compulsion) to reduce the anxiety.

  Not everyone with the gene will have symptoms of Tourette syndrome. If a parent passes the gene to a child, the child may not have any symptoms. If a daughter inherits the gene, there is a 7 in 10 chance that she will have at least one sign of Tourette syndrome. If a son inherits the gene, there is an almost sure chance (99%) that he will have at least one sign of Tourette syndrome.

  The symptoms of Tourette syndrome can seem like other health conditions. Have your child see their healthcare provider for a diagnosis.

• 
  

  A child with Tourette syndrome is usually diagnosed around the age of 7. A primary care provider, pediatrician, child psychiatrist or a mental healthcare provider may diagnose your child. The healthcare provider will ask about:

  • Your child’s symptoms and health history
  • Your family’s health history
  • Developmental problems

  The healthcare provider will also:

  • Watch your child’s behavior
  • Ask for a history of your child’s behavior from teachers
  • Assess your child’s psychological, social and educational status

• 
  

  Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is. Some children may not need treatment. A child with Tourette syndrome can usually function well at home and in a regular classroom.

  In some cases, a child may need special classes, psychotherapy or medicine. These may be choices if:

  • Tics cause problems with daily function or school
  • Your child has a problem such as OCD or attention deficit/hyperactivity disorder (ADHD)
  • Your child has another emotional or learning problem

  A treatment called comprehensive behavioral intervention for tics can help children deal with tics and reduce tics.

  Your child may need medicines if they have related conditions such as ADHD, OCD or a mood disorder. Talk with your child’s healthcare providers about the risks, benefits and possible side effects of all medicines.

• 
  

  Many children who have Tourette syndrome also have attention problems. Some have trouble in school. But most have normal intelligence and don’t have a learning disability.

  Other conditions commonly seen in children with Tourette syndrome include behavior problems, mood changes, social challenges and trouble sleeping.

• 
  

  Your healthcare provider may advise genetic counseling. You can discuss with a counselor the risk for Tourette syndrome in a future pregnancy.

   

• 
  

  Your child may need support and help with:

  • Self-esteem
  • Relationships with family and friends
  • Classroom participation

  Develop a strong, positive relationship with your child’s educational team. Depending on how severe the disorder is, they can both support your child in the classroom and also help with social situations. As your child gets older, pay attention to social media and possible issues with bullying. Seek professional counseling for your child and their siblings to help deal with the emotional impact of Tourette syndrome. Talk with your child’s healthcare provider and school staff about the best ways to support your child.

  Tourette syndrome has no cure, and the condition is lifelong. It does not get worse over time. And some children see their tic symptoms decrease in their late teens and early 20s. People with Tourette syndrome also have a normal life expectancy. Tic symptoms tend to decrease with age, but ADHD, OCD, depression, generalized anxiety, panic attacks and mood swings can continue and cause ongoing problems in adult life.

• 
  

  Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms

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Tourette Syndrome (for Parents) – Nemours KidsHealth

What Is Tourette Syndrome?

Tourette syndrome is a condition that causes uncontrolled sudden, repetitive muscle movements and sounds known as tics. 

Two types of tics are associated with Tourette syndrome:

1. Motor tics: These are sudden, apparently uncontrollable movements such as exaggerated eye blinking, grimacing, head jerking, or shoulder shrugging.
2. Vocal tics: These include repeated throat clearing, sniffing, or humming.

Tics can be simple or complex:

• Simple motor tics usually involve just one muscle group, such as eye blinking or grimacing.
• Complex motor tics usually involve more muscle groups and might look like a series of movements. For example, someone might touch a body part or another person repeatedly. In rare cases, people with Tourette syndrome might have a tic that makes them harm themselves, such as head banging.
• Simple vocal tics can be throat clearing, sniffing, or grunting.
• Complex vocal tics can involve calling out, repeating other people’s words (a condition called echolalia), or involuntary swearing (called coprolalia).

At certain times, like when someone is under stress, the tics can become more severe, happen more often, or last longer. Or the type of tic may change.

Some kids can hold back their tics for a short time. But as tension builds, eventually it must be released as a tic. And if a person is concentrating on controlling the tic, it may be hard to focus on anything else. This can make it hard for kids with Tourette syndrome to have a conversation or pay attention in class.

The tics associated with Tourette syndrome tend to get milder or go away entirely as kids grow into adulthood. Until that happens, though, parents can help their child cope with the condition.

What Causes Tourette Syndrome?

Tourette syndrome is a genetic disorder, which means it’s the result of a change in genes that’s either inherited (passed on from parent to child) or happens during development in the womb. Tourette symptoms typically appear in childhood, usually when kids are between 5–9 years old. It’s not very common, and boys are more likely to be affected than girls.

The exact cause of Tourette syndrome isn’t known, but some research points to changes in the brain and problems with how nerve cells communicate. An upset in the balance of neurotransmitters (chemicals in the brain that carry nerve signals from cell to cell) might play a role.

Many kids and teens with Tourette syndrome have other behavioral conditions like ADHD, obsessive-compulsive disorder (OCD), learning problems, or anxiety.

How Is Tourette Syndrome Diagnosed?

To be diagnosed with Tourette syndrome, a child must have several different types of tics — specifically, multiple motor tics and at least one vocal tic for at least a year. They may happen every day or from time to time throughout the year.

A child with Tourette symptoms may need to see a neurologist, a doctor who specializes in problems with the nervous system. The neurologist may ask the child’s parents to keep track of the kinds of tics involved and how often they happen.

There isn’t a specific diagnostic test for Tourette syndrome. Instead, the health care provider diagnoses it after taking a family history, medical history, looking at the symptoms, and doing an exam. Sometimes, imaging tests like magnetic resonance imaging tests (MRIs), computerized tomography (CT) scans, electroencephalograms (EEGs), or blood tests can rule out other conditions that might cause symptoms similar to Tourette syndrome.

How Is Tourette Syndrome Treated?

Just as Tourette syndrome is different for every person, treatment can be different too. There isn’t a cure for Tourette syndrome, but most tics don’t get in the way of day-to-day life. If they do, doctors may suggest medicines to help control symptoms.

Tourette syndrome is not a psychological condition, but doctors sometimes refer kids and teens to a psychologist or psychiatrist. Seeing a therapist won’t stop the tics, but it can help to talk to someone about their problems, cope with stress better, and learn relaxation techniques. A therapist also can help them with any other problems, like ADHD, OCD, and/or anxiety.

Tics usually are most severe before the mid-teen years. Most people see great improvement in their late teens to early adulthood, though some will have their tics continue into adulthood.

What Else Should I Know?

Many people don’t understand what Tourette syndrome is or what causes it, so they might not know how to act around someone who has tics. If people stare or comment, kids and teens can feel embarrassed and frustrated. Someone who has it might have to explain the condition to others or deal with teasing or gawking.

These tips can help kids with Tourette syndrome cope:

• Get involved. Some experts say that when kids and teens are focused on an activity, their tics are milder and less frequent. Sports, exercise, or hobbies are great ways for kids to focus mental and physical energy.
• Lend a helping hand. Dealing with Tourette syndrome often makes kids and teens more understanding of other people’s feelings, especially other young people with problems. They might use that special sensitivity to volunteer. Knowing that they’ve helped others might help build confidence and ease any self-consciousness about feeling different.
• Embrace creativity. Creative activities such as writing, painting, or making music help focus the mind on other things — and they help it develop.
• Find support. The Tourette Syndrome Association sponsors support groups with others who understand the condition’s challenges.
• Take control. People with Tourette syndrome can feel more in control of their lives by researching the condition, asking their doctors plenty of questions, and taking an active role in their treatment.

Each person with Tourette syndrome will cope differently with its physical, emotional, and social challenges. Tourette syndrome doesn’t have to disrupt everyday life, though, and kids who have it can enjoy doing the same things as other kids.

Reviewed by: Shirin Hasan, MD

Date reviewed: June 2020

Autism symptoms, online autism test, questions about autism

How to treat a diagnosis?

Diagnosis is a tool to help move from thinking and hypothesizing about the human condition to action. As a general rule, diagnosis is a dynamic concept. And despite the fact that autism remains for life, life with autism can be quite independent under a combination of factors. That is why the diagnosis for specialists, the immediate environment of the family is a good reason to start early work with the child. The diagnosis also helps to clarify the understanding of the child’s behavior and the nature of the difficulties that he encounters.

Until the age of three, it is difficult to understand in which area the child’s problems lie. How can you help him then?

Thanks to the work of American, Canadian and British specialists, a number of behavioral markers have been developed by now, which, with a high degree of probability, can indicate the risk of autism affecting the development of a child as early as 6 months of age. If the risk of autism in the process of diagnostic work with a child is confirmed, then it is better to start work as if it were autism. This is important, because at the first stage, in any case, communication problems will be solved. In the future, if autism is not confirmed, then a specialist in the profile of specified problems can easily deal with the child, and the special classes done will only benefit this task. If later autism is confirmed, then early work with the child will increase the chance of his independent and independent adult life.

Why is it better not to delay contacting specialists and start working as early as possible?

First, because the psyche of any person develops due to information coming from outside, and autism blocks the flow of complete adequate information about the environment. With the normal development of the child, nothing needs to be taught purposefully, everything starts by nature itself: the child coos, babbles, turns, singles out loved ones, imitates, plays, jokes. With autism, all this must be specially taught, otherwise the potentially safe areas of the child’s development may remain unsuitable for his independent life. In other words, the sooner the impact of autism on a child’s development is mitigated, the better.

Secondly, at an early age, the child’s psyche has such properties as flexibility and plasticity. This allows you to make learning the most successful and effective.

What guides you in choosing a place to study?

• avoid offers related to “complete cure” for autism

• decisions on pharmacotherapy, drug support for the child are made only by an experienced child psychiatrist who examined the child (saw him in person!)

• when working with children with autism, individualized care is very important – a specialist should first study your child, your difficulties, and then suggest ways to work with him

• be careful about new or experimental methods of correction and treatment, rely on scientifically -reasonable approaches

• as a parent, you know your child best, which means that you are the “right hand” for specialists and are directly involved in the correctional process

What is the role of the immediate environment? What can grandma, grandpa, other relatives do?

In matters of applying for assistance, the right to represent the interests of the child lies with his legal representatives. As a rule, these are the parents of the child. Sometimes it can be other relatives of the child or guardians. In this case, there must be relevant documents that confirm the right of legal representation. When contacting our Center, an agreement is concluded with the legal representative of the child. This is the legal side of the issue.

At the same time, apart from legal issues, the role of the immediate environment is very large. First of all, the support of the parents of the child himself, who have to work ten times more, while it seems to others that they work ten times less, is extremely important. At the stage of voicing a diagnosis or the risk of a diagnosis, as a rule, any family feels confusion, resentment, fear, “doom”, guilt, and really needs support. The decision on what to do next may be delayed, not taken, due to the fact that the family does not feel that it can cope with the challenge, does not find places where it would receive help, does not want to believe that the child has difficulties. Love, understanding and care on the part of relatives can give an additional resource to parents and help them believe in their abilities. Acting as a “big family”, consistently following the recommendations of specialists, one can achieve much greater success in working with a child than one by one.

What is the forecast?

Autism is currently incurable. The issue is the quality of adulthood. In this regard, the prognosis can vary greatly: from an independent and independent life in society with little support as needed to complete dependence on the constant accompaniment and direct assistance of other people in the performance of daily activities. The prognosis is influenced by many factors: the severity and depth of disorders, the age at which the intervention began, its complex nature, sufficient volume and duration, the correct choice of the main and auxiliary methods, close cooperation between specialists and the family.

Due to the many factors that affect the prognosis, we recommend that when working with children with autism, set specific small goals for the next 4-6 months and achieve them while being “here and now”.

How many lessons do you need and how often?

On the one hand, life gradually becomes curative. On the other hand, the child needs special classes during which skills and abilities are developed that allow him to solve everyday problems and, ideally, learn new skills on his own. The volume of these classes is determined individually. Under the condition of homework, work with the specialists of the Center starts from 2 hours a week.

10.5 months. The seventh leap in child development: construction and consistency

Tatyana Chkhikvishvili

Tatyana Chkhikvishvili

Head of online programs, psychologist , sleep and breastfeeding consultant

Mother of two children

The child begins to understand that in order to achieve the goal, he needs to perform actions in a certain sequence. He is trying to add cubes or a pyramid – before he sometimes succeeded by accident, but now he acts completely consciously.

Probably, you are already used to the fact that the baby constantly scatters everything, and as soon as you build a turret, he immediately destroys it.

At about 10.5 months, the long-awaited time for self-construction begins. A new developmental leap will occur in the tenth month of a baby’s life and can last from 3 to 7 weeks.

Child’s crisis calendar

Mastering the sequences

Now the child understands that in order to achieve the goal, you need to perform several sequential actions. This characterizes the seventh growth spurt. You will increasingly see how the baby is trying to put cubes on top of each other or collect a pyramid.

Signs

As usual with developmental leaps, changes disturb the baby, which affects his behavior.

During a crisis period a child usually:

• is worried when you leave. Clings to your clothes;
• shows jealousy: acts up when you communicate with someone else;
• eats little, becomes very picky about food;
• may protest against dressing and diaper changes, resist disembarkation;
• can become very affectionate;
• shy of others;
• abruptly changes mood from laughter to tears;
• needs more attention.

Games to develop new skills

Dressing up
Change your baby in front of the mirror, ask him to help you: stretch your leg, raise your arm, turn around. At this point, you can explain to the baby the concepts of “left” and “right”.

Wash
Let the baby comb his hair in front of the mirror, wash, brush his teeth. Young children love to imitate adults or older siblings. The joint process of washing will be pleasant and fun.

Household help
Show your baby how you do household chores, say everything you do. Give him a cloth to wipe the toys. Or a piece of dough that he will knead while you bake the cake (this is a great warm-up for your fingers). Give pre-washed vegetables and ask them to wash them themselves.

Self-catering
Give the baby a spoon. Let him bring it to his mouth, eat something on his own. You can give a child’s fork. The baby will develop coordination, and the process of eating will become more interesting.

What else can you do with your baby?

Tell your little one short nursery rhymes. Touch your nose, ears, forehead and name parts of the body. Do the same with the objects around the baby.

During this period, kids perceive and memorize simple finger games well: “Magpie-crow”, “Goat is horned”, “Ladushki”.

Let the child touch fabrics of different textures, tear paper or cotton. Give him a “treasure” box that he can dig through and pull out interesting little items and then put them back in. You can put the pasta in a bottle with a narrow neck and mess around in the cereal. Everything that involves fine motor skills has a great effect on the development of the psyche and intelligence of the child.

Wrap the toy in pretty paper and have your child unpack it. Hide a small object in the palm of your hand or under an opaque cup, put the same one next to it and ask the baby to find a toy. Let him guess what needs to be done to find the item.

Now the baby can master a simple sorter, get acquainted with shapes and colors.

Sleep during a developmental leap

The child is very impressed with his new possibilities. As a result, he is agitated and sleeps worse. Both night and daytime sleep may worsen; or both at once. The time to fall asleep and the frequency of nocturnal awakenings increase, and the morning rise can become very early. Sleep can become very restless: the baby turns in bed, waving his arms and legs.

Don’t worry, this is a normal manifestation of a development crisis. When the baby gets used to his new skills, he will calm down and his sleep will improve again. Now it is very important that you give your child a sense of calm and security – this will help calm him down.

If the mother is worried and tense, this affects the baby and makes him even more nervous – because if the mother is worried, then something terrible is really happening.

Try to put aside everything for a while and focus on the baby, give him as much attention and contact as possible, especially before bedtime.