Tics and Involunatary Movements

What are Tics?

Tics are uniform, repetitive, involuntary movements of a muscle or a small muscle group. It is usually the muscles of the face, neck or shoulders that are involved. These involuntary movements are called motoric tics and are by far the most common form of tics. Tics might also be sudden sounds or words, if the speech muscles are involved, these are called vocal tics. Boys and men tend to have tics more so than girls and women. Tics usually develop in childhood and youth, and it is estimated that up to 10% of all children at some point has tics.

What causes Tics?

It’s not clear exactly what causes tics, nor is there necessarily one particular cause. They’re thought to be due to changes in the parts of the brain that control movement. They often seem to run in families, and there’s likely to be a genetic cause in many cases. They also often occur alongside other conditions, such as ADHD and OCD. Tics can sometimes be triggered by the taking of illegal drugs, such as cocaine or amphetamines, and are occasionally caused by more serious health conditions such as cerebral palsy or Huntington’s disease.

Usually there is no reason for tics. However, tics can be debilitating, especially in the form called Tourette’s syndrome where both involuntary body movements and sounds such as snorting, cough, whisper or grunting. Tourette syndrome is a hereditary condition, so there will often be others in the family with similar symptoms.

Tics can be increased and exacerbated by stress and nervousness. Tics often improve during or after hard physical activity and often disappear completely during sleep.

Types of Tics

There are many types of tic. Some effect body movement (motor tics) and others result in a sound (vocal or phonic tics).

•blinking, wrinkling the nose or grimacing

•jerking or banging the head

•clicking the fingers

•touching other people or things

•coughing, grunting or sniffing

•repeating a sound or phrase – in a small number of cases, this may be something obscene or offensive

Tics can be simple or complex. The simple motoric tics involve very small muscle groups and are simple movements such as blinking, flinching, grimace, wrinkle of the nose, lip protrusion, jerking shoulders and the head throwing the arms around involuntarily. There are also simple vocal tics, which consists of snorting, coughing, whistling, humming, grunting, screaming, yelling or gasping.

The complex motoric tics are combined movements, which mean that more muscle groups must work together. This might be jumping, clapping, touching objects or others, tongue or lip biting, scratching, sticking out the tongue or compulsive awkward body positions. Complex vocal tics are more or less meaningful words, phrases or sentences that interrupt the flow of speech. This can lead to the impression of stutter.

Treatment of Tics

The vast majority of tics require no treatment. Thorough information about the condition to both patient, family and social circles is usually sufficient. Particularly children may have problems with bullying, and it may therefore be a good idea to inform the day care or the school, so there is an understanding of the problem. Particularly children with Tourette’s syndrome are often perceived as naughty or badly mannered and they often experience many unjust defeats.

Treatment isn’t always needed if a tic is mild and isn’t causing any other problems. Self-help tips, such as avoiding stress or tiredness, are often very helpful for the majority of people. If a tic is more severe and is affecting everyday activities, therapies that aim to reduce how often tics occur may be recommended.

The main Therapies for tics are:

Child Psychotherapy-  this aims to give young people coping strategies, relaxation, sand play therapy and a lot other interventions to help relieve the discomfort for the young person.

Also the therapist will work with the client to see if there is any deeper issues ie, trauma, shock, abuse, something he may have seen, something he doesn’t like in his reality, etc and help the young person overcome this, in turn will overcome his suffering.

A therapist will work with their client to identify the cause of the tic and will focus on fostering a method that is less noticeable to relieve it.

An example of behaviour reversal could be that the sufferer has an intense vocal tic that leads them to repeat phrases out loud. To counteract the tic, they could take a number of deep breaths instead. This acts as a less obvious release in comparison to a tic.

Habit reversal therapy – this aims to help you or your child learn intentional movements that “compete” with tics, so the tic can’t happen at the same time.

Exposure with response prevention (ERP) – this aims to help you or your child get used to the unpleasant sensations that are often felt just before a tic, which can stop the tic occurring.

There are also medicines that can help reduce tics. These may be used alongside psychological therapies or after trying these therapies unsuccessfully.

By Cory Spence (Psychology Student) @ Child Therapy NI