New Treatment for Tics Discovered at Mom’s Kitchen Table

Eye-blinking, sniffing, throat-clearing, finger-flexing, shoulder-shrugging – they are all simple tics, most of which go away. Pediatricians will advise you to ignore them. And that’s fine. Tics are really common, about 1 in 5 elementary school children will have one at some point, and only about 1-2% of those kids will go on to have a true Tic Disorder like Tourette Syndrome. But, in the meantime, tics are kind of annoying.

I was talking to a mom-friend of mine the other day about the weird things kids do, when she brought up childhood tics.

If there is a kind of tic, my son has had it.

She tried to ignore her son’s tics, as her doctor advised. His eye-blinking would go away, and he’d be fine, until he started a habit of throat-clearing, then that would go away, and then he started rolling his eyes. And that’s when my friend stumbled onto something big. She had always recognized that her son was capable of suppressing his tics, and would remind him, but it didn’t really make a difference.

That’s when she changed direction and said “You know, you look kind of crazy when you do that.” Just saying that made a huge difference and he got much better at suppressing his eye rolls, until finally they just went away.

The really amazing thing is that a group of scientists at Washington University just discovered the same treatment, but in the lab. They discovered that tics improve when you reward kids for suppressing them. They studied 21 kids, age 5-14, with tics that had begun on average 3 months before the study. The kids were given poker chips when they went more than 10 seconds without their tic. But from the “kitchen table science lab” it seems that avoiding public embarrassment might be a more powerful reward for a 9 year-old boy.

Tics are still kind of a black box, and something that pediatricians know are a generally benign and short-lived phenomenon in childhood. Since they aren’t dangerous and they go away on their own, they haven’t been studied as much as other conditions. Research indicates that tics are unmasked when a child’s developing brain just hasn’t gained the mature function that adults have to inhibit neurologic impulses.  As their brain matures, the tics will go away. We do know that they tend to occur more at times of relative stress, like starting school, or being more tired. And of course, they are seen more often in children with ADHD and obsessive-compulsive disorder, probably because these children have an even more difficult time suppressing random brain firing.

Don’t let what you read on the Internet scare you. Lots of kids without these conditions can have tics too. It’s just a sign that a child’s nervous system is developing. A good way to reassure yourself that one of these strange behaviors is a tic and not something else, is that the behavior does not occur during asleep.

Now you can add cognitive neuroscientist to the list of mom’s job skills.

In Press: Greene, D.J., et al., Reward enhances tic suppression in children within months of tic disorder onset. Dev. Cogn. Neurosci. (2014) Parenting Team Contributor

Author: Wendy Hunter, MD

Pediatrician at Children's Primary Care Medical Group, La Jolla, CA

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