Tic and Tourette Syndrome Service

Tourette Syndrome is a nervous system disorder that starts in childhood and can continue through adulthood. Its primary symptom is involuntary tics, which are sudden twitches, repetitive body movements or sounds.  The Child Mind Institute offers diagnostic and treatment services to help children and adolescents when tics persist and interfere with their school or social lives.

Tics often co-occur with common childhood disorders including anxiety disorders, obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), behavior disorders, and learning disorders.

Diagnosis

All patients at the Child Mind Institute receive a thorough diagnostic evaluation before starting treatment. We begin by interviewing (often separately and together) the child and her parents, as well as gathering information from a variety of other sources, including teachers, previous therapists and pediatricians. We also use standard diagnostic measures to better assess the symptoms and concerns. The child may also be seen for neuropsychological evaluation if there are concerns for learning or attention problems. After the evaluation is completed, we provide accurate diagnoses, comprehensive feedback and treatment recommendations. We also partner with pediatric neurologists who can conduct a full neurological evaluation if it is indicated.

Treatments

We incorporate the latest research about effective treatments and tailor it with sensitivity to the experiences and needs of each person. We use evidence-based treatments to reduce symptoms and teach children, adolescents and young adults skills to maintain their success in the long-term. Treatment may be provided individually, and may also involve parents and/or other family members.

If we identify co-occurring disorders through our evaluation process, we can provide evidence-based treatment for those disorders. We will work with you to prioritize treatment that makes the most sense for your child and your family.

Depending on the presentation of symptoms, treatments for Tourette disorder may include the following interventions:

Comprehensive Behavioral Intervention for Tics (CBIT) including Habit Reversal Therapy (HRT)

CBIT and HRT are empirically supported behavioral treatments aimed at giving patients effective tools to reduce and manage their tics. Treatment includes helping patients be more aware of their tics, training them to do a competing behavior when they feel the urge to tic, and identifying situations where tics are made worse and attempting to change them.

Medication management

In some cases, medication can be useful in reducing the frequency and severity of tics associated with Tourette disorder. Before prescribing any medication, our board certified child and adolescent psychiatrists make sure that the family understands why a particular medicine is being recommended and what to expect once their child begins taking it. The psychiatrist will take time and care in finding the right dose, and continue to monitor the child’s progress as he grows and develops to make sure his treatment continues to be effective.

Parent and family involvement

Parents spend the most time with their children, so it is important for family to be involved in treatment and reinforce it outside the office. Parents will be asked to help children practice the new skills they are learning at home and will participate in some clinical sessions.

School consultation

School can be a challenging environment for some students, and progress made in office-based treatments does not always carry over to the school setting. We know that educators can provide invaluable support for children who are struggling, so our clinicians partner with educators to find strategies and tactics that work in the classroom — making the learning environment better for everyone.

Learn more about Tic and Tourette Syndrome in our guide.

Our Team

Wendy N. Moyal, MD
Wendy Nash Moyal, MD

Child and Adolescent Psychiatrist

Child Mind Institute

Kelly Janke, PhD, ABPP-CN

Clinical Neuropsychologist, Learning and Development Center

Child Mind Institute

Sarper Taskiran, MD

Child and Adolescent Psychiatrist

Child Mind Institute