Chronic Motor or Vocal Tic Disorder Basics

Tics are sudden, recurrent, involuntary movements or vocalizations. A child who has only motor tics or vocal tics, but not both, may be diagnosed with chronic motor or vocal tic disorder. This guide offers information on diagnosis and treatment for children with vocal tic disorder.

Tic Disorders: What Are They?

This disorder is characterized by tics, which are sudden, rapid, recurrent motor movements or vocalizations. If a child has both motor and vocal tics, he is diagnosed with Tourette’s disorder; if he has only motor tics or vocal tics, but not both, he is diagnosed with chronic motor or vocal tic disorder. Transient tics are common over the course of development. It is their persistence that raises concern. To meet criteria for a chronic tic disorder, the tics must persist in one form or another for more than a year. Onset must be before 18 years of age.

Tic Disorders: What to Look For

A child with tics experiences what appear to be uncontrollable movements or vocal sounds. For example, a child with motor tics may engage in repetitive and rapid shoulder shrugging, eye blinking, lip biting, or facial grimacing. A child with vocal tics may repetitively clear his throat, hum, sniff, snort, or squeal. A very small percentage of children have what’s called coprolalia, which involves involuntary cursing or making socially inappropriate remarks. Some children describe an uncomfortable feeling in their bodies before a tic occurs; this is called a “premonitory urge.” Many children feel brief relief of this uncomfortable feeling after the tic occurs. Not all children with tics experience such urges.

Tic Disorders: Risk Factors

Boys are more commonly affected than girls, and children have more tics when they are feeling anxious, excited, or tired.

Tic Disorders: Diagnosis

To be diagnosed with chronic motor or vocal tic disorder a child must have either single or multiple motor or vocal tics, but not both. Although the tics may wax and wane in frequency, they must persist, in one form or another, for more than a year and appear before 18 years of age.

Tic Disorders: Treatment

Behavioral Therapy: The best-known behavioral treatment for tic disorders is a form of cognitive-behavioral therapy (CBT) called habit reversal training. A child is taught to recognize the premonitory urge that precedes an oncoming tic, and to identify the situations that may trigger the tics. The child and therapist develop a “competing” response—an action the child performs when he feels the urge—that is incompatible with the tic, and less noticeable to others. For example, a child whose tic involves sniffling his nose may do a breathing exercise instead. Children may also be taught relaxation techniques to decrease the frequency of the tics.

Pharmacological: There are a variety of medications commonly prescribed to help control the symptoms of tic 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.

Tic Disorders: Risk For Other Disorders

Tic disorders commonly occur with other conditions, including attention-deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). Many children with tic disorders may also experience anxiety and depression because of the social implications of having tics, as well as the disruption it causes in their daily lives.