Tourette Syndrome: An Overview
What is Tourette Syndrome?
Tourette Syndrome (TS) is a neurodevelopmental disorder (i.e., as the brain develops, the symptoms and the disorder develop) that becomes evident in early childhood or adolescence. It is part of the spectrum of Tic Disorders and is characterized by sudden, rapid, repetitive, involuntary movements and vocalizations called tics.
The average onset of tics is between ages 5 and 7 and typically begin with eye blinking and facial movements. Motor tics often precede the onset of vocal tics and simple tics often precede the onset of complex tics (Leckman, King, & Cohen, 1999).
Coprolalia (curse words or socially inappropriate utterances) occurs in only 10-15% of patients (Leckman, King, & Cohen, 1999).
Boys are three to five times more likely to have TS than girls. People from all racial and ethnic groups can have TS (A National Profile of Tourette Syndrome, 2011-2012 ).
Tics are relatively common in children, affecting 12-18% of the school-aged population (Scahill, Sukhodolsky, Williams, & Leckman, 2005).
Some Tic Disorders may be transient, while others will persist into adolescence and adulthood.
It is common for people with Tourette Syndrome to be affected by another co-occurring condition. Research suggests that it is common for children with TS to also have Attention Deficit Hyperactivity Disorder (ADHD) and 30-40% develop Obsessive Compulsive Disorder (OCD) (Dedmon, 1990).
Tourette is a very unique disorder and each case is very unique. The only thing consistent about TS is the inconsistencies.
People with tic disorders often have premonitory urges. These urges usually occur right before the tic. They feel similar to an urge to sneeze or scratch an itch.
Tics Can Be Simple or Complex
Motor tics are tics that cause movement.
Examples of Simple Motor Tics
Eye blinking, eye movements, nose movements, mouth movements, facial grimacing, leg movements, shoulder shrugging, arm jerking, abdominal tensing, head jerking, etc.
Examples of Complex Motor Tics
Hopping, Clapping, smelling, throwing, holding funny expressions, sticking out the tongue, kissing, pinching, tearing paper, touching other people or things, twirling, copropraxia (demonstrating socially inappropriate gestures), tearing paper, etc.
Vocal tics are tics that produce a sound.
Examples of Simple Vocal Tics:
Whistling, coughing, sniffing, screeching, animal noises (e.g., barking), grunting, throat clearing, humming, tongue clicking, yelping, etc.
Examples of Complex Vocal Tics:
Syllables, Phrases which may or may not be meaningful, Coprolalia (vocalizing socially unacceptable words) Palilalia (repetition of one's own words), Echolalia (repeating words or phrases of others) differences in speech patterns (e.g., unusual rhythms, tone accents, intensity of speech), blocking, etc..
Medical Diagnosis
These three Tic Disorders are named based on the types of tics present (motor, vocal/phonic, or both) and by the length of time that the tics have been present. Below are the criteria that a doctor or other health care professional will use to diagnose TS or other Tic Disorders. There is no test to confirm the diagnosis of Tic Disorders, but in some cases, tests may be necessary to rule out other conditions.
To be diagnosed with Tourette Syndrome (TS), a person must:
Have two or more motor tics (for example, blinking or shrugging the shoulders) and at least one vocal tic (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time.
Have had tics for at least a year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on.
Have tics that begin before age 18 years.
Have symptoms that are not due to taking medicine or other drugs or due to having another medical condition (for example, seizures, Huntington disease, or postviral encephalitis).
To be diagnosed with Persistent (Chronic) Motor or Vocal Tic Disorder, a person must:
Have one or more motor tics (for example, blinking or shrugging the shoulders) or vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase), but not both.
Have tics that occur many times a day nearly every day or on and off throughout a period of more than a year.
Have tics that start before age 18 years.
Have symptoms that are not due to taking medicine or other drugs, or due to having a medical condition that can cause tics (for example, seizures, Huntington disease, or postviral encephalitis).
Not have been diagnosed with TS.
To be diagnosed with Provisional Tic Disorder, a person must:
Have one or more motor tics (for example, blinking or shrugging the shoulders) or vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase).
Have been present for no longer than 12 months in a row.
Have tics that start before age 18 years.
Have symptoms that are not due to taking medicine or other drugs, or due to having a medical condition that can cause tics (for example, Huntington disease or postviral encephalitis).
Not have been diagnosed with TS or persistent motor or vocal tic disorder.
The Nature of Tics
Tics come and go over time, varying in type, frequency, location, and severity.
The first symptoms are usually in the head and neck area and may progress to muscles of the trunk and extremities.
Motor tics generally precede development of vocal tics and simple tics often precede complex tics.
Tics can be impacted by stress, fatigue, anxiety, illness, hunger, excitement, talking about tics/being reminded not to tic, scheduling changes (e.g., returning to school, Holidays, vacations, etc.), being alone, hunger, and menstruation.
Tics can be improved by sleep, activities that require focused attention and motor control, relaxation, and physical activity.
Tics can be suppressed for a short period of time.
Treatment/Interventions for Tourette
There is no cure for Tourette Syndrome, but there are treatment options including medication and behavior therapy. This site will focus on behavior therapy since several national and international professional organizations now recommend behavior therapy as the first-line intervention for tics.
Comprehensive Behavioral Intervention for Tics (CBIT):
CBIT is a non-drug treatment that trains patients to be more aware of tics through competing behavior when they feel the urge to tic. The goal of this program is to teach the patient effective tic management skills rather than to cure the tic disorder.
CBIT consists of three important components:
Training the individual to be more aware of his/her tics
Training the individual to engage in a competing behavior when he/she feels the urge to tic
Making changes to day to day activities in ways that can be helpful in reducing tics
For more information, CLICK HERE
TicHelper
Tic Helper is an online, self-guided therapy program for families of children with Chronic Tic Disorder and Tourette Disorder.
TicHelper is based upon Comprehensive Behavioral Intervention for Tics, or CBIT, and was developed by experts in the field of Chronic Tic Disorders and Tourette Syndrome. The program is an 8-week intervention that involves education about tics, skill-based lessons, and daily practice.
For more information, CLICK HERE
Resources for Parents & Students
COVID-19 Resources by the Tourette Association of America
The Tourette Association of America can provide FREE education in-service presentations (virtual presentations during the COVID-19 pandemic) for your child’s school.These presentations cover tips for managing Tourette Syndrome and Tic Disorders in the classroom, accommodations, as well as the impact of common co-occurring conditions on the student.
To schedule a presentation or learn more, please visit tourette.org/classroom-training.
Books on Tourette
The Keeper: The Unguarded Story of Tim Howard by Tim Howard
Insignificant Events in the Life of a Cactus by Dusti Bowling
Front of the Class by Brad Cohen
An Unlikely Strength: Tourette Syndrome and the Search for Happiness in 60 Voices , by Larry Barber
The Life That Chose Us: Educators with Tourette Syndrome Paperback by Dr. Jennifer K. Stenger
Teaching the Tiger A Handbook for Individuals Involved in the Education of Students with Attention Deficit Disorders, Tourette Syndrome or Obsessive-Compulsive Disorder by Marilyn Dornbush & Sheryl Pruitt
ABC's of Tourette Syndrome by Hailey Sasine Burden
What Happened to Twitch Morgan? A life with Tourette Syndrome by David Jowsey
Kissing Doorknobs by Terry Spencer Hesser
Icy Sparks by Gwyn Hymaan Rubio
Tourette Syndrome: 1o Secrets to a Happier Life by Michael S. Okun
Taking Tourette Syndrome to School by Tira Krueger
Tic Talk: Living with Tourette Syndrome, A 9-Year-Old Boy's Story in His Own Words by Dylan Peters
Coping with Tourette Syndrome: A Workbook for Kids with Tic Disorders by Sandra Buffolano
Forget Me Not by Ellie Terry
Are you interested in getting involved with the Tourette Association of America and receiving the latest news in Tourette Syndrome and Tic Disorders?
News, Events, & Webinars
The Tourette Association of America (TAA) is working diligently to provide ample programming and events for individuals, families, educators and medical professionals in 2021. Your involvement and support of TAA events and initiatives is crucial to raising awareness and understanding of Tourette Syndrome and Tic Disorders.
January 9, 2021 at 11:30am-5:30pm EST: TAA Teen Summit
This fun and educational event provides a forum for teens and youth to learn more about TS and Tic Disorders. Teens will connect with peers and discuss topics that are important to them.January 12, 2021 at 7pm EST: TAA Bingo Night
TAA virtual Bingo Night works just like the real thing. Purchase a ticket, get your virtual cards, encourage your friends and family to join you, and have fun alongside the Tourette Syndrome community across the country!January 20, 2021 at 7pm EST: Just for Dads: A Discussion on Tourette Syndrome and Parenting
This discussion focuses on the father’s perspective of supporting children with TS. Paul Raleigh, Marc F. Schmidt, Ph.D., and Keith Coffman M.D., who have kids with TS within the age range of 5-23, will lead the discussion and share their experiences.January 28, 2021 at 7pm EST: TAA Trivia Night
Save the Date! The TAA has a fun trivia session planned for the community!February 10, 2021 at 7pm EST: Tourette Syndrome: Managing OCD and Anxiety in School
This webinar, as part of the Education Professional Webinar Series, will uncover how OCD and anxiety can present with Tourette Syndrome.February 26-27, 2021 & March 2-3, 2021: TAA Youth Ambassadors Training
Applications for the next TAA Youth Ambassador training are due Sunday, January 10. The program trains and supports teens aged 12-17 to speak about TS and Tic Disorders with their local communities.February 26-27, 2021 & March 2-3, 2021: TAA Rising Leaders Training
Applications for the next TAA Rising Leader training are due Sunday, January 10. Rising Leaders are a community of civically engaged volunteers, aged 18-25, working to educate their communities across the country on TS and Tic Disorders.March 3, 2021 at 8am-5pm EST: Virtual National Advocacy Day
Join the TAA to advocate for the needs of the approximately one million people in the US living with TS or other Tic Disorders. The early bird registration rate is 25% off until January 7!March 4, 2021 at 3pm EST: Unleash Your Superpower! Why Students With TS Need an OT in Their Corner
In this webinar, as part of the Occupational Therapist Webinar Series, participants will learn how to apply their expertise to assess underlying factors that are impeding progress and develop a team-oriented approach for success in school, home, and community.March 9, 2021 at 3pm EST: Identification and Management of ADHD and Impulse Control in TS
This webinar, as part of the Provider Education Webinar Series, will define both disorders and explore best ways to manage them in children and adults with Tourette Syndrome.March 18, 2021 at 3pm EST: Success in the Educational Environment: It’s Not All About Grades
The presenter in this webinar, as part of the Occupational Therapist Webinar Series, will detail numerous ways in which OTs should be involved within the educational arena.March 24, 2021 at 7pm EST: Classroom Strategies and Accommodations for Students with Tourette Syndrome
This webinar, as part of the Education Professional Webinar Series, focuses on strategies for the classroom to assist a student with Tourette Syndrome.April 1, 2021 at 3pm EST: Case Vignettes, Applications and Resources for OTs
The speakers in this webinar, as part of the Occupational Therapist Webinar Series, will bring a variety of case vignettes and review treatment goals for each context.April 8, 2021: Refractory Tourette Syndrome
This case-based webinar, as part of the Provider Education Webinar Series, will explore courses of action for clinicians to consider when symptom treatments in TS do not respond sufficiently to usual approaches.April 21, 2021 at 7pm EST: Instructional Teaching Strategies to Support Students with TS and ADHD, Anxiety, and Executive Function Needs
In this webinar, as part of the Education Professional Webinar Series, learn how ADHD, Anxiety, and Executive Function needs can impact learning and social skills in a classroom.May 13, 2021 at 3pm EST: Advances in the Treatment of Tics
During this webinar, as part of the Provider Education Webinar Series, behavioral therapy, medication and Deep Brain Stimulation will be explored.May 14-16, 2021: 2021 National Conference
National Conference is the largest national research and practice conference dedicated to TS. Attend presentations that enrich your knowledge of the condition, and connect with members of the TS community.May 15 - June 15, 2021: Miles for Tourette
Save the Date! Lace up your shoes and join us throughout Tourette Syndrome Awareness Month to run, walk, or cycle wherever you are!May 19, 2021 at 7pm EST: Positive and Proactive Supports for Challenging Behaviors Associated With Tourette Syndrome and Co-Occurring Conditions
This webinar, as part of the Education Professional Webinar Series, will provide successful philosophies and strategies that focus on positive and proactive supports for students with TS.June 6, 2021: National Awareness 5K Run/Walk
Save the Date! Join the TAA for the National Awareness 5K Walk/Run at Astoria Park in New York City. This year's event features a Kids Fun Run and the 5K Run/Walk.June 16, 2021 at 7pm EST: Handwriting and TS: Common Issues that Impact Learning
Participants in this webinar, as part of the Education Professional Webinar Series, will learn how the complexity of underlying issues can combine to create a barrier to written work production.June 28, 2021: Illinois Golf Classic and Ladies’ Game Day
Save the Date! The annual Golf Outing and Ladies' Game Day is one of the largest fundraisers for the TAA and the support we receive from this event is vital.July 13, 2021 at 3pm EST: Transitioning to Adult Care: Time is Ticcing Away
In this webinar, as part of the Provider Education Webinar Series, attendees will discuss the process of transitioning from pediatric to adult care.
Educational Professional Series recordings
Handwriting and TS: Common Issues That Impact Learning
Tourette Syndrome: Getting Started
Dr. John T. Walkup, MD
Division of Child and Adolescent Psychiatry
Weill Cornell Medical College, New York
Part 1
Part 2
Part 3
Part 4
Stories of Inspiration & Hope
List of Famous People with Tourette Syndrome
Billie Eilish-An American singer and songwriter
Howie Mandel-A Comedian and host of Deal or No Deal
Steve Wallace-A NASCAR driver
Mahmoud Abdul-Rauf-A former basketball player known for having the most accurate free-throw shooting records
Brad Cohen-An American motivational speaker, teacher, school administrator, and author
A Virtual Quilt -The Tourette Association of America has designed a virtual quilt to showcase the Tourette Syndrome and Tic Disorder community, entwined with stories of inspiration, hope and community. This virtual quilt is a narrative of our unique experiences and stories to embrace and comfort one another. TS may impact everyone differently, but we are all woven together in community. It symbolizes our resilience, resourcefulness, and optimism. We are stronger together.
Are you interested in receiving the latest news in #TouretteSyndrome and Tic Disorders? Sign up for emails from the Tourette Association of America ➡️ tourette.org/get-connected
Co-occurring Conditions
Tourette Syndrome often occurs with other neurodevelopmental and neuropsychiatric conditions. The most common co-occurring conditions include the following:
Learning difficulties
Behavior problems
Anxiety
Mood problems
Social skills deficits and social functioning
Sleeping problems
For more information, CLICK HERE
Tourette Community & Support Groups
The Tourette Association of America has FREE Online Support Groups
The options include three parent-focused groups - Tourette Syndrome 101, Living with Tourette Syndrome, and TS and Explosive Behaviors/Rage, as well as a young adult group and a Spanish-speaking group.
Click Here to Register for an Online Support Group
Click Here for the Tourette Association of America Facebook Page
Local Support Group:
Fresno Tourette Syndrome Support Group Facebook Page
Tourette Association of America Youtube Channel -This Youtube channel is home to hundreds of videos with content from webinars to advice to personal stories, and it serves as a fantastic resource for the #TouretteSyndrome and Tic Disorder community.
Tourette Association Youth Ambassadors
Tourette Association Youth Ambassador Program
Since its establishment in 2005, the Tourette Association Youth Ambassador Program has been an ever-expanding group of teens with TS (and their siblings, friends and classmates) who speak about Tourette Syndrome and tic disorders to their peers at school, sports leagues, scout troops, camps and after school programs. The purpose of the Program is to spread tolerance of and understanding about TS.
The YA Program trains teens to advocate for themselves and for others and to educate their peers with accurate information about this often misunderstood and misdiagnosed disorder. The Program has also aimed to educate lawmakers and the public about TS, and to raise awareness about the impact of federal legislation on the health and well-being of people with TS.
The teen and their parent or guardian comprise a YA Team – with the teen giving presentations and the adult helping with scheduling and other arrangements.
Protective Laws
The United States Department of Justice considers Tourette Syndrome a qualifying disability. Individuals with Tourette Syndrome are protected under three laws:
ADA (Americans with Disabilities Act)
Section 504
IDEA (Individuals with Disabilities Education Act)
Additional Resources
Resources and support
Find a local chapter
Centers for Disease Control and Prevention
Data and Statistics on Tourette Syndrome
American Academy of Neurology
The Treatment of Tics in People with Tourette Syndrome and Chronic Tic Disorders
Living with Tourette Syndrome
Self-Care
TicFit Workout Series
Participate in the TicFit workout series!
About TicFit: This workout series is designed as an exercise protocol to help you use a specific way of exercising to manage your tics. Every tic interrupts your breath. Sometimes breathing is the tic. Activities like exercise are proved to help to reduce motor tics and the goal of this series is to provide each person more specific direction. Cardio helps because it regulates your breath but you can do that with strength workouts as well.
For more information go to the TicFit Website