- Tics are repetitive involuntary movements.
And they can be split into two groups.
So one is Vocal tics.
And so that's a phonic sound.
It's often simple.
So that could be something like a throat clear, or a cough,
or a grunt or even a shout.
The other type is called Motor tics.
And motor tics are often kind of bursts of movement.
So that could be something like a nose crunch,
or an arm movement or even a head jerk.
Those are a series of movements.
So those often look more purposeful in nature.
So that could be something like a twirl or a jump,
or something that even looks like a dance movement.
And then there's complex vocal tics as well.
And that's like a saying a series of words or sentences,
but often they don't fit
into what the child is talking about.
Probably the most famous tic disorder is Tourette's.
Tourette was discovered by George de la Tourette,
who named it after himself in 1884.
And Tourette's, you have to have multiple motor movements,
and one vocal tic over the course of more than one year.
To have a diagnosis of something like a tic disorder,
or Tourette's, a lot of times
that's become functionally impairing.
So what that means
is that gets in the way of me thinking
that gets in the way of me talking to others.
The other difference between just kind of having a movement
and something like a tic or Tourette
is something called premonitory urge.
And so that's kind of like a feeling of itching or burning,
or I just got to do this thing
for everything to be all right.
We know that tics run in families,
so that means that there's a genetic contribution to that
similar to hair color, or eye color or height.
We also know that there might be situations
in our environment that increase our tic behavior,
So that could be experiencing stress
or having something like a diagnosis of anxiety.
Tics are Often diagnosed with other mental health diagnosis
like OCD, ADHD, anxiety and learning disorders.
The medication most oftenly prescribed
for kids with tic disorders
are often in the Atypical antipsychotic, Antiepileptics
or Alpha 2 agonists family.
One of the treatments that we have here
at Akron Children's Hospital is something called
Comprehensive Behavioral Intervention for Tics.
Or CBIT for short,
and so CBIT is a short term therapy.
It's usually eight sessions over the course of 10 weeks
and it's often with parents involved as well.
And so the first part of this therapy is
we try to figure out what that premonitory urge
looks like for that child.
So what do they experience prior to the tics.
We also spend a lot of time thinking about
what's going on in their environment
when they're ticking more.
So these kids they're having tics more in class
are these kids that are having tics more
when they're relaxing and playing video games?
So we spend a lot of that treatment
first trying to figure out those antecedent conditions.
Then what we do, the keystone of CBIT
is called habit reversal.
And habit reversal means selecting a physical movement
that I can do that's going to replace the tic
and make it physically impossible to do the tic.
So if I have an arm jerking tic,
one of the common strategies we might use
is to teach the child to feel the premonitory urge.
And when they feel that urge to tic
when they normally would go like this,
we train them to kind of maybe hold their elbow in
at their side, and we practice that together in session.
And then finally, because this is a comprehensive
intervention, we spend a lot of time talking about
stress management, relaxation skills,
being able to advocate for themselves and talk about tics.
And even we work collaboratively with the schools
to figure out what tics look like on the school setting.