RHC for Health Professionals
- If diagnosis is in doubt or uncertain
Tics in Children: Advice for Referrers
Warning
Tics are very common in childhood and most do not require any investigation or treatment. They generally improve over time but can have a waxing and waning pattern, often with different types of tic. They can be both vocal, most commonly sniffing or grunting, and motor. Older children can often suppress them for a short period of time and therefore they may be worse at home than at school. Tics are often accompanied by other associated disorders such as ADHD, OCD, ASD, mood disorders and problems in relation to conduct.
Referral to medical paediatrics is often not required and the parents can be directed to the self-help information below. If the diagnosis is uncertain videos can be reviewed by a paediatrician using the vCreate system via SCI gateway.
- If invasive tics are impacting on school and sleep
- Significant associated mental health concerns
Please include the following points from history in the referral letter
- Current and any previous motor or vocal tics
- Duration of symptoms
- Any associated neurological or psychiatric conditions
- Other neurodevelopmental symptoms i.e. ADHD, ASD, sensory issues
- History of Repetitive behaviour, Coprolalia, Echolalia, Palilalia
- Any relevant social history, including school attended
- Psychosocial impairment, impact on activities of daily living, pain or injury
- Family history of neurodevelopmental disorder and psychiatric illness
Please include the following points from the clinical examination in the referral letter
- Any neurological abnormalities
- Please advise parents to video any events
- Watchful waiting
- Advise parents to ignore tics and do not bring attention to them
- Do not ask the child to stop the tics
- Advise parents to ensure young people have movement breaks
- Encourage parents to discuss situation with education
Tourette’s Scotland or Tourette’s Action have general information regarding tics for children and their families and is not specific to those with a diagnosis of Tourette's. Chewable products to detrain from tics are available to purchase online.
- Tourette Scotland
- Great Ormond Street Hospital: Tourette Syndrome information pack
- Tourettes Action: Tic disorders - a guide for parents and professionals
- Child Mind Institute: Tics and Tourettes
- The Brain Charity: Tourette Syndrome
NHS GGC MENTAL HEALTH ONLINE RESOURCES/APPS
GENERAL SELF-HELP ONLINE RESOURCES