Tics in Children: How to Help Your Child Find Relief
You're watching your child at the dinner table when you notice it: a blink, a head jerk, a little cough that doesn't seem to go anywhere. Maybe it faded last month and came back as something new. Maybe it's been getting stronger, and now you're up at night with the questions nearly every parent of a child with tics ends up asking. Is this going to get worse? Will it ever go away? What can I do to help? And if it's time for treatment, do we have to start with medication?
If that's where you are, you're not alone, and there is more you can do than you might think.
The short version: Tics are neurological, they naturally rise and fall, and many children improve over time. When tics are painful, embarrassing, or getting in the way of daily life, a therapy called CBIT (Comprehensive Behavioral Intervention for Tics) can teach kids to reduce their tics without medication. It can also be added if a child is already on medication and still has tics.
What Are Tics?
Tics are sudden, rapid, repetitive movements or sounds that aren't rhythmic or purposeful. They come in two types:
Motor tics are movements of the body. Simple ones include eye blinking, nose twitching, facial grimacing, head jerking, and shoulder shrugging. Complex ones look more coordinated, like touching objects, hopping, multi-step movements of the arm, or repeating a gesture.
Vocal tics are sounds. Simple ones include throat-clearing, sniffing, grunting, and humming. Complex ones can include repeating words or phrases.
Facial tics, especially blinking and grimacing, are often the first ones parents notice and are very common. A tic lasting under a year is called a provisional tic disorder and are often monitored to see if they go away on their own. When tics last longer than a year a diagnosis of persistent motor or vocal tic disorder. If both are present it is called Tourette’s Disorder or more commonly Tourette Syndrome.
What Causes Tics in Children?
Tics are neurological. Research points to differences in how the brain's motor-control circuits, especially the basal ganglia, process signals and use chemicals like dopamine. Genetics play a large role, which is why tics often run in families. A tic is not a choice, not defiance, and not something a child can switch off with willpower.
What about "nervous tics"? Many parents search for "nervous tics," and it's an understandable phrase. But anxiety doesn't cause tics. It does make them worse. Stress, excitement, tiredness, illness, and even boredom can turn up the volume on tics that are already there.
The premonitory urge
Many children, especially older ones, describe a feeling right before a tic: an itch, pressure, or tension that builds until the tic relieves it. This is the premonitory urge, and it's the key to understanding tics. The tic isn't random. It's a response to a real physical sensation, and the relief is real, which is why the cycle keeps repeating.
Why Tics Get Worse
For many parents, the scariest part isn't the tic itself. It's watching it escalate and wondering whether it will ever stop.
Here's what helps to know. Tics naturally wax and wane. They get stronger for a stretch, then quieter, and old tics are often replaced by new ones. A sudden flare-up, or a brand-new tic showing up after the old one faded, is a common pattern and not a sign that your child is getting sicker. Flare-ups often line up with stress, poor sleep, a busy stretch at school, or a big change.
Tics also tend to follow an age pattern. They often peak in the early teen years, around ages 10 to 12, and many children see real improvement by adulthood. That's reassuring, but I also want to be honest: some tics don't fade, and a child can have a hard few years in the middle. Waiting it out isn't your only option. Learning the tools now can make a big difference.
Why Suppression Alone Doesn't Work (At least Not for Long)
The instinct when tics first show up is to say "stop doing that." Nearly every parent does it, and it comes from love. But it usually backfires. Pointing out tics increases self-consciousness, and stress makes tics worse. Asking a child to hold a tic in is exhausting, because the urge doesn't go away, and kids often end up drained or ashamed. What works is giving a child a skill to use in the moment instead of a demand to suppress.
CBIT: How It Gives Kids Relief
CBIT is a structured, skills-based therapy. It's drug-free, and it targets the urge-tic cycle directly instead of digging for a cause.
Awareness training. Your child learns to notice the early signs of a tic, including the premonitory urge, and to recognize their own patterns.
Competing response training. Your child learns a small, subtle movement they can do in place of the tic as soon as the urge shows up. It blocks the tic without drawing attention. This response is then held until the urge fades to a manageable level.
Function-based changes. Together we identify the situations that make tics worse, such as stress, fatigue, or particular settings, and adjust them. Parents are part of this, learning how to support practice at home without turning it into a battle.
Relaxation training. Your child learns simple calming skills, like slow belly breathing and muscle relaxation, to lower the stress and tension that can make tics flare.
Does CBIT work?
Yes. In the largest trial of CBIT in children (published in JAMA in 2010), about half of the kids who got CBIT had a meaningful reduction in tics, compared with fewer than 1 in 5 in the comparison group. Most of those gains held up months later. Kids in the trial attended eight sessions over about ten weeks, so this is a matter of weeks, not years.
Recommended first-line. The American Academy of Neurology recommends CBIT as an initial treatment for children whose tics are bothersome, before or alongside medication.
What "relief" realistically looks like
CBIT doesn't promise that every tic disappears. The goal is fewer, milder tics and a child who feels in charge of their body again, less embarrassed, less exhausted, and better able to focus on school and friends. For many kids, that shift in confidence is as important as the tic count.
Tics Rarely Travel Alone
Many children with tics also deal with ADHD, anxiety, or OCD. Those conditions can shape how tics show up and how well a child can practice new skills. A distracted, overwhelmed child will have a harder time with awareness training. Good treatment looks at the whole child, not just the tic.
When to Seek Help
Talk with your pediatrician or neurologist, and consider a CBIT-trained therapist, if:
Tics have lasted more than a few weeks or keep getting worse
Tics are painful, cause injury, or interfere with sleep, school, or friendships
Your child is embarrassed, being teased, or pulling back from things they love
You're weighing medication and want to know what else is available
Your child is on medication and tics are still getting in the way
About the Author
I'm Aaron Edmiston, LPC, owner of Blueprint Therapy Services. I specialize in tics and Tourette Syndrome, ADHD, and related conditions. I was trained in CBIT by Dr. John Piacentini through the Tourette Association of America's Behavior Therapy Institute. I also live with Tourette syndrome myself and have a child with tics. So when I tell a child that tics are real and that they're not broken, I mean it. CBIT is short and structured, typically 8-10 sessions, so families aren't signing up for open-ended therapy.
I see families in the Boerne and San Antonio area and offer secure telehealth CBIT anywhere in Texas.
Frequently Asked Questions
Are tics in childhood normal?
Very often, yes. Tics are common in school-age children, and most are temporary. A pediatrician can help you tell whether yours needs a closer look.
Will my child's tics get worse?
Tics naturally rise and fall, and a flare-up doesn't mean a permanent decline. They often peak in the early teen years and improve for many kids afterward. If tics are becoming painful or disruptive, that's the time to add support.
Do tics go away on their own?
Frequently. Many tics fade within a year. Some persist or change form, and those are the ones where CBIT can help.
Does my child have to take medication for tics?
Not necessarily. That's a decision to make with your child's medical provider. Behavioral therapy like CBIT is a recommended first-line option, and it can also be used alongside medication.
What if my child is on medication and still has tics?
That's common, and it doesn't mean treatment has failed. CBIT can be added to build skills on top of what medication is doing.
Is there a way to stop Tourette's tics?
You can't order a tic away, and trying tends to make things harder for kids. What works is teaching a child to notice the urge and respond with a competing behavior, which is the core of CBIT. The goal is reducing tics and restoring a sense of control, not guaranteeing they'll never happen.
Can stress cause tics in children?
Stress doesn't cause tics, but it can make existing ones more frequent or intense.
Can CBIT be done through telehealth?
Yes. Research supports telehealth delivery of CBIT, and many kids do well practicing skills in their own home.
Ready to Talk?
If tics are taking a toll on your child or your family, you don't have to figure it out alone. I offer virtual CBIT for children and teens across Texas, whether you're looking for an alternative to medication or a next step alongside it. Schedule a free consult with Blueprint Therapy Services to talk through what you're seeing.