One day your child seems completely fine. Then suddenly, you notice an eye blink. A few days later, maybe there’s a facial movement, a head jerk, throat clearing, sniffing, or another repetitive movement or sound that seems to have come out of nowhere.

And once you notice it, it can be really hard not to notice it.

If your child suddenly develops tics, your brain probably starts asking a million questions. Why is this happening? Is it going to get worse? Should I tell them to stop? Do we need to see a doctor? Is this Tourette Syndrome? Did something cause this?

As a CBIT therapist who works with children and families with tic disorders, one of the biggest things I want parents to know is that you do not have to figure everything out on day one.

There are, however, a few things I recommend doing—and a few things I recommend avoiding—when tics first appear.

First, What Does a Tic Look Like?

Tics are sudden, repetitive movements or sounds that can be difficult or impossible to control completely.

Motor tics involve movement and might look like eye blinking, facial grimacing, head or neck movements, shoulder shrugging, abdominal tightening, or movements of the arms, hands, or other parts of the body.

Vocal tics involve sounds and can include sniffing, throat clearing, coughing, humming, squeaking, clicking, or sometimes words and phrases.

One of the most confusing things for parents is that tics can change. Your child might blink repeatedly for several weeks and then suddenly stop blinking but start moving their neck. A vocal tic might disappear and return later. Your child may have several tics at once or go through a period when you barely notice any at all.

This waxing and waning is a common characteristic of tic disorders, so a changing tic doesn’t automatically mean something is getting worse.

Try Not to Immediately Tell Your Child to Stop

When you first notice a repetitive movement or sound, your natural reaction may be to say, “Stop doing that,” “Why do you keep blinking?” or “Can you try not to make that noise?”

But if what you’re seeing is a tic, your child isn’t simply choosing to do it.

Some children can temporarily suppress their tics, but that can take significant attention and effort. Many children also experience a premonitory urge, which is an uncomfortable sensation that comes before the tic. They may describe it as pressure, tension, tingling, an itch, or simply a feeling that something isn’t right until they complete the movement or sound.

Repeatedly pointing out the tic can also make your child much more aware of something they may not have been particularly bothered by in the first place.

Instead, try to keep your response neutral. You don’t have to pretend the tic doesn’t exist, but you also don’t need to make every tic an event.

Start Paying Attention to the Bigger Picture

When tics first appear, I recommend observing before jumping into “fix it” mode.

Think back to when you first noticed the tic and whether it has changed since then. You may begin to notice that your child tics more when they’re tired, excited, stressed, sick, relaxing after school, or going through a big transition.

Sleep, fatigue, stress, excitement, illness, changes in routine, and attention can all influence how noticeable tics are for some children. At the same time, sometimes there isn’t an obvious explanation for why tics suddenly increase or decrease.

That’s why I don’t recommend obsessively tracking every tic or trying to identify one single thing that “caused” it. Looking at patterns over time is much more helpful than counting every movement or sound throughout the day.

Talk to Your Child About Their Tics

You absolutely can talk about tics. In fact, intentional conversations about tics can be incredibly helpful.

The key is making those conversations feel safe and neutral rather than turning your child into a tic detective all day long.

Find a calm moment and ask something simple like, “Have you noticed that movement your body has been doing?” You can ask whether it bothers them, whether it ever feels uncomfortable, whether they know when it’s about to happen, or whether they ever feel like they need to hold it in.

Then listen.

Some children are extremely aware of their tics and bothered by them. Other children barely notice them until an adult points them out.

That distinction is important because the presence of a tic doesn’t automatically mean that tic needs to be treated.

Pay More Attention to Impact Than Frequency

This is one of the biggest mindset shifts I encourage parents to make.

More tics don’t automatically mean a bigger problem.

A child might tic frequently and genuinely not care. Another child might have a relatively infrequent vocal tic but spend the entire school day worrying that someone is going to hear it.

That second child may actually be experiencing a much greater impact from their tics.

Instead of focusing only on “How much is my child ticcing?”, start thinking about how the tics are affecting their everyday life.

Are they painful? Are they interfering with sleep, reading, handwriting, concentration, sports, or other activities? Is your child embarrassed or avoiding certain situations? Are they spending a significant amount of energy trying to suppress their tics around friends or at school?

Those answers tell us much more about whether a child needs additional support than tic frequency alone.

Remember That Tics Don’t Always Exist in Isolation

Sometimes parents come to me because tics are the most visible thing happening, but once we start talking, we realize something else is having a much bigger impact on the child’s day.

Children with tic disorders can also experience challenges with anxiety, ADHD, obsessive-compulsive symptoms, sensory processing, emotional regulation, or executive functioning.

That doesn’t mean every child with tics has another diagnosis. It simply means we want to look at the whole child, not just the movement or sound we can see.

If your child is ticcing but the thing that’s actually making school miserable is anxiety, then anxiety deserves our attention too. Treatment should focus on what is interfering with your child’s life—not simply what’s easiest for adults to notice.

Talk to Your Pediatrician

If your child has developed a new repetitive movement or sound and you’re unsure whether it’s a tic, it’s reasonable to bring it up with your pediatrician.

One practical tip is to take a short video when you see the movement or hear the sound at home. Your child may not tic in exactly the same way during an appointment, so having a video can help your provider understand what you’re seeing.

Your pediatrician can look at your child’s overall history and presentation and determine whether additional evaluation is needed. This is especially important if the movement seems unusual, is causing injury or significant pain, appears alongside other new neurological symptoms, or you’re simply not confident that what you’re seeing is actually a tic.

A Tic Does Not Automatically Mean Tourette Syndrome

This is usually one of the first places a parent’s mind goes. Your child develops a tic, you Google it, and suddenly you’re reading about Tourette Syndrome. Having a tic does not automatically mean your child has Tourette Syndrome.

There are different tic disorder diagnoses, and diagnosis depends on things like which types of tics are present and how long they’ve been happening.

Tourette Syndrome involves multiple motor tics and at least one vocal tic at some point during the disorder, although motor and vocal tics don’t have to happen at the same time. Tics must begin before age 18 and persist for more than one year since the first tic began.

So if your child’s tics started two weeks ago, you don’t need to determine their long-term diagnosis today. Give yourself permission to observe, gather information, and talk with the appropriate provider instead of trying to diagnose your child through Google.

Make Home a Place Where Your Child Can Tic Freely

This becomes especially important once kids start spending long days at school. Some children become very aware of their tics around other people and try to suppress them because they don’t want classmates or teachers to notice. Then they walk through the front door after school and suddenly seem to be ticcing significantly more.

Parents sometimes interpret this as, “Their tics are getting so much worse!”

But that’s not necessarily what’s happening. Fatigue, transitions, and the natural waxing and waning of tics can all play a role. For some children, home may also simply be the place where they feel comfortable enough to stop trying so hard to control their body.

Try not to greet that increase with, “Wow, your tics are really bad today,” or “Can you stop doing that?”

Home should ideally be a place where your child knows, “I don’t have to hide my tics here.”

Want to Start Helping Your Child at Home?

If you’re reading all of this thinking, “Okay, I understand the tics better…but what can I actually do?” I created a resource specifically for that.

Empower Your Brain & Body: Practical Tools for Managing Tics is my 68-page digital workbook designed for parents, individuals with tics, and families who want to better understand tics and have practical strategies they can begin using at home.

It goes beyond simply explaining what tics are. You’ll learn about identifying patterns and triggers, sensory and regulation strategies, breathing and mindfulness, sleep, daily habits, nutrition and gut-brain health, and other lifestyle factors that may influence tic management.

If you’re in the “My child has tics—now what?” stage, the workbook is a great place to start.

Get Empower Your Brain & Body: Practical Tools for Managing Tics →

When Should You Consider CBIT Therapy?

Not every child with tics needs therapy.

But if tics are painful, distracting, socially uncomfortable, interfering with school or everyday activities, or causing your child to spend significant energy trying to suppress them, Comprehensive Behavioral Intervention for Tics (CBIT) is worth exploring.

CBIT is an evidence-based treatment for tic disorders. And importantly, CBIT isn’t simply teaching a child to hold in their tics.

Children learn to become more aware of their individual tics and the urges that may come before them. They then learn specific strategies, including competing responses, to help stop the tic from happening. With practice, a child can see a 70-80% reduction in tics. CBIT addresses one tic at a time and it typically takes 2-3 sessions to address one tic. So, you can see a reduction in one tic within 3 weeks! CBIT also looks at situations and environmental factors that may make tics easier or harder to manage.

At Three23 Therapy, I provide virtual 1:1 CBIT therapy for children, teens, and adults with tics and Tourette Syndrome. Rather than using a one-size-fits-all approach, we identify the specific tics that are interfering with your child’s life and build strategies around their individual needs.

The goal isn’t necessarily to make your child completely tic-free. The goal is to give them more control over the tics that are getting in their way and reduce the frequency as much as possible.

Learn more about 1:1 CBIT Therapy at Three23 Therapy →

So, What Should You Actually Do First?

If your child suddenly develops tics, you don’t need to overhaul their entire life overnight. You don’t need to buy ten supplements, eliminate half their diet, schedule five specialists, and spend every evening Googling every movement they make.

Start simpler.

Keep your response calm and neutral. Watch the overall pattern without obsessively tracking every tic. Talk to your child about whether the tics actually bother them. Look at how they’re functioning at home, at school, and socially. Talk with your pediatrician when appropriate.

If you want to begin learning and implementing strategies at home, start with the Empower Your Brain & Body Tic Workbook. And if your child’s tics are getting in the way and they need more individualized support, 1:1 CBIT therapy may be the next step.

Most importantly, don’t let the tic suddenly become the center of every interaction you have with your child.

Your child is still the exact same kid they were before you noticed that first tic.

Sometimes the best first step is understanding what’s happening, taking the pressure off, and figuring out which tics—if any—actually need intervention.

Peace + Blessings,

Emily Reid, OTR/L