Your child’s tics were barely noticeable for weeks. Maybe you even thought they were going away.

Then suddenly, they’re back.

The eye blinking is happening constantly. A new neck movement appeared. The throat clearing is louder. Or maybe several new tics seemed to show up at once. Naturally, your first thought is: What happened?

Parents often assume that a sudden increase in tics means something has gone wrong or that their child’s tic disorder is getting progressively worse. But one of the most important things to understand about tics is that they naturally change over time.

As a CBIT therapist who works with children and families with tic disorders, this is one of the most common questions I hear. So let’s talk about why your child’s tics may suddenly be worse—and what you should actually do when it happens.

First, Tics Naturally Wax and Wane

Before looking for a trigger, understand this: tics wax and wane. That means their frequency, intensity, type, and location can increase and decrease over time. Your child may have a few difficult weeks followed by several weeks when their tics are barely noticeable. An eye-blinking tic may disappear and be replaced by a neck movement. A vocal tic may suddenly become more frequent. Old tics can return, and new tics can appear.

Sometimes you’ll be able to identify something that contributed to the increase. Other times, you won’t. That doesn’t necessarily mean you’re missing something. Fluctuation is part of the natural course of tic disorders. Instead of assuming every increase means your child is getting worse, zoom out and look at the pattern over time.

Why Do Tics Suddenly Get Worse?

Although tics naturally fluctuate, there are several factors that can make them more noticeable. And usually, it isn’t as simple as finding one single trigger.

Stress and Anxiety Can Increase Tics

You may notice more tics during stressful periods—starting school, taking a test, navigating friendship problems, traveling, performing in front of others, or dealing with changes at home. But here’s something parents often miss:

Excitement can increase tics too.

A birthday party, vacation, sporting event, holiday, or even playing a favorite video game can create enough emotional and physiological arousal to influence tics.

So rather than thinking only in terms of “Is my child anxious?”, think about your child’s overall level of arousal and regulation. Their nervous system doesn’t necessarily distinguish between “bad stress” and “I’m SO excited!” in the way we might expect.

Fatigue and Poor Sleep Can Make Tics More Noticeable

Sleep is one of the first things I ask families about when tics suddenly increase.

Has bedtime gotten later? Is your child waking during the night? Did school start and suddenly they’re waking an hour earlier? Have sports or activities made evenings busier?

A tired brain has fewer resources available for attention, emotional regulation, and motor control. For some children, tics become much more noticeable when they’re fatigued. This is also why you may see more tics toward the end of the day.

If your child’s tics suddenly increase, look at the last week or two of sleep—not just last night.

School and Changes in Routine Can Affect Tics

The beginning of the school year is a perfect example.

Your child suddenly has a new teacher, different classmates, earlier mornings, more sitting, increased academic expectations, homework, sports, and a completely different daily rhythm.

Even if your child loves school, that’s a lot for the brain and body to adjust to.

The same thing can happen around holidays, vacations, moving, changes in extracurricular activities, or other disruptions to your child’s normal routine.

This doesn’t mean you need to avoid change. It simply means transitions are worth considering when you’re trying to understand a temporary increase in tics.

Your Child May Be Suppressing Tics

Sometimes tics aren’t actually increasing throughout the entire day. You’re just seeing more of them during the times your child feels comfortable letting them happen.

For example, your child may suppress tics at school because they’re worried about classmates noticing. They walk through the front door at 3:30 and suddenly the tics seem intense.

It can look like:

“School is making my child’s tics worse.”

But another possibility is:

“My child has been working hard to control their tics all day, and home is where they’re finally letting them happen.”

Suppressing tics can require significant attention and effort, particularly when a child is experiencing a strong premonitory urge.

If you’re consistently seeing a major increase after school, don’t only ask your child about the tics. Ask:

“Do you feel like you have to hold your tics in at school?”

“Do you worry about other kids noticing?”

“Do you feel comfortable ticcing around your teacher or friends?”

Those answers may tell you much more.

Attention Can Influence Tics

Here’s where things can get tricky.

Your child’s tics increase, so naturally you start watching them more closely.

Then you start asking about them.

“Your blinking is really bad today. Are you okay?”

“Why are you doing that one so much?”

“Did your tics happen at school?”

“Can you feel that one coming?”

Suddenly, everyone is thinking about tics all day long—including your child. Attention and awareness can influence tics for some people, which is why I generally recommend that families avoid constantly pointing them out.

This doesn’t mean you can never talk about tics. Intentional conversations about tics are healthy and important.

But there’s a big difference between having a purposeful conversation and commenting every time your child’s body moves.

Illness Can Temporarily Change Tics

Some parents notice tic changes when their child is sick or recovering from an illness.

Think about everything that changes when a child doesn’t feel well: sleep may be disrupted, energy changes, routines disappear, stress on the body increases, and medications may sometimes change too.

All of those factors can affect the bigger picture.

If you notice a sudden change around an illness, document when it started and discuss significant or unusual changes with your child’s medical provider rather than assuming the illness itself explains everything.

Sometimes There Isn’t an Obvious Reason

This may be the hardest answer for parents. You can have the sleep routine dialed in. School is going great. Your child isn’t particularly anxious. Nobody has been sick.

And the tics still increase. That’s possible. Tics are neurological and often triggered from inside the body. Waxing and waning is part of their natural course. We don’t always get a satisfying explanation for every increase.

Constantly searching for the thing that caused a difficult tic week can create more anxiety for you and more attention around the tics for your child. Sometimes the best response is simply:

We’re seeing more tics right now. Let’s see how this develops.

Does a New Tic Mean My Child Is Getting Worse?

Not necessarily. A child can develop new tics while old ones decrease or disappear. The location and type of tic can also change. This can be incredibly frustrating for parents because just when you think you’ve figured out one tic, another one appears.

But a new tic does not automatically mean the overall condition is progressing or becoming more severe. Instead of counting the number of tics your child has, look at impact.

Is your child in pain?

Are the tics interfering with school?

Are they having trouble reading, writing, sleeping, eating, or participating in activities?

Are they embarrassed by the tic?

Are they avoiding friends or activities?

Are they spending significant energy trying to suppress it?

Or are you more bothered by the tic than your child is?

That last question can be uncomfortable, but it’s an important one.

What Should I Do When My Child’s Tics Suddenly Increase?

First, try not to panic. Avoid immediately telling your child to stop or asking them about the tic every time you notice it. Instead, zoom out and consider what has changed recently.

Look at sleep, routine, school demands, illness, stress, excitement, and whether your child may be suppressing tics in certain environments. Then talk with your child.

You might simply say, “I’ve noticed your tics have been happening a little more lately. Have you noticed that too? Are any of them bothering you?”

Their answer should help guide what happens next. If they aren’t bothered and the tics aren’t interfering with daily life, you may not need to do much beyond observing. If they’re uncomfortable, distracted, embarrassed, in pain, or spending significant energy trying to control their tics, then it’s worth looking at additional support.

When Should We Consider CBIT?

When tics begin interfering with your child’s life, Comprehensive Behavioral Intervention for Tics (CBIT) can help.

CBIT is an evidence-based treatment for tic disorders. It teaches children to become more aware of their urges that happen before the tic and then learn specific competing responses to stop the tic from happening. The result is a reduction in the frequency of the tic. You can see an 70-80% reduction of tics when using the strategies consistently. CBIT addresses one tic at a time and it typically takes 2-3 sessions to address one tic. You can see a strong reduction of one tic within 2-3 weeks!

CBIT is not the same thing as telling a child to suppress their tics all day. The goal isn’t to eliminate every movement or sound. It’s to give your child practical tools and more control over the tics that are actually getting in their way.

At Three23 Therapy, I provide virtual 1:1 CBIT therapy for children and teens with tics and Tourette Syndrome. Treatment is individualized around your child’s specific tics, their daily routines, and how those tics are affecting school, home, and everyday activities.

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

Want to Start With Strategies at Home?

If your child’s tics have increased but you’re not sure they’re ready for therapy—or you simply want to better understand what’s happening—I created Empower Your Brain & Body: Practical Tools for Managing Tics as a resource families can use at home.

The 68-page digital workbook walks through understanding tics, identifying patterns and triggers, sensory and regulation strategies, breathing and mindfulness, sleep, daily habits, nutrition and gut-brain health, and practical tools for tic management.

It’s a great starting point for parents who are thinking, “I know tics can change, but what can we actually do to support my child?”

Get the Empower Your Brain & Body Tic Workbook →

The Biggest Thing to Remember

A difficult tic day doesn’t erase your child’s progress.

A difficult tic week doesn’t necessarily mean their tic disorder is getting worse.

And a new tic doesn’t mean you’ve done something wrong or missed the one trigger you were supposed to find.

Tics change.

Pay attention to patterns, but don’t let your family become consumed by tracking them. Keep home a comfortable place for your child to tic. Focus on whether the tics are actually affecting their quality of life rather than simply how noticeable they are.

And when a tic is getting in the way, that’s when we can give your child tools to help.

Peace + Blessings,

Emily Reid, OTR/L