Tics, Tourette Syndrome, School Support

For many children with tics, going back to school brings a whole new set of challenges.

At home, your child may feel comfortable letting their tics happen freely. At school, suddenly they’re sitting in a quiet classroom, surrounded by other kids, expected to focus, and wondering:

Can everyone hear me?

Did someone see that?

Is my teacher going to tell me to stop?

Should I try to hold my tics in?

Even when tics themselves aren’t significantly interfering with schoolwork, worrying about tics can be disruptive.

The good news is that a few intentional conversations and the right school supports can make a huge difference.

Here’s what I recommend parents consider when helping a child manage tics at school.

First: Remember That Tics Aren’t a Behavior Problem

Tics are sudden, repetitive movements or sounds that a child does not simply choose to have.

They may include things like:

• Eye blinking or facial movements
• Head or neck movements
• Shoulder shrugging
• Arm, hand, or body movements
• Sniffing
• Throat clearing
• Coughing
• Humming or squeaking
• Words or phrases

Some tics are barely noticeable. Others can be loud, frequent, physically uncomfortable, or distracting.

And tics naturally wax and wane, which means a child who had very few tics last month may suddenly have significantly more during the school year.

This is important for teachers to understand.

A child isn’t necessarily experiencing a major setback because their tics increased. And they aren’t intentionally being disruptive when a vocal or motor tic happens repeatedly during class.

The CDC specifically recommends educating school personnel about Tourette Syndrome and tic disorders because understanding the neurological nature of tics can help create a more supportive school environment.

1. Tell the Teacher About Your Child’s Tics

If your child is comfortable with it, one of the most helpful things you can do is tell the teacher about the tics before they become an issue.

This doesn’t have to be a huge conversation.

The goal is simply to make sure the teacher understands:

• What your child’s tics may look or sound like
• That the tics are involuntary
• That your child doesn’t need to be corrected for them
• That calling attention to the tics can make your child uncomfortable
• What your child would like the teacher to do if another student comments on them

This prevents an otherwise well-meaning teacher from saying things like:

“Can you stop making that noise?”

“Do you need a tissue?”

“Please sit still.”

“Why do you keep doing that?”

Imagine being a child who is already trying not to draw attention to a tic and suddenly having a teacher point it out in front of the entire class.

That’s exactly what we’re trying to prevent.

Educating the teacher also gives your child an advocate in the classroom. If another student asks about the tic, imitates it, laughs, or repeatedly brings attention to it, the teacher already understands what is happening and can respond appropriately.

School staff don’t need to make tics a big deal.

They just need to understand them.

2. Ask Your Child How Tics Actually Affect Them at School

Parents sometimes assume they know which part of school is hardest.

But your child’s answer might surprise you.

Maybe the tic itself doesn’t bother them at all.

Maybe they’re exhausted from holding it in.

Maybe they’re worried someone will notice.

Maybe a hand tic makes writing difficult.

Maybe a blinking tic makes reading harder.

Maybe they’re struggling to concentrate because they’re constantly thinking about whether the next tic is going to happen.

The CDC notes that tics can interfere with activities such as reading and writing, while the effort of trying not to tic can itself become distracting during school.

Instead of guessing, have an intentional conversation.

Try asking:

“How do your tics affect you at school?”

“Are any of your tics distracting or disruptive to you during class?”

“Do you worry about other kids noticing your tics?”

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

“Is there a certain class or part of the day when your tics are harder?”

“What would you say if someone asked you about your tics?”

“Is there anything your teacher could do that would make school easier?”

Then listen. The goal is to understand whether they feel like the tics are affecting their learning, comfort, confidence, or social experience. Once you understand, you can determine if the tics need intervention or if the child wants to learn how to control them – CBIT therapy is the #1 recommended treatment for tics.

3. Don’t Make “Holding In Your Tics” the School Strategy

This one is important. A child should not spend seven hours of their school day thinking:

Don’t tic. Don’t tic. Don’t tic.

Many people with tic disorders can temporarily suppress their tics. But suppression requires awareness, attention, and effort. That means a child may technically appear to have “fewer tics” while actually using a significant amount of mental energy trying to control them.

And that energy isn’t available for math, reading, listening to the teacher, interacting with friends, or simply being a kid.

Some children also experience a buildup of the premonitory urge—the uncomfortable sensation that often comes before a tic—while suppressing. When they finally reach a place where they feel comfortable ticcing again, they may notice a temporary increase in tics.

Parents often see this after school. Your child walks through the front door and suddenly the tics seem much stronger. That doesn’t necessarily mean school caused the tics. It may mean home is where your child finally feels safe enough to stop controlling them.

As much as possible, we want children to feel comfortable allowing their tics to happen naturally rather than spending the entire school day trying to hide them.

4. Give Your Child a Simple Way to Explain Their Tics

Children don’t owe everyone an explanation for their tics. But having an answer prepared can make unexpected questions feel much less intimidating. Your child might say:

“It’s just a habit. My brain makes my body do it sometimes. I’m fine, you can just ignore it.”

Or:

“I have tics. They’re movements and sounds that happen automatically, but I’m fine. You can just ignore it.”

Or simply:

“It’s something I do sometimes. I can’t really control it.”

Older children may want to explain Tourette Syndrome or their tic disorder in more detail. Other children may want to say almost nothing. Both are okay. The purpose is to help your child feel prepared instead of caught off guard.

Ask:

“If someone at school noticed your tic and asked about it, what would you want to say?”

Then practice the answer together.

5. Consider a 504 Plan for Tics

Not every child with tics needs formal school accommodations.

But if tics are interfering with your child’s ability to concentrate, write, test, participate, communicate, or comfortably access the school environment, it may be worth discussing a 504 Plan with the school.

A Section 504 Plan provides accommodations designed to give eligible students with disabilities equal access to their education. Importantly, a child does not necessarily need to be failing academically before school supports are worth discussing.

A student might have excellent grades while simultaneously spending enormous amounts of energy suppressing tics, worrying about classmates noticing, struggling through written assignments because of a hand tic, or avoiding participation because of a vocal tic. The Tourette Association of America notes that accommodations should be individualized to the student’s specific needs.

What Can a 504 Plan Include for a Child With Tics?

There isn’t one standard “tic 504.” The accommodations should match the specific ways tics are affecting your child.

Depending on the child, helpful accommodations may include:

• Permission to leave the classroom briefly to release tics without penalty
• Access to a quiet or private testing environment
• Extended testing time when tics interfere with completion
• Preferential seating or seating with easy access to the door
• Movement breaks
• Permission to stand or change position
• Reduced handwriting demands when motor tics interfere with writing
• Access to a computer or keyboard for written assignments
• Teacher notes or copies of instructional materials
• A plan for teachers to respond neutrally to tics
• Using non-distracting fidgets that can help calm tics
• Permission for vocal and motor tics to occur without disciplinary consequences
• Additional time to complete assignments when tics significantly interfere
• A predetermined plan for managing peer questions or teasing

For example, a child with a loud vocal tic might benefit from taking a test in another room—not because there’s anything wrong with the tic, but because the child can focus on the test instead of worrying about suppressing the sound.

Another child might strongly prefer staying with the class.

That’s why accommodations should always be individualized. The goal isn’t simply to make the classroom quieter or eliminate tics. The goal is to remove barriers so your child can learn.

6. Look Beyond the Tic Itself

Sometimes the most disruptive part of a tic disorder isn’t actually the visible tic.

It may be:

• Anxiety about other students noticing
• Difficulty concentrating
• Sensory sensitivities
• Handwriting difficulties
• Executive functioning challenges
• Fear of being called on
• Exhaustion from suppressing
• Social anxiety or embarrassment

This is another reason it’s helpful to talk with your child instead of only counting how frequently they’re ticcing.

Ask yourself: What is actually making school difficult right now? That’s the problem you want to solve.

7. Create a Team Around Your Child—Without Making Tics Their Identity

Your child’s teacher should know enough to support them. The school counselor or other relevant staff may need to know. A 504 team may need to be involved.

But your child also deserves to go to school without feeling like everyone is watching their tics. The sweet spot is quiet support. Adults understand what’s happening. They know how to respond. Accommodations are available when needed. Your child knows who they can go to for help. And then everyone gets back to the business of school.

Your child’s tics don’t need to become the most interesting thing about them.

What Should Teachers Do When a Student Tics?

Most of the time? Nothing.

If the tic isn’t hurting the child or preventing them from participating, teachers can usually continue teaching without commenting on it. That neutral response communicates something powerful to the student:

You’re okay. You don’t have to hide this here.

If a tic is interfering with an activity, the teacher can quietly use the supports already established for that student rather than correcting or disciplining the tic. The Tourette Association of America specifically cautions that attention from adults or peers can make tics worse, making a calm, informed response especially important.

The Goal Isn’t a Tic-Free School Day

This may be the biggest mindset shift for parents as well as the student. Success isn’t:

“My child made it through the entire school day without ticcing.”

A better definition of success is:

“My child went to school, participated, learned, interacted with friends, and didn’t spend the entire day worrying about their tics.”

We’re not trying to teach children that their bodies need to be perfectly still or sound perfectly quiet in order to belong in a classroom. We’re helping them understand their brain, advocate for what they need, and develop tools that allow them to participate confidently in their everyday life.

And sometimes the best thing adults can do for a child’s tics at school is surprisingly simple: Understand them, accommodate them when necessary, and stop making them the center of attention.

Frequently Asked Questions About Tics at School

Should I tell my child’s teacher about their tics?

In many cases, yes. If your child is comfortable with it, educating the teacher can prevent tics from being mistaken for disruptive behavior and helps the teacher respond appropriately if other students notice or comment on them.

Should teachers tell a child to stop ticcing?

No. Tics are involuntary neurological movements or sounds. Calling attention to them or repeatedly asking a child to stop can increase stress and force the child to devote more attention to controlling their tics.

Should my child suppress tics at school?

Children shouldn’t feel that they have to suppress their tics simply to avoid bothering other people. Some children can temporarily suppress tics, but doing so can require significant concentration and effort. School supports should focus on helping the child learn and participate rather than requiring them to appear tic-free.

Can a child get a 504 Plan for tics or Tourette Syndrome?

Potentially. Section 504 eligibility depends on whether the student’s impairment substantially limits one or more major life activities. For students with tic disorders, areas such as concentrating, thinking, reading, writing, and communicating may be relevant. Schools determine eligibility based on the individual student’s needs.

What accommodations can help tics at school?

Helpful accommodations may include breaks, alternative testing environments, extended time, flexible seating, reduced handwriting demands, access to technology, permission to leave the classroom briefly, and a neutral-response plan for teachers. Accommodations should always be individualized.

Why are my child’s tics worse after school?

Some children suppress or minimize their tics during school because they don’t want other students to notice them. Once they return to a comfortable environment, they may tic more freely. Fatigue, stress, transitions, excitement, and the natural waxing and waning of tics can also contribute to changes throughout the day.

When Tics Are Interfering With School

If your child is spending a significant amount of energy managing, hiding, or worrying about their tics, they may benefit from additional support.

Comprehensive Behavioral Intervention for Tics (CBIT) is an evidence-based behavioral treatment for tic disorders. CBIT teaches children how to recognize tic urges, understand patterns surrounding their tics, and use specific strategies to manage tics that are bothersome or disruptive.

At Three23 Therapy, I provide virtual CBIT therapy and practical tic support designed to help children and families understand what’s happening and build strategies that actually fit into everyday life—including school.

You can also download the Supporting Students in School guide for parent-friendly information you can share with your child’s teacher.

👉 Learn more about CBIT therapy and tic resources at Three23Therapy.com.

Peace and Blessings,

Emily, OTR/L
Occupational Therapist