Tourette’s syndrome is a disorder that usually starts during childhood.¹ People with the disorder suffer from tics, which can range from blinking and shoulder shrugging to saying random words and phrases or even sometimes swearing.¹ Tics tend to get worse when the person is anxious or tired, and be less noticeable when the person is focused on an activity that involves a lot of concentration such as playing a sport or reading a book.¹ Tics can have a major impact on a person’s quality of life, and can cause problems at school.²

Tics are the main symptom of Tourette’s syndrome.¹ Tics are sudden involuntary movements or vocal sounds, which can be categorised as ‘simple’ or ‘complex’, with simple tics typically being of short duration and complex tics often of longer duration.³

• Simple motor tics – eye blinking, shoulder shrugging and extending the hands and feet.³
• Simple vocal tics – throat clearing, sniffing and grunting.³
• Complex motor tics – a combination of simple tics that can appear purposeful, such as sexual or rude gestures, or imitation of another person’s movements.³
• Complex vocal tics – repeating sounds or words, or grunting/barking socially unacceptable words (e.g., obscenities or racial slurs).³

Eye blinking and throat clearing are among the most common symptoms, although tics can include almost any muscle group or vocal sound.³ Swearing is rare and only affects about 1 in 10 people with Tourette’s syndrome.¹

Worldwide, up to 1% of children have Tourette’s syndrome,⁴ which is 2–4 times more common in boys than in girls.³ Tics typically emerge between 2 and 14 years of age¹ but are most severe between 10 and 12 years of age with a decline in severity during adolescence.³

Tics can cause embarrassment, low self-esteem, and can lead to social isolation and in some cases may result in conflict with others, and even pain and injury (e.g., from scratching oneself or neck jerks).⁵ In addition to tics, people with Tourette’s syndrome may be unusually sensitive to touch (e.g., to clothing tags or tight socks), have behavioural problems, and suffer from disrupted sleep, which can have a major impact on their quality of life.⁶

A study in 2015 showed that 86% of people (n=1,374) with Tourette’s syndrome also had a psychiatric disorder. The most commonly present (in 72% of patients), was attention deficit hyperactivity disorder (ADHD) and obsessive–compulsive disorder (OCD).⁷ Often, the psychiatric disorder is more problematic for the person than the tics.⁸

Children with Tourette’s syndrome, particularly those with severe symptoms and those with co-occurring disorders, are likely to have problems at school, and to need educational help.²

There’s no single test for Tourette’s syndrome therefore tests and scans such as an MRI may be used to rule out other conditions.¹

Tics can sometimes be difficult to differentiate from the repetitive behaviours that are associated with OCD, which can complicate the diagnosis.³

Tic severity usually improves in adolescence with symptom severity further reduced in adulthood.³ For children with mild and non-disabling tics, treatment should involve education and supportive therapy to help strengthen self-confidence.⁵ Treatment of more disabling tics may involve behavioural therapies and medication.¹