Tourette's Disorder
Treatment Overview
Treatment for Tourette's disorder (TD) focuses on managing tics—helping your child and others cope with the tics. Most cases of Tourette's disorder are mild and will not need medical treatment. Educating yourself, your child, and people who have regular contact with your child (such as teachers) about Tourette's disorder will help your child thrive. Creating a supportive home and school environment where tics are accepted and accommodated is also important.
In some cases, such as when other conditions are present, counseling may be helpful. If your child's tics affect his or her life significantly, medicines or behavior therapies such as habit reversal may be considered. The tics can be decreased, but there is no cure for Tourette's disorder at this time.
Finding the right treatment for Tourette's disorder can be time-consuming, especially if other disorders and problems such as attention deficit hyperactivity disorder (ADHD) are present. The Tourette's disorder organizations listed in the Other Places to Get Help section of this topic often can refer you to health professionals who understand Tourette's disorder and the treatment available.
If Tourette's disorder occurs along with other disorders or problems, work with your child and doctor to find out which symptoms are causing the most difficulties. Get input from teachers to give you a sense of what is happening in your child's school environment. (Your child's symptoms may be quite different in school than at home.)
Targeting specific problems is important so you know which to treat first. Some medicines that are used to treat tics may not help with any other condition.
Sometimes tics can be reduced by first treating conditions that can occur along with TD. This is because some conditions, such as behavioral problems, can make tics worse. Conditions such as depression or anxiety usually need to be treated before TD.
For more information on conditions that often occur with Tourette's disorder, see the following topics:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Obsessive-Compulsive Disorder (OCD)
- Depression in Children and Teens
Because everyone who has Tourette's disorder has unique tics and considerations, treatment must be tailored to fit the child.
- Children with mild tics may only need extra support and changes made to their environment to avoid triggering tics. Often tics will improve from making a few changes at school, such as allowing your child to take tests untimed and in a private room. It may also help to take steps to reduce problems that your child has as a result of the tics, such as being embarrassed about having tics when around other kids. For example, you may be able to talk with teachers about showing a video to your child's classmates about Tourette's disorder.
- Children whose tics seriously affect their quality of life or ability to function in school, at home, and in the community may benefit from medicine or therapy to control their tics.
Both you and your child should work with your child's doctor to manage Tourette's disorder. It is important that decision making is shared as much as possible. Talk to a doctor about finding help for you and your child together and individually.
As your child grows and goes through different developmental stages, you will likely need to provide more information about TD to encourage his or her understanding and good management of the condition. Over time, you will also need to see whether adjustments are needed in your child's school environment. Counseling may also be more important for your child in some stages of development than others.
Initial treatment
Initial treatment for children with Tourette's disorder may include:
- Educating yourself and others.Understanding Tourette's disorder makes it possible to recognize what your child is going through and to help others understand as well. Your doctor will often start the educational process by talking with you and your family about Tourette's disorder. The family can then keep learning about the disorder through the resources that Tourette's disorder organizations provide. Your doctor, local hospitals, and community outreach programs can help you. For organizations that can help, see the Other Places to Get Help section of this topic.
- Understanding how tics affect your child. Try to identify what triggers tics. It may help you to find patterns by writing down when tics occur and what is going on in your child's life during these times.
- Making changes. Your child may have fewer tics if you and your child's other caregivers make changes at home or school, such as alternating house chores with free time or allowing for rest periods in school.
- Habit reversal. Your child may be able to control problematic or embarrassing tics through habit reversal. Habit reversal focuses on creating an awareness of tic behavior and a response to replace the tic.3 This technique should be taught by a qualified professional. Ask your doctor for recommendations.
- Counseling. During counseling sessions, a qualified therapist helps your child cope with thoughts, feelings, or behaviors relating to Tourette's disorder. Counseling cannot stop tics, but it may decrease anxiety and help your child feel better about himself or herself. Family members may be asked to participate in the counseling sessions.
Ongoing treatment
The symptoms of Tourette's disorder change as your child gets older. Tics come and go and seem worse at times. School performance and social situations that involve talking with or in front of others can be especially hard for your child. Ongoing treatment consists of matching your management of the disorder to how the tics are currently affecting your child.
- Understand Tourette's disorder and continue to educate yourself and others about the disorder.
- Be aware of how tics change as your child grows. Continue to record the kinds of tics your child develops and what seems to trigger them.
- Make changes at home or school when needed. A solid support system is important for helping your child to successfully manage tics.
- Continue counseling, if necessary. If appropriate, continue to use habit reversal, which focuses on creating an awareness of tic behavior and creating a response to replace the tic.
Treatment if the condition gets worse
If Tourette's disorder is disrupting your child's life, such as affecting his or her school work or ability to function at home or in the community, consider:
- Making additional changes at home or school to accommodate any changes in how tics occur.
- More extensive counseling for everyone who is affected by the disorder.
- Using habit reversal if taught by a well-trained professional. Habit reversal focuses on creating an awareness of tic behavior and creating a response to replace the tic.
- Using medicine. Medicine can help make tics less severe or occur less often. But some medicines have severe side effects. Always talk with your child's doctor about the benefits and risks of using medicine.
Adult treatment
Because an adult with Tourette's disorder has had the disease since childhood, treatment generally is well established and depends on each adult's situation. It is important that those who interact with the adult who has Tourette's disorder understand the disease and that tics are not willful. Medicines may be necessary, as is counseling if Tourette's disorder is severely affecting the adult's life.
Other treatment
Deep brain stimulation (DBS), in limited studies, has shown promise as treatment for reducing tics in adults. In this procedure, electrodes are surgically placed in certain areas of the brain, such as the basal ganglia. These electrodes are connected to another device that is surgically placed in the chest. The device in the chest sends signals to the electrodes in the brain. This process can help prevent or limit tics. Researchers continue to investigate this treatment and the risks of side effects, such as bleeding in the brain or unwanted changes in motor function. At this time, DBS is an experimental treatment and is not considered for use in children.4
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| Author: | Debby Golonka, MPH | Last Updated: September 27, 2007 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics Karin M. Lindholm, DO - Neurology | |
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| Topic Contents | |
| Topic Overview | |
Health Tools  | |
| Symptoms | |
| Exams and Tests | |
 | Treatment Overview |
| Home Treatment | |
| Other Places To Get Help | |
| Related Information | |
| References | |
| Credits | |