1. Myth: Everyone with Tourette syndrome blurts out obscenities.
Fact: Many people believe that swearing is a defining symptom of Tourette syndrome. And this makes sense: It’s probably the most common symptom portrayed on television and in movies. However, only 10 to 15 percent of people with Tourette syndrome experience it, Woods said.
2. Myth: Bad parenting causes tics.
Fact: “We know for sure that Tourette’s is genetically based,” Woods said. Scientists haven’t been able to isolate a specific gene. Rather, they believe that multiple genes interact in predisposing a person to the disorder. Twin studies have found a concordance rate of approximately 70 percent in identical twins and 20 percent in fraternal twins, he said.
In people with Tourette syndrome, there appears to be a dysfunction in the basal ganglia, which is involved in motor control. Specifically, the basal ganglia “don’t inhibit movement the way they should. The unwanted movements that get out would normally be stopped.”
Environment also plays a role. “Tics are very sensitive to what goes on around them.” Tics can worsen whenever kids are stressed out, anxious or even excited. For some kids, concentrating on another activity “can make tics go away.”
3. Myth: The only treatment for Tourette syndrome is medication.
Fact: “Many kids with tics don’t need treatment,” Woods said. Whether a child gets treatment depends on the severity of their tics and how much they interfere in their daily life. When a child does need treatment, behavior therapy can help.
The comprehensive behavioral intervention for tics (CBIT) teaches kids to recognize when they’re about to tic and to use a competing behavior. Individuals with Tourette syndrome typically experience a premonitory urge, a physical sensation that occurs immediately before a tic. It may feel like an itch, pressure or tickle, Woods said.
In his book The World’s Strongest Librarian, author Josh Hanagarne likens it to the urge to sneeze: “There’s a pressure that builds up in my eyes if I want to blink, in my forehead if I want to wrinkle it, in my shoulders if I want to jerk them up toward my ears, in my tongue if I need to feel the edge of it slide against a molar, in my throat if I need to hum or yell or whistle. The urge can also be everywhere at once, which results in a tic where I flex every part of my body, hard and fast.”
When kids feel the urge, they can perform a behavior that interferes with the tic. As the authors of this journal article write: “For example, if a patient has the urge to engage in a shoulder tic, the competing response might involve isometric tensing of arm muscles while pushing the elbow against the torso. Thus, the competing response encourages the patient to respond to the urge to tic in a new way.”
CBIT also helps kids spot and cope successfully with the stressors that worsen their tics. Research has shown positive effects for CBIT in both kids and adults. For instance, this study found that CBIT decreased the severity of kids’ tics. This study also found a decrease in tics in adults who received CBIT.
Unfortunately, behavior therapy isn’t widely available. Medication is used more frequently to treat tics. Doctors typically prescribe clonidine or guanfacine as the first line of treatment, Woods said. They also may prescribe atypical antipsychotics, such as risperidone, he added.
4. Myth: Teaching kids to suppress one tic will trigger more or different tics.
Fact: Research has found that when kids successfully suppress their tics, they don’t experience an increase in tics. One study even found that after the suppression condition, tics decreased by 17 percent when compared to the baseline.
Research also has shown that treating one type of tic does not increase other types. In this study kids received treatment for vocal tics, while motor tics were left untreated. The motor tics did not increase. In fact, there was actually a 26 percent decrease in motor tics.
While Tourette syndrome tics can be bothersome and intrusive, they tend to shrink in severity or dissipate altogether over time. For kids and adults whose symptoms are especially disruptive or don’t go away, effective treatment is available.
- Learn more about Tourette syndrome at the website for the Tourette Syndrome Association.
- This article in the APA’s Monitor on Psychology explores the advances in behavior therapy for Tourette syndrome in greater detail.