Common triggers of tics in Tourette's disorder

Your child's tics related to Tourette's disorder may seem worse in certain situations or during times when he or she experiences strong emotions. Common triggers include:

• Stressful events, such as a family fight or poor performance at school.
• Anger or excitement. Difficulties with other kids can make your child angry or frustrated. Or he or she may get flustered when eager for a fun event, such as a birthday party or vacation.
• Allergies, physical illness, or fatigue.

Many doctors consider it safe to give medicines to treat attention deficit hyperactivity disorder (ADHD), with a few exceptions, to children who also have Tourette's disorder. Although stimulant medicines have been reported to increase tics in some children, controlled research suggests that most children do not experience any worsening of tics due to stimulant medications. Some children's tics even appear to improve while the child is taking stimulant medications.¹

Your child's tics may decrease or be less severe when he or she:

• Has a supportive home and school life.
• Gets enough sleep.
• Becomes involved in new activities that are of great interest. Tics often improve while your child is focused on an activity as long as there is not a lot of surrounding stress or agitation from being overexcited.

Remember that tics related to Tourette's disorder also sometimes increase or decrease for no obvious reason.

Your child may also be able to hold back, or suppress, tics for a short time. Typically, a child does this when he or she:

• Is in a new place, such as at a new friend's house.
• Is in a new situation, such as having someone new over for dinner.
• Knows that someone is watching for tics, such as a doctor.

After holding back tics, most children will soon have a short period afterward when tics are noticeably worse.

Citations

1. Kurlan R (2003). Tourette's syndrome: Are stimulants safe? Current Neurology and Neuroscience Reports, 3(4): 285–288.