Why Tic-Like Behaviors Are on the Rise in Children and Teens

During the COVID-19 pandemic, more young people experienced what are called tic-like behaviors.

“In many cases, these were not tics but rather a movement disorder,” says Kathleen Maxwell, family nurse practitioner for pediatric neurology at University Hospitals Rainbow Babies & Children’s Hospital.

“The pandemic and disruption of normal life may have provoked anxiety, and led to an increase in mood-related disorders and sudden tic-like behaviors. Those children with a previous history of tics may have noticed an increase in frequency and severity.”

Social media usage was also implicated, as videos of tic behaviors received a lot of attention on social media platforms such as TikTok. Many patients developed symptoms similar to those shown in videos. The patients were often teens with no history of tics.

Facts About Tics

“Most often tics are temporary and do not result in any problems or concerns,” says Dr. Maxwell. Tics can be simple as facial twitching, or they can be complex, involving different parts of the body. While these symptoms would concern any parent, they’re often are mild and resolve or improve significantly with time.

Tics can occur in as many as 1 in 5 children. Tourette syndrome is a tic disorder that occurs in about 1 in 160 school-age children. A person with Tourette has both motor and vocal tics for more than a year.

Tics usually begin between 3 and 8 years of age. Tics can worsen during high-stress, high excitement or emotional situations. If tics persist for more than one year, the severity usually peaks around 8 and 12 years old. Diagnosis is based on signs and symptoms.

Common Motor Tics

• Facial distortions or twitching
• Head twitching or jerking
• Eye blinking
• Lip biting
• Arm jerking
• Shoulder shrugging
• Hopping
• Kicking
• Mimicking others

Common Vocal Tics

• Grunting
• Yelling
• Sniffing
• Barking
• Coughing
• Throat clearing
• Repeating words and phrases

Managing Tics in Children

Mild tics may not require treatment. But educating patients, family and schools is recommended. One good resource is the Tourette Syndrome Association, says Dr. Maxwell.

“Treatments are available for tics if warranted. Tics are treated if they are causing social or physical discomfort for the individual,” she says.

Specialists who can help include neurologists, psychiatrists and other behavioral health specialists.

• Behavioral therapy is often recommended for complex tic disorders. This would include habit reversal therapy
• There are several medications that can be used if needed. These would include guanfacine, clonidine, Topamax, haloperidol, pimozide and aripiprazole

Also, simple steps can make a difference.

• Children need reassurances that they are okay and should not feel bad or embarrassed about tics.
• Parents, caregivers and teachers should not direct attention to tics or react negatively.
• Work on techniques for anxiety and stress management.
• Involve children in enjoyable activities as much as possible.
• Keep a good schedule that includes good sleep hygiene.

Related Links

The pediatric neurology team at University Hospitals Rainbow Babies & Children’s has the expertise to accurately evaluate, diagnose and treat the full range of neurological disorders children. Learn more.