Tourette’s is a disorder of multiple tics, including motor and vocal tics that are present for more than one year. A tic is a sudden, rapid, involuntary, and recurrent stereotyped movement or vocalization. Tics are experienced as being irresistible but can be suppressed for varying lengths of time, especially during periods of interesting activities. Alternatively, they can be increased by stress. Examples of Simple Motor Tics include eye blinking, facial grimacing, coughing, shoulder shrugging, and neck jerking. Complex Motor Tics may include facial gestures and touching or smelling an object. Simple Vocal Tics may include sniffing, snorting, barking, throat clearing, and grunting. Complex Vocal Tics include repeating words or phrases out of context, swearing, and repeating the last word or phrase heard.
The frequency and type of tics present in Tourette’s changes over time. Most often Tourette’s begins with a simple tic of eye blinking. Tics may disappear for periods of time, leading one to think he no longer has it. The same tic may return, or new types of tics may take its place.
Tourette’s most commonly starts in childhood and is strongly associated with hyperactivity, distractibility, and impulsivity. It can also be exacerbated by central nervous system stimulant medication, which is commonly given for ADD and ADHD.
Although they can exist together, we do not know how many children with Asperger’s Disorder have Tourette’s Disorder. We do know that it in the general population it is seen in approximately 4–5 individuals per 10,000. It is 11⁄2 to 3 times more common in males than females. It can start as early as age two, but more commonly starts in childhood or adolescence. Once the tics surface, they usually last a lifetime. It is most often a genetic disorder, with only 10 percent of those afflicted having the nongenetic type.
Depression, anxiety, low self esteem, and embarrassment are also experienced by children with Tourette’s. School functioning can also be impaired by the obsessions and compulsions that often coexist with Tourette’s.
While neuroleptic medication is the only form of treatment for tics, most physicians avoid prescribing this major tranquilizing drug, preferring instead to let the tics occur naturally.