Understandably, most parents are concerned....

By the time most families come to see me, they've already spent hours Googling, talking to teachers, asking their pediatrician, and wondering if they're missing something.

They're worried. Sometimes they're exhausted. And almost all of them are hoping I'll tell them, "This is no big deal." Others are so panicked they've already convinced themselves their child has something much more serious than a tic disorder.

While every child is different, there are a handful of things I find myself saying at almost every first appointment.

"This isn't on purpose."

This is usually where we start. Children don't choose to have tics. Yes, many kids can hold them in for a little while, but it takes an incredible amount of effort. I often compare it to trying not to blink or trying not to scratch an itch. You can do it...until eventually you can't. That's what supressing feels like.

"They do not have control"

This one surprises a lot of parents.

Many children spend their entire school day working incredibly hard to suppress their tics. By the time they get home, they're mentally exhausted.

Home is where they finally feel safe enough to let them out.

So when parents tell me, "School says they hardly tic at all, but it's nonstop once they're home," I usually tell them that's actually a pretty common pattern and often demonstrates that your child feels safe and supported enough to release them in your presence.

"Please don't tell them to stop."

I know. It's almost instinctive. Most parents aren't trying to be critical. They're trying to help.

But repeatedly pointing out tics usually has the opposite effect. Kids become more aware of them, more self-conscious, and sometimes the tics actually become more noticeable simply because everyone's paying attention to them.

They don't need reminders.

"Tics change. That's what they do."

Parents are often alarmed when one tic disappears and another one shows up. First it's blinking, the next week it's sniffing, then next month it's a shoulder shrug.

That doesn't necessarily mean things are getting worse, nor does it mean the tics are going away. One of the hallmarks of tic disorders is that they naturally wax and wane. They can change in frequency, intensity, and even type over time.

It's confusing if you don't know to expect it.

"There are things we can do."

One of the biggest myths I hear is that families just have to wait and hope their child outgrows it.

Fortunately, that's not true.

Sometimes tics do become less noticeable with time. Sometimes they don't. The good news is that we don't have to simply cross our fingers and hope for the best. Evidence-based treatments like CBIT can make a meaningful difference when tics are interfering with school, friendships, confidence, or everyday life.

One Last Thing...

If there's one thing I hope every parent leaves that first appointment knowing, it's this:

Your child isn't broken.

They're not doing this for attention.

And neither you nor your child caused this.

Most families walk into that first appointment scared.

My hope is they leave understanding what's happening and realizing they're not nearly as alone as they thought they were.

If you're looking for answers about your child's tics, specialized treatment for tic disorders can help you understand what's happening and what evidence-based treatment options are available.

Looking for help with tic disorders?

Learn more about our evidence-based treatment for tic disorders, including Comprehensive Behavioral Intervention for Tics (CBIT) for children, adolescents, and adults.

Written by Ashley Annestedt, LCSW

Ashley specializes in OCD, Tourette syndrome, tic disorders, skin picking disorder, trichotillomania, and PANDAS/PANS using evidence-based approaches including ERP, I-CBT, ACT, CBIT, and ComB. For nearly 20 years, she's helped children, adolescents, and families better understand these conditions and return to living fuller, more confident lives.