The early warning signs of tics and Tourette Syndrome

This winter break, I have spent some time thinking about why I wasn’t diagnosed sooner and why my mom did not see the early warning signs as warning signs as part of the larger picture for a TS+ child.

For those of you who are unfamiliar with the term TS+, it stands for Tourette Syndrome in combination with the co-morbid conditions that commonly come along with Tourette. I myself have OCD, Generalized Anxiety Disorder, Sensory Processing Disorder, and Panic Attack Disorder (although I haven’t had a major, full-fledged panic attack in about two years), and impulsivity issues also known as disinhibition.

Some other co-morbid disorders that can come along with TS are ADD, ADHD, mood disorders such as bipolar disorder, Asperger’s Syndrome, rage issues and other disorders as well.

In this post, I will outline and summarize two of the main types of tics that are warning signs for TS+ in a younger child anywhere from the ages of 2 years old to a middle school-aged child.

It is important to remember that in order for the types of things I describe to be tics, that they must be repetitive in the sense that you will see your child doing these things over and over again throughout the week, month or even day.

1) One of the first classic warning signs for the TS+ child is a simple tic, usually in the face. Simple facial tics like eye blinking, slight facial grimacing or slight facial twitching will usually be the first tic a child has. After a child’s first simple tic, other tics may develop in the trunk, arms and legs. A simple tic, however, is not always the first tic for a child, and each child with TS or TS+ will differ in the way they present with various symptoms.

TS is a very unique disorder as a result of the fact that every case is different, which includes the way the symptoms start. I think my first tic was a slight facial grimace; however, it was so subtle that neither myself nor my parents can be 100 percent sure.

I have seen videos and pictures of myself that make it look like this was my first tic, which started when I was about 3-4 years old and probably continued in the same way until a little after 1st or 2nd grade. I seem to find pictures of myself around this age all with a very similar positioning of my face, which also makes me think this may have been my first tic.

The tic looks like it was a slight facial grimace in some pictures but then looks like a much larger facial movement in other pictures. I really don’t think my parents even noticed it at the time. They probably thought I was just a “twitchy” or “nervous” kid.

2) For some kids, they have more complex tics as children, and for some these more complex tics can even come before the more simple tics. It is a little less typical for a child to get complex tics before simple tics, but it can certainly happen.

One type of complex tic that can be common in children is what I call a compulsion-like tic. These tics appear to be more like compulsions but are tics none the less. Complex compulsion-like tics are very common in children to show up at some point in childhood and more commonly show up after simple tics show up.

Some examples of compulsion-like tics that I had personally when I was younger are skipping, lip/skin picking, lip licking, lip biting, hair sucking, hand/finger smelling, sating off into space/doubling vision, grabbing at various parts of the body, putting hands down pants, and shirt or sleeve chewing.

Some other possible compulsion like tics are hand/finger licking, stomping, and other types of complex body movements. It is important to remember that although these tics look more purposeful in nature than something like a simple eye blink, they are tics nonetheless and the child has no more control over these tics than a simple tic. Asking your child to stop doing these kinds of tics will only make them worse.

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21 thoughts on “The early warning signs of tics and Tourette Syndrome

  1. I don’t know how old this blog is but, I was on YouTube watching random stuff and then a thing on Tourette Syndrome came up. I was fascinated and I clicked on the video. After I watched the video my head started twitching and I kept opening my mouth and this carried on for about an hour. I knew I was doing the stuff but I had to do it and I was like “what on earth is happening?”. Now everytime I watch a video of someone having tics, I like have a head twitch for an hour but I don’t have Tourette’s. Do you have any clue what it is?

    • Probably the mirror neurons. I read in Psychology that there are neurons in the brain that help us think and act like the people we watch.

  2. Reading this helped me to believe that my 9 year old son has TS and or TS+. He has a bad raw rash around his top and bottom lip. He constantly, every 5 seconds licks, bites, and opens his mouth wide like he is stretching it or trying to pop his hears. He can’t control it, and half the time doesn’t know he is doing it. It breaks my heart to watch him go through this, because everything burns his lips and it looks so horrible like he has clown make-up around his mouth. Is this so serious he needs a doctor asap!? Or is there a medicine that can help with TS and or TS+over the counter or prescribed by a specialist?

    • i think that you should seek treatment for the rash (if you haven’t already) and then decide if he has it. commonly in children, when they have chapped lips or bumps in there mouths, they try to relive the itch or burn by licking the area, widening your mouth also temporarily helps the pain. my brother has chapped lips quite frequently, and does the same thing, although, he isnt a very good example, he also has tourette! hopefully this helped! <3

      • Your absolutely right! My son Eugene also had rashes when he was younger, about 8 years old, we also found out he only had rashes. We found out it was actually impetigo. It scared the living hell out of me when I first saw it. We made the same mistake of seeing a specialist, but later found out what it actually was. I would advise you to see a doctor to get some medication.

      • i agree, my son was recently diagnosed with impetigo, im almost certian that is what your son has, The main symptom is red sores that form around the nose and mouth!

  3. I don’t know if this IS TS or something else entirely, but there are times when I feel like this weird shiver-like? feeling and a strong head twitch, my hands/fingers twitch fairly often, and my legs spasm a bit as well, shrug thing in one shoulder. There’s also this really strange noise that I’ve made a few times every day for the past 2-3 years, if I try to suppress it it becomes painful and it feels like my throat is closing up. I get asked constantly if I’m okay, or if I have to go to the hospital.

    I was watching some tourettes documentaries today and I suddenly had a fear that it might be what’s wrong with me.
    There’s not really one thing that happens constantly throughout the day, but it’s usually a mixture of several different things. Some answers to this would be greatly appreciated! I’ve been wondering about it for a long time.

  4. My mother always tells me that my tics are just nervous tics from my anxiety and never bothers to take me to the doctor about it, since I had a CAT scan a few years ago and they found nothing. I know that in order to have Tourett’s you have to have at least two motor tics and one vocal tic. I have at least four motor tics and one, if not two, vocal tics. Is there a way to determine whether or not I have nervous tics or Tourett’s?

    • You need one vocal and one motor tic to be present for at least a year in order for it to be diagnosed as tourette’s. A neurologist could help with diagnosis.

  5. My younger sister has developed a tic in her face, should I be concerned? She twitches her mouth and her eyes get wide and then she mellows out. But it’s not that noticeable. My family have been concerned about it for a few days. We would like to know if it’s serious and we should take her to the doctor?

    • It’s hard to say for sure but I understand your family’s concern. Give our office a call at 908-575-7350 so we can help you with some next steps.

  6. So our daughter is 7 and we’ve had done big changes over last 18 months in her life with 2 new siblings and moving into different home. She’s always appeared to struggle with paying attention and focusing-very easily distracted and highly sensitive with everything-feels things so extreme. Over last 6 months I’ve noticed very strange repetitive movements a hop on one leg, neck jerk, eye roll to upper right and sometimes overly smule liked forced. The newest one is she will twirl or spin. Is it normal for their to be so many? Is dte just a kid starved for attention or does stress exacerbate symptoms of TS?

    • Stress can absolutely exacerbate tics but only a doctor can make a TS diagnosis. Give NJCTS a call at 908-575-7350 to get a recommended doctor in your area.

    • Hi Jessica,
      How is your daughter? My daughter seems to have similar tics for quite a while now? Wondering if you did anything about them?
      Thx

  7. Hi I’m only 13 but I have some questions. Ever since I was like 7 I would do this weird thing where I would like rock back and forth against a wall and I don’t do that as much anymore but I rock on my one foot while standing. I also bite my lip a lot for no reason and I have this weird thing where my left shoulder jerks or rolls back like I’m stretching unexpectedly. My neck also jerks some times. I just don’t know what it is and when I heard about this I was worried that I might have Tourette’s. Should I be concerned?

    • Hi Emily! What you’re describing may be tics or maybe not, only a doctor can make a Tourette diagnosis. Give NJCTS a call at 908-575-7350 to get a recommended doctor in your area.

  8. My 5 year old son has been having some concerning behavior and complaints, and I am starting to suspect TS. He does grimace, and he will make noises like growling in a way that disrupts class. He does blink in a strange way sometimes too. He has recently started to tell me he “feels weird” or he feels confused, and that he feels like there are too many memories in his head. On several occasions he has said he just doesn’t feel right. He has refused to participate in certain activities also with no explanation, and will just sit there and not engage. Obviously I want to help him, but I don’t want to put any ideas in a doctors head about what might be going on… the power of suggestion. Do these sound like things you felt?

    • It’s great that he’s able to convey to you how he feels. I would first start a discussion with your primary. In order for it to be diagnosed as tourette’s it needs to be present for a year. With ts, often comes other conditions . To me, it sounds like he could be describing anxiety. When my daughter becomes overwhelmed and anxious, she”ll flat out refuse to participate in activities.

  9. Hey, so I was kind of just wondering. I have been noticing I have quite a few tics. I twitch, chew my nails and I don’t know all the time that I am doing it, my eyes twitch, I bite my lip, I do mumble, hum, and I have noticed recently that I sometimes will say totally random words uncontrollably. My mother is accusing me of faking it as a joke, and I know I am not. I don’t shout it, but I just say a word, I can’t stop it from coming out. I said terracotta the other day when she and I were taking a walk and talking. I kind of just am confused. If anyone has any idea on what the problem is, I would love to hear your opinions. Also, how do you get diagnosed for tourettes?

  10. Hi!

    I’m a teenage girl with no professional diagnosis for anything other than prescription glasses (although I believe I might have G.A.D and possibly slight depression), but recently I’ve started noticing that I make weird movements that I can’t help, and some compulsive-type things.

    I pick my lips *a lot*, and nine-times-out-of-ten cause them to bleed (I pick them increasingly often if I’m stressed or upset, also), and make this type of throat-clearing noise, which if I don’t do makes me feel like I have something in my throat, although it sounds more like gargling without water.

    My legs and fingers also twitch sometimes, although they aren’t major, and I don’t appear to have any facial tics that I’ve noticed. I feel like I’m being a pest and overreacting, so I’m sorry if there’s something I’m missing that’s painfully obvious.

    • Hi Endre! Do not worry about over reacting. If something is worrying you, talk to someone about it. Give NJCTS a call at 908-575-7350 to get a recommended doctor in your area.

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