Tourette’s Disorder (TD) in Children and Adolescents


ICD-10 code: F95.2

Tourette’s disorder (TD) is part of a cluster of diagnoses called the motor disorders.  Motor disorders are a group of psychiatric conditions that include:

  • Developmental coordination disorder
  • Stereotypic movement disorder
  • Tic disorders

Motor disorders are a group of psychiatric conditions that affect the ability to produce and control bodily movements. Motor disorders may involve developmental delays and deficits involving fine and gross motor functions. Developmental coordination disorder is characterized by deficits in the acquisition and execution of coordinated motor skills and is manifested by clumsiness and slowness or inaccuracy of performance of motor skills that cause interference with daily living. Stereotypic movement disorder includes patterns of repetitive and seemingly driven yet purposeless motor behaviors. Examples of such behaviors include movements of the head, body, and hands that are developmentally abnormal. Tic disorders involve sudden, rapid and recurrent, non-rhythmic motor movements or vocalizations. Such motoric or vocal manifestations are observably involuntary.

Several types of tic disorders can be distinguished in DSM-5.  These are as follows:

  • Tourette’s disorder
  • Persistent (chronic) motor tic disorder
  • Persistent (chronic) vocal tic disorder

TD is characterized by the presence of multiple motor tics and one or more vocal tics.  Persistent (chronic) motor tic disorder is characterized by the presence of single or multiple motor tics and the absence of any vocal tics.  Persistent (chronic) vocal tic disorder is characterized by the presence of a single or multiple vocal tics and the absence of any motor tics.

Tics can be simple (of short duration) and can include motor behaviors such as eye blinking, shoulder shrugging, or movement of the extremities, or vocal behaviors such as throat clearing, sniffing, and grunting.  Complex tics are of longer duration (on the order of seconds) and may include combinations of motor or vocal behaviors.  Complex tics may involve imitating another person’s motor or vocal behaviors, sexual or obscene gestures (copropraxia) or utterances (coprolalia), or they may be apparently nonsensical combinations of motions and/or vocalizations.

Because many individuals experience one or more tics at some point in their lives, a tic disorder is diagnosed only when the tics persist for one year or longer.

What is Tourette’s Disorder?

TD is a psychiatric disorder that affects between 0.05 – 3% of children and adolescents.  The disorder typically has an onset around age 5 – 7, with symptoms often remitting by early adulthood.

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Understanding Tourette’s Disorder

Tourette’s disorder can range from mild to severe.  In severe cases, the tics can cause musculoskeletal pain or injury.  Social isolation or bullying can also occur, particularly in adolescence.  Children with TD often experience other psychiatric disorders, including attention deficit/hyperactivity disorder, obsessive-compulsive disorder, and separation anxiety disorder, while adolescents with TD are more likely to experience major depressive disorder, substance use disorder, or bipolar disorders.  

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How is Tourette’s Disorder Treated?

Tourette’s disorder is treatable. Published treatment recommendations for children and adolescents with TD are available from the American Academy of Child and Adolescent Psychiatry and the European Society for the Study of Tourette Syndrome (ESSTS) Guidelines Group (Pharmacological Interventions and Behavioral Interventions).  Note that in the case of mild TD, treatment may not be necessary and the tics may remit spontaneously.  However, in the case of moderately or more distressing or impairing tics, treatment can be helpful.

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