Attention & Behavior

Tourette Syndrome & Tic Disorders

Tics aren't chosen, and suppressing them all day costs more than most adults realize.

If you're here because you're scared, that's okay. You're not alone, and noticing is the first act of advocacy.

Read as much or as little of this page as you have room for today. It will still be here tomorrow.

What this is

Understanding Tourette Syndrome & Tic Disorders

Tourette syndrome involves both motor and vocal tics lasting more than a year. Tics wax and wane, change over time, and get worse with stress, excitement, and — importantly — the effort of holding them in.

Many children can suppress tics at school and then release them in a flood at home. Teachers may therefore report seeing "nothing," while you're living with the rebound. That suppression is exhausting and it costs attention and energy that should be going toward learning.

Tourette's rarely travels alone. ADHD and OCD co-occur very frequently, and they often affect school more than the tics do. Ask for all three to be assessed.

Could this be it?

Early signs, by age

None of these are a diagnosis, and no child shows all of them. This is a list to help you notice patterns and describe them clearly to someone who can evaluate.

Toddler & preschool

Repeated blinking, facial grimacing, head jerking
Throat clearing, sniffing, or grunting with no illness
Movements that come in bouts and change over weeks

Early elementary

Both motor and vocal tics appearing over the year
Tics worsening with stress, excitement, or fatigue
Attention difficulty and impulsivity alongside tics
Peers noticing and commenting; child becoming self-conscious

Older kids & teens

Exhausting suppression at school, big release at home
Tics interfering with handwriting, reading, or test-taking
Social anxiety and avoidance because of tics
OCD-type rituals or "just right" urges alongside tics

What to do next

In this order, when you're ready

1
Get a medical evaluation and ask about CBIT
Comprehensive Behavioral Intervention for Tics (CBIT) is an evidence-based behavioral treatment. Ask your pediatrician or neurologist for a referral.
2
Ask that ADHD and OCD be assessed too
They co-occur very frequently and usually affect school more than the tics. Put all three in the evaluation request.
3
Educate the school — this is the big one
Ask for staff training so nobody disciplines your child for a tic. "Stop that" from a teacher is both futile and humiliating. Tourette Association resources are made for exactly this conversation.
4
Give tics somewhere to go
Ask for a discreet pass to a private space where your child can release tics without an audience. It's one of the highest-value accommodations available.
5
Write down what you're seeing
Dates, examples, the exact words your child used, how long homework took. You don't need a diagnosis to keep a record — you just need a notebook. This becomes the backbone of every conversation that follows.
6
If your child is under 3, call early intervention today
IDEA Part C gives every state a free early intervention program for babies and toddlers from birth to age 3. You do not need a doctor's referral and you do not need a diagnosis — a parent can refer their own child. Search "[your state] early intervention Part C" or ask your pediatrician for the number. For ages 3 and up, the same law (IDEA Part B) makes your local public school district responsible, even if your child doesn't attend school there yet.
7
Put your request for an evaluation in writing
Email or hand-deliver a dated letter to the school principal and the special education director asking for a full initial evaluation, and say what you're worried about. Writing it down starts the legal clock. Ask for a copy of your Procedural Safeguards at the same time.
8
Talk with your pediatrician
A medical visit can rule things in or out — hearing, vision, sleep, iron levels, anxiety — and can open the door to outside evaluations and therapies that run alongside anything school provides.
9
Say it out loud to your child, gently
Kids usually already know something is harder for them. Naming it kindly — "your brain works in a particular way and we're figuring out what helps" — turns shame into a plan.

Try this at home

Small things you can do this week

These are everyday activities, not therapy or instruction. Ten warm minutes beats an hour that ends in tears — stop before either of you is done being pleasant.

All agesOngoing

Let the tics be boring

Don't comment, correct, or count. Attention and suppression both raise tic pressure — a household that doesn't react is a genuine treatment.

Ages 5+30 min

Build a decompression hour

Tics often explode after school because they were held in all day. Quiet, low-demand time right after the bus makes the evening survivable.

Ages 7+15 min

Write the explanation together

Two sentences your child can say to a curious classmate. Having the words ready turns a dreaded moment into a manageable one.

These ideas are general parenting suggestions for families reading about Tourette Syndrome & Tic Disorders. They aren't therapy, instruction, or medical advice — follow the plan your child's team has set.

Looking ahead

When your child reaches their teens

Starting somewhere between 14 and 16, the IEP has to begin planning for life after school: postsecondary goals, independent living skills, vocational training, and connecting with adult services before school ends. Decision-making changes at 18, too.

Read the transition planning guide

Where to read more

Organizations we trust

These are national nonprofits, university centers, and government resources. Firm Footing isn't affiliated with any of them — we just think they're worth your time.

Your IEP meeting

Before, during, and after

An IEP meeting is a working meeting, not a verdict. You are a full member of the team, and you can ask for another meeting any time.

Evaluations to ask for

Name these specifically in your written request — a general request gets a general answer.

Medical/neurological evaluation of tics
ADHD and OCD assessment
Academic achievement testing, especially written expression
Observation across the day, including unstructured times
Assessment of how tic suppression affects attention and stamina

Before the meeting

Ask for a copy of the draft IEP, the evaluation report, and any progress data at least a few days ahead. You are allowed to read before you decide.
Send a short list of your concerns and questions in writing before the meeting so they must be addressed on the record.
Write your own one-page "parent input statement" — who your child is, what's working, what isn't, what you want by the end of the year. Ask that it be attached to the IEP.
Bring someone: a partner, a friend, a note-taker, or an advocate. You are allowed to bring anyone with knowledge or special expertise about your child.
Check your state's rules on recording, and give written notice if you plan to record.

During the meeting

Ask each person to say what data they used. "What is that based on?" is a complete, polite question.
Slow the meeting down when a term goes by that you don't know. "Can you say that in plain language?" is your right, not an interruption.
Test every goal out loud: What exact skill? How will it be measured? What's the target number? Under what conditions? By when?
Check that the services page matches the needs page — every need described in the PLAAFP should have a goal, a service, or an accommodation attached to it.
If you disagree, don't refuse to sign in silence. Ask for your disagreement to be written into the meeting notes, and ask what the school proposes instead.

Services to ask about

Counseling as a related service for coping and self-advocacy
Staff training on tics — what they are and what not to do
Specially designed instruction in organization if ADHD co-occurs
Occupational therapy if tics interfere with handwriting

Accommodations to ask about

A discreet pass to a private space to release tics, no permission needed
Testing in a separate setting so tics aren't public and aren't suppressed
Extended time; breaks during long tasks
Alternative to handwriting when motor tics interfere
Not being called out or disciplined for tics — written explicitly into the plan
Peer education, with your child's consent and on their terms
Reduced homework on high-tic days

After the meeting

Send a same-day follow-up email summarizing what was agreed and what's still open. A friendly written summary becomes the record.
Read the final IEP against your notes when it arrives. If something is missing or different, say so in writing within days, not months.
Calendar the progress reporting dates and ask for the actual data, not just "making progress."
If services aren't being delivered, ask for the service log in writing. Missed minutes can mean compensatory services.
If you disagree with the school's evaluation, you can request an Independent Educational Evaluation (IEE) at public expense — ask in writing.

Still not sure

Bring the document, or bring the question

If you already have an IEP or evaluation in hand, Decode My IEP will read it with you and flag the vague goals. If you just want to ask something out loud, Sprout answers in plain language.

Decode my IEP Ask Sprout a question

Related guides

Firm Footing is an independent resource. Nothing on this page is medical, psychological, or legal advice, and none of the organizations linked here are affiliated with us. Special education rules vary by state and district — your state's Parent Training and Information Center can help you with local specifics for free.