Researcher Dr. Kevin Black estimates that 50% of children may have tics at some point during their childhood.1

Let’s not just be surprised by this huge percentage, but also look at what can be done about it!

Just what is a tic?

A tic is an involuntary muscle movement that is repeated. It can be a “motor” body tic, like jerking your arm or tossing your head back over and over—or a verbal tic, like making noises or saying words uncontrollably.

There are three main categories of tics.

To meet the diagnostic criteria for each of these, the tics would have started before age 18 and should not have been caused by a medication. (This is not to say that adults don’t sometimes develop tics for the first time but this is not as common.) Below is a summary from an article by the CDC on diagnosing tics.

  • A provisional tic disorder: Single or multiple motor and/or vocal tics. The tics have been present for less than one year.
  • Persistent (chronic) motor or vocal tic disorder: Single or multiple motor or vocal tics have been present—but not both motor and vocal. The tics have persisted for more than one year.
  • Tourette syndrome: Both multiple motor and one or more vocal tics have been present at some time, although not necessarily concurrently. The tics have persisted for more than one year.

Doctors like to apply labels to symptoms, but actually the distinction between categories is considered somewhat arbitrary, particularly the time requirement (one year) before diagnosing a person with Tourette’s, versus the same symptoms at a duration of 11 months. The specific diagnosis does not serve to determine medication needs as much as does the severity and level of distress caused by the tics.

Ruling out and treating tics due to an infection

The three tic categories above are not intended to include tics that are due to a specific medical condition, such as an underlying viral or bacterial infection, including Lyme disease. An increasing and alarming number of children are exhibiting symptoms of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS), which includes PANDAS (due to strep).

PANS symptoms usually come on suddenly. A child with this disorder may have a dramatic onset of obsessive-compulsive behaviors and a restriction in eating along with some of these symptoms: anxiety, mood swings, deterioration in school work, sleep disturbances and tics, among other symptoms. It is important to see a knowledgeable physician as soon as possible if you suspect your child may be suffering from PANS.

Learn more from the PANDAS Network here

Not dealing with tics? Please share this with someone who is!

Why do I ask you to share this article? Because all parents of children with tics have one thing in common: They feel helpless. They want to make the tics stop, they want to help their child, but they don’t know what to do.

I know this because I was one of those parents. And I have since spent more than 25 years collecting feedback from others in the same situation, and sharing what they or their doctor found helpful to relieve the tics.

What to do when tics begin

Small, fleeting tics are quite common with kids. I recommend you try some of the common sense approaches below. If these efforts are pursued consistently, tics may be reduced or eliminated.  If not, or if they worsen to the point of being of concern, consult your pediatrician and/or a neurologist to rule out any nervous system disorders.

Often, doctors will advise to “watch and wait,” to see if tics go away on their own. Also, it is usually recommended to reduce stress, because it is well known that stress can make tics worse.

Medications are available to treat tics, but they can have serious side effects, so doctors use them with caution and only when they feel it is necessary.

What doctors frequently fail to do is recommend changes in the diet or environment to reduce tics, because studies have not been completed in this area. That’s where parents come in!

What’s a parent to do about tics?

First, make some common sense adjustments. Just as migraines and asthma attacks have triggers, like certain foods, perfume, and exposure to smog or allergens, so, too, do tics.

In fact, Tourette syndrome is considered to be 60% genetic and 40% environmental. You just don’t hear much about the role of the environment, and unfortunately, the medical community has downplayed its importance and failed to research the topic.

Rather than wait for studies that can be a long time coming, you can try some of the tips below. Take action and check what in the “environment”—which includes diet—could be playing a role in tics.

You will have to play detective. Once you find a trigger, do your best to avoid or eliminate it.

Finding Tics Triggers

Clues about triggers for tics can be gleaned from another medical condition that often overlaps with Tourette syndrome: Migraine. Did you know that migraine headaches are four times as common among people with Tourette syndrome as the general population? Triggers for migraine are widely studied and shared with patients. For starters, You can get some good ideas on possible triggers from the American Migraine Foundation.

In addition, I outline eight types of tic triggers in my book, Stop Your Tics by Learning What Triggers Them.

These were categorized from nearly 2000 responses on surveys and from feedback from patients, families, and physicians. The types include

  1. sensory influences
  2. allergens
  3. food and drink
  4. toxins
  5. medications
  6. lifestyle
  7. physical imbalances
  8. weather

Within each those types are a number of specific exposures or agents. There is no one answer for everyone. In the book, tools and advice are given for identifying and dealing with triggers.

Getting started with triggers

Eliminating tics triggers is not usually the total answer for everyone, any more than avoiding dust will remove all symptoms for someone with inhalant allergies.  But it is clearly advisable for someone to avoid identified tics triggers. Why suffer more than you have to?

It is well known that stress can make tics worse. With this in mind, patients and families can aim to reduce stress on the physical body, not just by relaxing or focusing on the emotional level. Ask a medical practitioner or nutritionist to recommend nutrients that are helpful for reducing stress (i.e., B vitamins).

You can also try to calm the child’s nervous system by avoiding environmental factors that can aggravate it. These aggravating factors may be right under your nose!

Identifying tics triggers

Each of the points below are supported by common sense, as well as by studies showing a positive connection for each with  other health conditions:

  • Allergy has been linked to tics in several studies. If your child has allergies, be diligent with avoiding allergens, such as dust, mold, inhalants and animal dander. Pursue allergy treatment, if needed.
  • Keep a log and watch for any dietary triggers for symptoms. For example, artificial colors, flavors, and preservatives have been proven to cause hyperactivity. Ask yourself if tics get worse after eating items with these additives. Also, watch for any pattern with tics after consuming other items to see if a food allergy or intolerance are involved. In addition to additives, some common examples are corn, wheat, dairy, nuts, soy, and sugary items. These are patient-specific.
  • Avoid pesticides and herbicides! After all, these are developed to purposely disrupt the nervous system. It is a no-brainer to stay away from these. Eat organic when feasible, and use alternative pest control.
  • Go natural at home. Typical scented products—from laundry detergent to air fresheners—can aggravate the nervous system. Also, get “back to the basics” with cleaning products. You can explore the internet for ideas (i.e., time-proven classics like using baking soda and vinegar to clean) or purchase non-toxic products made by companies like Seventh Generation.
  • Encourage playtime, board games and sports over screen time (using tablets, cell phone, computer, video games) in kids. Parents and practitioners have reported seeing an increase in tics after a child spends time with screens.

Each person is unique, so are their tics triggers 

Resourceful parents and adults dealing with tics can often find ways to reduce symptoms. Avoiding triggers is only one approach that might help, and keep in mind that what bothers one person may not bother someone else.

Have an open mind as you go through this process. It is well worth the effort to be watchful and aware of anything in the environment and diet that might be affecting stress and tics.

As Dr. Leo Galland wrote in The Allergy Solution: “Nothing produces such dramatic relief as identifying an allergic trigger and eliminating it.”


  1. Black, Kevin J., Elizabeth R. Black, Deanna J. Greene, and Bradley L. Schlaggar.
  2. “Provisional Tic Disorder: What to Tell Parents When their Child First Starts
  3. ” F1000 Research 5 (2016), 696. — Accessed January 28, 2019
  4. Migraine Headache in Patients with Tourette syndrome — Accessed January 28, 2019
  5. Rogers Demare, Sheila Stop Your Tics by Learning What Triggers Them, Association for Comprehensive NeuroTherapy (2018)
  6. Association of Tourette syndrome and obsessive-compulsive disorder with allergic diseases in children and adolescents: a preliminary study. — Accessed January 28, 2019

Subscribe for DrGreene’s Newsletter

Sheila DeMare contributor