Vocal Tics (Sounds and Noises)

Some children (and adults) make repetitive sounds that serve no communicative or health purpose. These sounds are called “vocal tics.” A vocal tic can be a cough, much like the cough one has when one has a cold, except that in the case of a tic – there is no cold and consequently no need to clear the passages of mucous! Sometimes the doctor will mistake this kind of cough for post-nasal drip – a small irritant in the throat. However, a true vocal tic is more like a bodily habit without a physical cause; there is no post-nasal drip. In addition, the cough does not stem from “nerves” or nervousness and therefore, it is also inaccurate to call it a “nervous habit.” A vocal tic is a biological disorder that is usually inherited. Calm people can have tics just as easily as anxious people. Nonetheless, stress does tend to aggravate tics, resulting in a temporary increase in symptoms.

Coughs are only one kind of vocal tic. A person can make any sound, including words. There are barks, hisses, grunts, sniffles, clicks and other noises. There are words or phrases that are repeated and in one kind of vocal tic (corprolalia), there are expletives (swear words) or “dirty words” that seem to jump out of nowhere.

If a child has both vocal tics and motor tics (repetitive, non-purposeful movements like jerking, bobbing, twitching and so on), he may have Tourette’s Syndrome. If he has only one kind of tic for less than a year, he may have transient tic disorder. Chronic Tic Disorder is the name given to tics that last longer than one year. Some children with tic disorders also have other disorders such as ADHD, OCD, mood disorders, anxiety disorders and conduct disorders. Many children, however, have simple tic disorders that improve with treatment or even on their own over time.

What Causes Tics?
Brain abnormalities can cause tics. Both structural changes in the brain and biochemical changes have been found in those who have tic disorders. Tic disorders run in family trees. Tic disorders commence before the age of 18. Sometimes they begin after taking a medicine (i.e. Ritalin, antidepressant medication, Cylert and Cocaine can all trigger tics in sensitive individuals). Sometimes tics may begin after a strep infection (in a similar way to PANDAS – the post-viral form of Obsessive-Compulsive Disorder). Sometimes injuries or other health conditions (even a common cold) can trigger the development of a tic. In all cases, the environment is thought to trigger a gene that is present in the child.

Although more tics occur when a child is feeling stressed or anxious, neither stress nor anxiety cause tics. Emotional distress worsens or aggravates a tic disorder temporarily. Stress reduction techniques bring tics back under control. The condition waxes and wanes – sometimes throughout life, but very commonly only until the end of adolescence when the tics may just disappear by themselves.

What Helps Tics?
Some medications can be helpful for tics – speak to your doctor or psychiatrist about this approach. Behavioral therapy can also be very helpful in reducing the tendency to tic. A psychologist can create the proper intervention for this kind of therapy. In addition, some alternative treatments have been found to be helpful in treating tics. For instance, nutritional interventions such as abstaining from coffee, pesticides, certain chemicals and so on, can sometimes help. Bach Flower Therapy (especially the remedy called Agrimony) has been very helpful for some children and teens with tics – consult a Bach Flower Practitioner for best results. Homeopathy and acupuncture might also be helpful. In fact, any intervention that helps reduce stress can help reduce the tendency to tic. Experimenting with several different healing modalities will help parents assess which one or ones have a positive effect on the course of the disorder.

Asking a child to stop making noises is NOT helpful and in fact, may lead to more tic behavior as the request itself induces stress. Tics are not done on purpose and they CANNOT be resisted. A child can delay a tic, but not stop it. Therefore, the youngster needs parental understanding and tolerance. The tic is not the child’s fault; rather, he or she is suffering from a disorder of the brain. Fortunately, tic disorders can be relatively mild, they can remit spontaneously and even when they do persist, they do not tend to interfere with academic performance or other normal functioning.

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