For Professionals

The clinic provides a comprehensive assessment of children and young people with complex tics between 3 and 17 years of age. Young people are most often referred to the Tics Service if they have additional co-occurring difficulties, and where there is a question about the diagnosis or advice on treatment is required.

Tics are fast, repetitive muscle movements that result in sudden and difficult-to-control body jolts or sounds. These are very common in children of primary school age, are often harmless and do not require specialist assessment.

Tourette syndrome is a neurodevelopmental condition characterised by motor (body) and vocal (sound) tics. These usually begin in childhood, and if they last longer than a year, a child could be diagnosed with Tourette syndrome.

There are no specific tests used to diagnose Tourette syndrome. Diagnosis is made through observation and history taking. There are some standards for diagnosing Tourette syndrome, agreed internationally, as follows:

A child or young person must:

• have multiple motor and one or more vocal tics that happen regularly, although not necessarily at the same time
• have tics occurring many times a day, or on and off for longer than one year. There should not have been a tic-free period of more than three months
• be younger than 18 years old
• not have any other conditions that could cause the tics

Although there is some discussion about these standards, most doctors use them as a guide for diagnosing TS.

This is a detailed assessment which will be carried out with members of our team to gain a full understanding of what the current difficulties are, and to screen for any neurodevelopmental or mental health difficulties.

During the assessment, a detailed interview will be carried out led by Psychiatrists, Psychologists and other members of our team. As we work closely with local community services, we may invite external professionals from local teams to join the assessment.

Once the assessment is complete, we will write a detailed letter describing the assessment and recommendations. This will be sent to the young person’s family, referring team and their GP.

We aim to offer all interventions in collaboration with the young person’s local child and adolescent mental health team (CAMHS). Depending on the specific needs identified at the assessment, interventions may include a range of therapeutic approaches and/or medication, if appropriate.

We accept referrals for young people from all over the UK. If a child lives a long distance away, and requires specialist mental health treatments, we will recommend local treatment. We can consider flexible packages of shared care depending on the needs of the child, including consultation, joint working and telemedicine. The Tics Service always works very closely and in collaboration with local services within a shared care model.

Interventions that may be provided will be evidence-based, short and intensive to achieve the maximum effect. They will be tailored to the young person’s needs.

The Tics Service currently offers the following interventions:

1. group psychoeducation session on tics and Tourette syndrome
2. group psychoeducation session on tic attacks, functional tics and tic-like movements
3. behavioural therapies for young people with tics using Exposure and Response Prevention (ERP) or Habit Reversal Therapy (HRT); these could be provided within a group or delivered individually.
4. medication recommendations to local treating teams
5. cognitive assessments to understand a child’s learning strengths and challenges
6. specialist follow-on assessments such as assessments for Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), where judged to be a clinical priority in the management of tics.
7. school consultation: to discuss strategies to best support young people with tics in the classroom

Read more information about our referral criteria and our referral form.