Usually when Dr. Joseph Pinter sees young patients with tics, it's the parents who are most bothered.
A 4 or 5-year-old who's blinking his eyes excessively or rolling her eyes every few seconds may not even be aware of what he or she is doing. It most likely doesn't interfere with daily activities or schooling. But some parents, alarmed that they can't control the behavior, resort to repeatedly reminding a child to stop it.
Pinter, a pediatric neurologist at OHSU Doernbecher Children's Hospital, said when it comes to kids and tics, he spends more time calming parents than treating their kids.
Here's the reassuring news about tics: In the vast majority of cases, they disappear within a year.
"It's normal to have tics," Pinter said. "In many cases they will go away."
Tics, involuntary movements or sounds usually in the head or neck, are extremely common in young children, especially among those in preschool and early elementary school. About 20 percent of young children will develop a tic at some point. Tics – hard eye-blinking, eye rolling, throat clearing – may come and go, and may be accompanied by a verbal tic.Experts suspect tics come from an imbalance between the brain's frontal lobe – which helps control such behaviors – and the middle part of the brain where motor functions are stored. As children age, the link between these parts of the brain improves and matures, and tics often fade away.
Pinter said for some children, tics can be intense but then disappear. For a small percentage of children, a combination of verbal and motor tics lasts longer than a year and typically leads to a diagnosis of Tourette Syndrome.
“We don’t know the reasons for these ups and downs, or why in most kids the tics are only there for several months and go away,” he said. “The best evidence is that these differences are due to genetic differences in how these neurotransmitters and connections are set up in different people.”
Pinter said most children with tics don't require medical treatment - unless the behavior lasts longer than a year or the tics interfere with daily activities.
Parents who notice their child has a tic should do their best to ignore the behavior."It doesn't help the kid to say, 'Stop that,' " Pinter said. "Then you see a kid who is more stressed out than ever because their parents are telling them to stop something they have no control over.
"What you have to do is not reinforce the tic either positively or negatively," he said. "Let it go and let the kid develop out of it."
If you're worried about your child's tics, call the pediatrician. But remember, Pinter said, most tics will eventually fade.
"Most parents who come in are terrified and there isn't a good reason for that," he said. "What I'd like them to know is that generally tics are benign."