Tics and Autism — What’s the Connection?

Does your child with autism display unusual behaviors or mannerisms? Are you beginning to wonder whether these repetitive movements or vocalizations are tics?

This leads to many parents asking, does my child with autism also have a tic disorder?

While there is no black and white answer here, as each child is unique, the short answer is yes, children with autism can have a tic disorder. Researchers continue to study this relationship, as autism disorders are more frequently linked to tic disorders than expected by chance.

What Is the Connection Between Autism and Tic Disorders?

Tic disorders are highly genetic and neurodevelopmental in nature.

While more research needs to be conducted, researchers have found that tics often develop due to an imbalance in dopamine and other brain chemicals within specific regions of the brain. For example, imbalances in the basal ganglia, which has been identified in both tic disorders and autism.

It is believed that the relationship between autism and tic disorders is likely related to both genetic and neurobiological factors. While studying individuals with Tourette’s syndrome, it was found that approximately one in five children also met the criteria for autism. However, this strong overlap may in part be due to difficulty in discriminating complex tics and autism spectrum disorder symptoms.

 

 

What Are the Different Types of Tic Disorders?

As stated by Dr. Zinner, an associate professor of pediatrics and a developmental-behavioral pediatrician at the University of Washington and Seattle Children’s Hospital, “tics are a semi-voluntary or voluntary response to involuntary sensation.” He describes this experience as an unpleasant urge or sensation, followed by a tic which then results in relief. 

Although tics are defined as sudden twitches, sounds, or movements, not all tic disorders are the same. Within the DSM-5, there are three distinct tic disorders, which differ from one another in terms of the type of tic present (vocal, motor, or both), as well as the length of time these symptoms are present.

Tourette Syndrome

Affecting approximately 1 percent of the population, Tourette syndrome causes both verbal and motor tics. These tics must be present for at least one year and can occur frequently throughout a day, or more sporadically. These tics develop before the age of 18, resulting in two or more motor tics (i.e. blinking, shrugging, etc.), as well as at least one vocal tic (i.e. humming, clearing one’s throat, yelling a certain word or phrase, etc.).

Chronic motor tic disorder

Affecting as many as 1 in 50 people, this disorder is defined by verbal or motor tics that occur for at least one year. This means that an individual will display one or more motor or vocal tics, but not both. As with Tourette syndrome, these tics begin before the age of 18 and occur many times daily, nearly every day — or throughout a period that lasts more than a year.

Transient motor tic disorder

Verbal or motor tics come and go, lasting for less than one year. Although this disorder affects up to 10 percent of children during their early school years, some research suggests that tics are more common among children with learning disabilities, as well as those with autism.

What Kind of Tics Are Most Common in Children with Autism?

Tourette syndrome (TS) is a co-morbid disorder with autism spectrum disorders. 

Previously, it was believed that tics in autism spectrum disorders was a result of neuroleptic medication. However, an increasing number of clinical reports and studies have now established that tics, such as those associated with TS, are common in individuals with autism spectrum disorders. Within this study, it was found that of those diagnosed with autism, 22 percent also showed symptoms of tic disorders — 11 percent with Tourette syndrome and 11 percent with chronic motor tic disorder.

On average, the most common age of onset is from five to seven, with the highest severity being between eight and twelve years of age. The most common tics that are initially present include facial movements, throat clearing, and eye blinking. However, these tics are often contrasted with other movements related to autism, such as stimming or stereotypical behaviors.

How to Help Treat Tics in Children with Autism

When aiming to treat tics in children with autism, there are several techniques and therapies. The approach taken will depend on the individual case. For example, the combination of facial tics and autism may require a customized treatment plant.

The first step in treating tics is to select the most significant symptoms, those being the ones that create the most problems within the child’s daily functioning. For some individuals, it is the tics themselves; whereas in others, it is comorbid autism-related behaviors. Since psychosocial stressors often worsen symptoms, counseling, and/or psychological interventions are often recommended.

Behavioral therapy is often recommended for both autism and tic disorders. More specifically, a form of CBT called habit reversal therapy (HRT). To treat tic disorders, it’s important for children to identify possible triggers. To better understand these potential triggers, a child and their therapist will discuss what it feels like when a child feels the urge that precedes an oncoming tic, so they can develop a competing response. For example, learning various breathing exercises and relaxation techniques to decrease tic frequency.

Since there are unique challenges which children with autism face, it’s important to seek treatment, guidance, and ongoing education from those who have experience and understand this spectrum disorder.

Carmen B. Pingree Autism Center of Learning is highly regarded on state, national, and international levels, offering state-of-the-art intervention for children and adolescents with autism. We understand that each individual child is unique, particularly in terms of their symptoms and everyday challenges. In addition to our numerous programs, we also offer in-home therapy and activities to help children with autism develop social, academic, communication, self-help, and functional living skills.

Want to learn more, contact us today!