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Tics in kids increased over the pandemic; parents want to know why

Is TikTok to blame?
/ Source: TODAY

Since the start of the COVID-19 pandemic, more children are being diagnosed with tics. In October, the Wall Street Journal covered the emergence; other stories and accounts followed.

In some cases, teens had watched TikTok videos by creators with tics, leading many to wonder: Did seeing those tics caused teens to develop their own?

Some experts don’t think that the increase in tics is so clear-cut.

“What you’re seeing not only across the country but in other countries as well is just a very large increase in teenage onset tic-like behavior,” Dr. David Moon, section chief for pediatric neurology at Helen DeVos Children’s Hospital, told TODAY Parents. “I would say in a normal year I might diagnose what I think are legitimate organic ticks in the teenager years three to five times a year … Since the start of the pandemic we have probably seen three to five referrals a week.”

The experts share what parents need to know about tics, how to help their children and what this surge in tics might mean.

What are tics?

Often when people think of tics they think of Tourette syndrome, a neurological condition where children display both motor and vocal tics. But tics can happen for other reasons. Think of tics as unwanted movements or verbal outbursts. So a vocal tic might be something like clearing one’s throat repeatedly. But the person feels like they have to do it and it’s not something they can control. Children might have tics because of conditions, such as autism. But in some cases, doctors can’t point to a reason a child has a tic.

“There are many kids that we follow that do not have an underlying condition that get diagnosed with tics,” Dr. Nivedita Thakur, medical director of the Movement Disorder Program at Children’s Hospital of Philadelphia, told TODAY Parents. “We often have kids that may have only motor tics or only vocal tics.”

She said often parents worry that a tic indicates there’s something wrong with their child, such as an atypical seizure. Sometimes there is a brain difference or underlying condition to blame and doctors will evaluate the child to rule out or consider possible causes.

“We will most definitely want to check and look at the brain and make sure there’s not a structural cause for what’s going on,” Thakur explained. “(We’re) trying to understand what the movement looks like. If there is an atypical seizure, there is another common workup that can be done.”

Some tics don’t significantly hinder a child.

“It’s really important to understand how the movement is impairing their day to day life. I see a lot of kids that do have tics but are really both socially and academically doing very well,” Thakur said. “We talk a lot about educating the school and making sure teachers are aware and people around them also understand that these are things they may not necessarily be able to control.”

The pandemic and tics

Experts believe that the stressful and unique conditions since March 2020 contributed to the rise in cases among children and teens. Having access to tic videos could contribute to the increase, though the pandemic itself likely has a larger role.

“One of the things that we surmise is that one of the reasons this has become such a nationwide and international phenomenon is that during the pandemic, people were isolated,” Moon said. “They naturally turned toward social media as a way to maintain connections and experience the world while they were holed up. So they got exposed to this (tic) ‘content.’”

Tics aren’t contagious in the sense that a child might see a TikTok personality with a tic and develop them. But if a child had a mild tic that wasn’t previously diagnosed, being around someone with a tic might make their tics more pronounced. If a teen feels overwhelmed by all the changes of the pandemic and sees someone on social media with a tic, their previously mild or undetected tic could emerge.

“I tend to prefer the term conversion disorder. Essentially what it means is there’s some internal psychological process that’s not being processed fully or deal with directly,” Moon said. “That tension comes out as a physical symptom.”

How to help a child with tics

Parents often don’t know what to do when their child develops a tic. Focusing on it or asking the child to stop can actually have the opposite impact that parents want.

“When you see a movement that is repetitive and … could be disruptive, you tend to want to say, ‘Stop doing that,’ or ‘Don’t do that,’" Thakur said. “That actually causes the kids a lot of times to become a little bit more anxious and can actually lead to an increase in these movements.”

That’s why doctors spend time educating adults about their child’s tics and how to help them.

“Not putting a lot of attention or focus on it may be helpful for them to not continue to do these behaviors,” Thakur said. “The anxiety of other people constantly seeing them or them feeling an internal pressure that they need to stop doing this movement can also cause them to increase.”