Tourette Syndrome

Written & reviewed by the BestDoctors.sg editorial team · Last updated 2 Sep 2026 · General information, not medical advice

Tics are common in childhood, and having the odd tic does not mean a child has Tourette syndrome. When both movement and sound tics have been present over time, however, a doctor may consider this diagnosis. It can be unsettling for families at first, but with the right information and support most children manage well. This guide explains what Tourette syndrome is, how tics work, the conditions that often go with it, and where families in Singapore can turn for help.

What Tourette syndrome is

Tourette syndrome is a condition of the nervous system that causes tics — sudden, repeated movements or sounds that a person finds hard to control. It usually starts in childhood, and tics often become milder, and sometimes fade, as a young person moves into adulthood. Many people manage well and lead full lives, doing well at school, work and relationships. It is worth correcting a widespread misconception straight away: the involuntary shouting of rude or swear words that is often shown in films and on television is, in reality, uncommon. Most people with Tourette syndrome never experience it. The condition is not a sign of poor upbringing, low intelligence or a behavioural problem, and tics are not something a child is doing on purpose to seek attention.

Tics explained

Tics fall into two broad groups. Motor tics are movements — such as blinking, eye-rolling, head jerks, facial grimacing or shoulder shrugs. Vocal (or sound) tics are noises made with the voice or breath — such as throat-clearing, sniffing, grunting, coughing or repeating sounds and words. Tics can be simple, involving one muscle group or a brief sound, or complex, involving a pattern of several movements or longer utterances. They tend to change over time, with old tics fading and new ones appearing.

Many people describe an uncomfortable feeling or building urge just before a tic — sometimes called a warning sensation — which the tic briefly relieves, a little like the urge to scratch an itch. Some people can hold a tic back for a while, for example in class, but this often takes effort and the tics may come out more strongly afterwards. Stress, excitement, tiredness and illness commonly make tics worse, while being calm, absorbed or relaxed can ease them.

Symptoms and pattern

The hallmark of Tourette syndrome is tics that come and go and change over time — waxing and waning in how often and how strong they are, sometimes over weeks or months. The diagnosis is generally considered when a person has had both several motor tics and at least one vocal tic that have been present, on and off, over a longer period, usually starting in childhood. Because tics naturally fluctuate, a quiet spell does not mean the condition has gone, and a flare does not mean it is getting permanently worse.

Related conditions

For many children, the tics are only part of the picture. It is common to also have attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive tendencies, anxiety, low mood, difficulties with sleep, or specific learning difficulties. Sometimes these related conditions affect a child’s daily life, schoolwork and friendships as much as, or even more than, the tics themselves. Recognising and supporting them is an important part of care, so it is worth mentioning any concerns about attention, worries, rituals or learning to the doctor, not only the tics.

Causes and who is affected

The exact cause of Tourette syndrome is not fully understood. It is thought to involve differences in how certain parts of the brain develop and communicate, and genetics play a part — it can run in families, so a child may have a relative with tics or a related condition. Importantly, it is nobody’s fault; it is not caused by parenting, diet or emotional upset, although stress can make existing tics more noticeable. Tics and Tourette syndrome are more commonly recognised in boys than in girls.

How it is diagnosed

There is no single test for Tourette syndrome. A doctor makes the diagnosis based on the history and the pattern of tics over time — what the tics are, when they began, how they have changed, and how they affect daily life. In Singapore, a family might first see their family doctor or a paediatrician, who may refer the child to a child neurologist or a child and adolescent mental health service. Sometimes tests are arranged, not to prove Tourette syndrome, but to rule out other causes of the movements or sounds and to look for related conditions such as ADHD, anxiety or learning difficulties. Sharing a description, or even a home video, of the tics can help the doctor.

Treatment and support

Many people with Tourette syndrome need no medical treatment beyond understanding, reassurance and support — particularly when the tics are mild and not distressing. When help is wanted, a behavioural therapy designed specifically for tics can teach a person to become aware of the urge before a tic and to use a competing response, which can reduce how much the tics interfere with life. Medicines are considered when tics are frequent, painful, distressing or disabling, and are always discussed carefully with the doctor, weighing benefits against possible side effects. Just as important is treating any related conditions — such as ADHD, obsessive-compulsive symptoms or anxiety — and arranging practical support at school, so that a child can learn and take part comfortably.

Living with it — self-care, school and family

For most families, the foundation is education and understanding. Learning that tics are involuntary, that telling a child to “stop it” does not help and can add stress, and that flares often settle, takes a great deal of pressure off everyone. Reducing avoidable stress, keeping a steady routine and making sure a child gets enough rest can all ease tics. At school, letting teachers know can prevent tics from being mistaken for misbehaviour; simple adjustments such as allowing short breaks, a quiet space, or extra time when tics interfere can make a real difference. Encouraging friendships, hobbies and physical activity supports confidence and wellbeing. Parents and carers benefit from support too — connecting with others who understand, and looking after their own wellbeing, helps the whole family cope.

When to see a doctor

Consider seeing a doctor if tics are distressing, if they cause pain or injury, or if they are affecting school, friendships or daily life. It is also worth seeking help if there are concerns about a child’s mood, anxiety, attention, learning or sleep, or if a related condition such as ADHD or obsessive-compulsive symptoms may be present. Seek prompt medical advice if movements start very suddenly and severely, follow an illness or injury, or come with other new neurological symptoms, so that other causes can be checked. A doctor can never be replaced by online information, but starting the conversation early often makes support easier to arrange.

Common questions

Do all people with Tourette syndrome swear uncontrollably?

No. This is the most common myth about the condition, largely because of how it is portrayed on screen. Involuntary swearing is actually rare, and most people with Tourette syndrome never experience it.

Are tics done on purpose?

No. Tics are involuntary. A person may be able to hold them back briefly with effort, but they usually build up and come out afterwards. Being told off for ticcing tends to increase stress and can make tics worse.

Will my child grow out of it?

Tics often become milder in the teenage years and adulthood, and for many people they ease considerably. The pattern varies from person to person, but a great many children go on to lead full, ordinary lives.

Does Tourette syndrome affect intelligence?

No. It does not affect intelligence. Some children do have learning difficulties or attention problems alongside it, and these can be supported at school so they do not hold a child back.

Can stress make tics worse?

Yes. Stress, excitement, tiredness and illness commonly make tics more noticeable, while calm, rest and being absorbed in an activity can ease them. Managing stress is a helpful part of everyday care.

Related guides

• ADHD
• OCD
• Anxiety disorders
• Autism spectrum disorder

Sources

• KK Women’s and Children’s Hospital
• Institute of Mental Health
• HealthHub
• NHS