It is essential that the treatment specialist explains the disorder to the parents and child. Everyone should make time for this. First of all, it is important that the treatment specialist explains what is known about the causes and background of tics and Tourette syndrome. It should be explained that tics are related to processes in the brain and that genetics play a role. A child who suffers from tics cannot do anything about it and no one can accuse the child of putting on an act or not doing its best to control itself.
Children do not choose to have tics, although some children may temporarily be able to suppress them. It may also be that a child does not have tics in one situation, like at school, but that they occur all the time at home. Tics are sometimes very complex and may occur more often at one time than another time. This is not necessarily related to psychosocial factor but rather to the natural course of tic disorders.
The clinician will also explain other disorders that often occur in combination with tics (comorbidity), such as possible obsessive thoughts and compulsive actions. Furthermore, children with tics also often suffer from attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), anxiety or depression. Children frequently find these accompanying problems to be more burdensome than the tics themselves. Together with the child and its parents, the clinician will examine what is the largest obstacle to the child: the tics or another disorder. When the child suffers more from the accompanying problems, the treatment will focus primarily on these disorders. The treatment of these accompanying problems in children with tics does not differ from the treatment of the same problems in children without tics. However, the treatment of the accompanying problems can also have a favourable effect on the tics.
When a decision is taken to treat the tics, the clinician may recommend monitoring the severity and development of the tics over a period of time. This provides insight into the natural fluctuations of tic severity over time.