Tics and Tourette's assessment (Clinical assessment of tic disorders and Tourette syndrome)
An assessment for a child or young person with tics, to understand what is happening, whether it fits a tic disorder or Tourette syndrome, and what support may help.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- The assessment is mainly a careful history and observation — there is no single test or scan that diagnoses tics or Tourette syndrome.
- Tics often come and go and frequently improve as a child gets older; many children need no medication at all.
- Conditions that travel with tics — like ADHD, OCD, anxiety or sleep problems — are often more troubling than the tics, so the assessment looks for these too.
- If your child ever has thoughts of harming themselves, get help straight away: call 999 or go to A&E if there is immediate danger; Samaritans 116 123; Papyrus HOPELINE247 0800 068 4141; or text SHOUT to 85258.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your psychiatrist will give you advice for your situation.
A clear explanation of what the tics are and what they are not
A single appointment is not the right route when there is a sudden, severe or dramatic onset of movements, or new neurological signs, which need prompt...
History-taking and observation. Your child may feel watched; clinicians usually try to put children at ease and may chat about other things while...
A clear written summary and plan, with a contact route for questions.
History-taking and observation. Your child may feel watched; clinicians usually try to put children at ease and...
The clinician usually explains their impression and an initial plan, which is often education and reassurance...
A letter usually follows, summarising the assessment and plan, which you can share with school.
If a tic disorder or Tourette syndrome is confirmed, support might include information, behavioural therapy or, in...
What is a tics and Tourette's assessment?
A tics and Tourette's assessment is an appointment to understand a child or young person's tics. Tics are sudden, fast movements or sounds that a person makes without meaning to, like blinking, head jerks, throat-clearing or sniffing. The clinician listens to the history, watches for tics if they appear, and asks how the tics affect school, friendships, sleep and how your child feels.
The main tool is a careful conversation. There is no blood test or scan that diagnoses tics or Tourette syndrome. The clinician puts together when the tics started, how they have changed, and whether there are both movement (motor) and sound (vocal) tics.
Many children have tics for a while and they settle on their own. Tourette syndrome is the name used when someone has had several motor tics and at least one vocal tic, on and off, for more than a year, usually starting in childhood. The assessment also looks for things that often come alongside tics, such as ADHD, OCD, anxiety or trouble sleeping, because these sometimes need more attention than the tics themselves.
The assessment does not, on its own, make tics go away. Its job is to explain what is going on, settle worry, and work out what (if anything) would help.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Tic disorder or Tourette syndrome?
| Feature | Provisional/transient tics | Tourette syndrome |
|---|---|---|
| How long | Less than a year | More than a year (on and off) |
| Type of tics | Movement or sound | Several movement tics and at least one sound tic |
| Usual course | Often settle by themselves | Wax and wane; often improve into adulthood |
These categories overlap and can change over time. A clinician makes the judgement; this table is only a rough guide.
Preparing for your test
- A parent or carer should attend; for older teenagers, your child's own view matters and they may want some time on their own with the clinician.
- Keep a short diary of the tics — when they happen, what they look or sound like, and anything that seems to set them off.
- If possible, take a short phone video at home, as tics often quieten in the clinic.
- Bring a list of any worries about attention, repetitive behaviours, mood, anxiety or sleep.
- Bring any school reports or notes from teachers about how your child is doing.
- Note any family history of tics, OCD or ADHD.
- Write down your main questions so they are not forgotten on the day.
What happens
The clinician — often a paediatrician, child and adolescent psychiatrist or neurologist — will spend most of the appointment talking with you and your child. They will ask about the tics, development, school, sleep, mood and family history, and they will watch for tics if any appear.
There is no needle, scan or special equipment for a tic assessment. Occasionally a clinician arranges other tests only to rule out a different cause, not to 'prove' tics.
At the end, the clinician usually explains what they think is going on, whether it fits a tic disorder or Tourette syndrome, and what (if anything) would help. Often the most useful outcome is simply understanding the condition and reassurance. You should normally receive a letter summarising the plan.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- A single appointment is not the right route when there is a sudden, severe or dramatic onset of movements, or new neurological signs, which need prompt and different assessment.
- It is not a substitute for urgent help if your child is in crisis or at risk of harming themselves.
- A tic-only assessment may not be enough if attention, anxiety, mood, learning or repetitive behaviours are the main concern.
- It cannot promise that tics will stop, so it is not the right setting for families seeking a guaranteed 'cure'.
Delay or rearrange if…
- Your child is acutely unwell or in a mental-health crisis — seek urgent help first.
- There has been a recent serious illness with a sudden change in movements, which may need a different, quicker review.
- You have no examples to describe (a short diary or home video first will make the assessment far more useful).
- Your child is too distressed to take part right now and would do better with a gentler, planned approach.
Alternatives to discuss
- Watchful waiting with a GP, as many tics are mild and settle by themselves.
- An NHS referral to paediatrics, neurology or CAMHS instead of going privately.
- A broader neurodevelopmental assessment if ADHD, autism or OCD seem to be the bigger issue.
- Information and support from reputable charities while you decide whether a formal assessment is needed.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- A clear explanation of what the tics are and what they are not
- Reassurance, as many tics are mild and improve over time
- Spotting other things that often travel with tics, such as ADHD, OCD or anxiety, so they can be supported
- Practical advice for home and school, and a letter that helps teachers understand
- A plan that may involve simply watching and waiting, rather than medication
Risks & complications
- Tics may not show up in the appointment, so the picture relies on your description
- Feeling self-conscious or upset talking about the tics
- Uncertainty at first, as a single appointment cannot always give a firm label
- A label that worries a child more than it helps if it is not explained gently
- Other conditions (like ADHD or OCD) being missed if the assessment is too focused on the tics alone
- Needing a further appointment or referral to a more specialist clinic
- A sudden, dramatic onset of tic-like movements that needs a different and prompt assessment
- Tics being mistaken for another movement or neurological problem, or the reverse
The biggest risk is over- or under-reacting to tics. Tics are common, often mild and frequently improve with age, so a good assessment avoids rushing into medication. Equally, it should look beyond the tics for ADHD, OCD, anxiety or low mood, which can matter more. Ask the clinician how confident they are, what the plan is if things change, and who you contact if your child becomes distressed.
Published figures to discuss
Tics are common in childhood and Tourette syndrome is much less common; figures vary widely between studies depending on how tics are defined and who is studied. Because the assessment relies on history and observation rather than a test, there are no meaningful false-positive or false-negative rates to quote, and natural waxing and waning makes any single snapshot uncertain. We have not stated numerical rates here to avoid implying false precision.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Tics fluctuate naturally | Common pattern | Tics often wax and wane, so improvement or worsening should not be attributed automatically to one trigger or treatment. | Guide sourcesClinical context |
| ADHD, OCD, anxiety or autism missed | Common comorbidity | Coexisting conditions often cause more impairment than the tics themselves and should be assessed. | Guide sourcesClinical context |
| Medication side effects | Treatment-specific | Medicines used for tics can cause sedation, weight change, mood effects or movement side effects and need monitoring. | Guide sourcesClinical context |
| Functional tic-like symptoms or seizures confused with Tourette's | Recognised differential | Sudden explosive onset, unusual movements, loss of awareness or neurological signs may need specialist review. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from a tic assessment. 'Afterwards' is mainly about understanding the plan, sharing helpful information with school, and knowing when to come back.
- Mixed feelings — relief at an explanation, but sometimes new worry about a label
- Tics carrying on changing day to day or week to week, which is expected
- Realising that watching and waiting, not treatment, is often the right first step
- Wanting time to read about the condition and talk it over as a family
Aftercare
- Try not to draw attention to the tics or ask your child to stop, as this can make them worse and add stress.
- Share the clinic letter with school so staff understand tics are involuntary, not bad behaviour.
- Keep noticing any worries about attention, anxiety, repetitive behaviours, mood or sleep, and report these.
- Support good sleep and help manage stress, which can ease tics.
- Keep any review appointments so the plan can be adjusted as your child grows.
- Know who to contact at the clinic if your child becomes very distressed about the tics or their mood.
- If you are ever worried about your child's safety, seek urgent help rather than waiting for the next appointment.
- Tic diary started
- Short home video of tics, if possible
- List of worries about attention, anxiety, mood or sleep
- School reports or teacher notes gathered
- Family history of tics, OCD or ADHD noted
- Main questions written down
- Clinic contact details and crisis numbers saved
⚠ Get urgent help if…
- Any thoughts of suicide or self-harm, or talk of not wanting to be here — get help immediately (999 or A&E if there is immediate danger; Samaritans 116 123; Papyrus HOPELINE247 0800 068 4141; text SHOUT to 85258)
- A sudden, severe and dramatic start of tic-like movements, especially after an illness
- Tics causing physical injury, severe pain, or movements that affect breathing or swallowing
- A big drop in mood, withdrawal, or your child being badly bullied or distressed because of the tics
- New weakness, problems with walking or coordination, fits, or loss of skills your child used to have
- Repetitive thoughts or rituals that are taking over daily life (possible OCD)
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your psychiatrist gives you.
Results & realistic expectations
A good outcome from the assessment is a clear, kind explanation of what the tics are, whether they fit a tic disorder or Tourette syndrome, and what will help. For many families this means reassurance and information rather than treatment.
The assessment cannot predict exactly how the tics will change, and it cannot guarantee they will disappear. It is a snapshot in time, and because tics naturally come and go, the plan may need to be revisited.
Tics typically wax and wane, often peaking in the early teens and then improving for many young people as they get older. Because of this, an assessment is a picture of how things are now, and a review may be useful as your child grows or if new difficulties appear.
Related tests, treatments or support
A tic assessment often goes hand in hand with looking at attention (ADHD), repetitive thoughts and behaviours (OCD), anxiety, mood and sleep, because these commonly occur together. Sometimes a separate, fuller assessment for one of these is arranged.
Follow-up & long-term care
After the assessment you should normally get a letter summarising the findings and plan. Depending on the impact of the tics, the clinician may offer review appointments, behavioural therapy, support for any other difficulties, or a referral to a more specialist tic service.
- Ongoing support for sleep and stress, which can influence tics
- Reviews to track tics and any other difficulties over time
- Updated information for school as your child moves classes or schools
- Reassessment if tics change markedly or new symptoms appear
Repeat, follow-on and what comes next
- Tics change over time, so an initial impression may be revised at review.
- Other conditions such as ADHD, OCD or anxiety can emerge later and change the plan.
- A firm label sometimes only becomes clear once tics have been present for more than a year.
- A further or more specialist assessment is sometimes needed if the picture is unusual.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear written summary and plan, with a contact route for questions.
- Honest explanation that tics wax, wane and often improve with age.
- A plan that screens for and supports ADHD, OCD, anxiety, mood and sleep.
- Information and a letter for school so tics are understood as involuntary.
- A clear crisis plan and signposting if your child's mood or safety is a worry.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Length of the appointment and whether more than one visit is needed
- The seniority and specialism of the clinician (for example a paediatrician, child psychiatrist or neurologist)
- Whether screening for other conditions such as ADHD or OCD is included
- Whether a written report or letter for school is provided
- Any follow-up reviews or onward referral to a specialist tic service
- Behavioural therapy (such as habit reversal) if recommended, which is usually charged separately
- The clinician's fee and their specialty
- What the assessment includes (history, observation, screening for related conditions)
- Whether a written report or school letter is included, and any extra cost
- Whether follow-up appointments are included or charged separately
- What happens if a more specialist assessment or referral is needed
- The cost of any recommended behavioural therapy or treatment
On the NHS? Tics and Tourette syndrome are commonly assessed on the NHS when clinically indicated, through the GP, paediatrics, neurology or CAMHS; private assessment may be used for speed, choice or a second opinion.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that there is no definitive test, so the assessment is a clinical judgement.
- Not discussing that many tics improve with age and that treatment is often unnecessary.
- Pushing medication without first explaining behavioural approaches and watchful waiting.
- Not being clear about who sees the report and how it might be used at school.
- Giving a worrying label without enough explanation, reassurance and a plan.
Marketing red flags
- Promising a quick or guaranteed 'cure' for tics or Tourette syndrome.
- Offering a same-day firm diagnosis as if it were a simple yes/no test.
- Selling expensive scans or supplements as necessary to diagnose tics.
- Downplaying common, treatable companions like ADHD, OCD or anxiety.
- Pressuring families towards medication as a first step for mild tics.
Choosing a specialist safely
- Check the psychiatrist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good psychiatrist will welcome every one of these.
- Do you think these are tics, and do they fit a tic disorder or Tourette syndrome?
- How confident are you, and what would change your mind?
- Are there other things — like ADHD, OCD, anxiety or sleep problems — that we should look at?
- What is the plan if the tics get worse, and is treatment needed now?
- What can we tell school, and can we have a letter?
- Who do we contact if my child becomes very distressed about the tics or their mood?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the psychiatrist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is there a test or scan that diagnoses Tourette syndrome?
Will my child definitely need medication?
Can I get this assessed on the NHS?
Will the tics go away?
The tics weren't there in the appointment — does that matter?
Should I tell my child to stop the tics?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Tourette syndrome NHS — Tics: treatment Tourettes Action — Getting diagnosed Great Ormond Street Hospital — Introduction to Tourette syndrome Royal College of Psychiatrists — Mental health information for young people
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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