The Blink and the Sniff

Daniel, eleven, in Dublin, began blinking hard and clearing his throat. Soon he was shrugging his shoulder and sniffing, and sometimes a small sound came out. When he was anxious or excited the movements grew stronger. I…

Daniel tried to hold the tics in, but that made him tired and tense, and they burst out at home. His parents worried he was doing it for attention. He began avoiding friends and eating lunch alone.

The family doctor watched, listened, and after learning that the movements and sounds had lasted more than a year, referred him to a specialist. Daniel was told he had Tourette syndrome, that tics often peak in the early teens, and that many people improve in adulthood. His parents learnt that scolding makes tics worse, and his school agreed to stop corrections and to explain it kindly to classmates.

Over the next year Daniel's tics went up and down, and were worse before tests. A therapist taught him ways to notice the urge before a tic and respond with a different, quieter movement. His teacher explained tics to the class in two sentences, and the laughing stopped. Daniel rejoined the football team, and his parents learnt to leave the room when they were tempted to say "stop."

How to recognise it

Sudden, repeated movements such as blinking or shrugging, and sounds such as throat clearing.
Both movements and sounds lasting more than a year suggests Tourette syndrome.
Tics get worse with stress or excitement and can be held in briefly, with effort.
Teasing, embarrassment and pulling away from friends.
Often begins in childhood and peaks in the early teens.

What this story explains

This story shows tic disorders and Tourette syndrome, how stress and excitement affect them, and why education, kind behavioural therapy and school support matter.

Probable root causes

Differences in brain circuits that control movement, often running in families.
Stress, tiredness and excitement that make tics stronger.
Co-occurring ADHD, anxiety or OCD in some children.
Teasing and scolding that add stress.

What to do

Observe and note the tics, and see a doctor.
Ask for an assessment and for help with any anxiety or attention problems that travel alongside.
Learn about behavioural therapies for tics from a specialist.
Explain tics to teachers and classmates kindly.
Reduce stress, protect sleep and allow breaks.
Protect him from bullying.

Whom to consult

Family doctor or paediatrician for a first check.
A neurologist or child psychiatrist for diagnosis and treatment choices.
A child psychologist for behavioural therapy and anxiety.
School counsellor to arrange support.

Do and don’t

Do	Don’t
Ignore the tics, not the child.	Do not say "stop it".
Educate classmates.	Do not stare or mimic.
Reduce stress.	Do not punish tics.
Keep activities he enjoys.	Do not assume it is attention seeking.
Connect with other families.	Do not hide him away.

How to behave and communicate

Reassure: "You are not doing this on purpose. We are on your team."
Keep a relaxed face and tone when tics happen.
Ask: "What helps you feel calm when it gets strong?"
Listen to how teasing feels.
Tell others calmly: "Daniel has tics. They are not rude, and it helps if you carry on as normal."