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A Blog from Your Kaiser Permanente Pediatricians in Northern California

Childhood Habits and Tics – What’s a Parent to Do?

When one of my sons is focusing hard he chews on something – often his T-shirt collar or his earbuds. Another cracks his knuckles. These habits drive me nuts! For much of second grade, my daughter flicked her fingers in a repetitive motion. This flick, flick, flick was a tic that worried me – “Was something more wrong?”

Habits

All of us have some “bad” habits – even children. Nail-biting, lip-licking, hair twirling, or thumb-sucking seem designed to make parents worry and nag. The worry is unnecessary and nagging won’t help! Habits like these are very common and even normal – they often serve a self-soothing or calming purpose for the child. But they usually go away in just a few months, if ignored.

Try these tips to manage habits:

  • Ignore the habit: That’s right – ignoring a habit will be the quickest path to it disappearing! You can actually prolong habits and make them more severe by constantly calling attention to them. This can increase feelings of stress and makes the child return to the self-soothing behavior. It’s more helpful to occasionally talk directly with your child about their habit. Quietly explain why you want them to stop the habit. Biting nails can lead to skin infections and gives them germs that may make them have colds, or other illnesses. Chewing on shirts ruins the shirt. Licking lips makes them dry and chapped. Then after you talk, most of the time say nothing more.
  • Try positive praise: To help your child quit a habit, try using positivity. Let them know you have faith in them – they will outgrow this and eventually stop. When you notice they haven’t done the habit for a while praise them! Star charts or stickers can work wonders for young kids.

Tics

Another frequent childhood occurrence are tics. These are rapid and repeated involuntary movements, most often of the face or neck, that a child is unaware of and unable to control. They can include eye blinking, shoulder shrugging, grimaces, sniffing, neck twisting, grunts, or throat clearing. They’re present during the day and usually disappear during sleep. Most children outgrow tics.

How do you tell the difference between tics and habits? Tics are “stereotyped” – the movement or sound is exactly the same each time. Also, tics cannot be controlled – or not for long. Habits can be controlled by the child.

Your child may be worried or get teased about having a tic and want to talk about it with you. They may want to understand why this is happening to them since they can’t control it.

Try these tips to help your child with tics:

  • Reassure them that many children have tics, and most outgrow them soon.
  • Come up with a way for your child to explain to other children what is happening when they notice and stare. They could say, “When I get excited or nervous, my body takes over. Some people’s hearts beat faster or hands shake. I do this.”
  • Make sure your child gets enough sleep. Tics may be worse when a child is tired, irritable, and anxious.
  • Encourage friends and family to ignore the tic.
  • Ask your child’s teachers to intervene if your child is teased or bullied.
  • Expect that tics may worsen for 1 to 2 hours after school. Kids try to control them while at school and but need to “let go” when they come home. You can think of this as a good sign – they feel safe at home with you.
  • Make sure your child knows they can talk about feelings and problems with you or another trusted adult

If tics make your child self-conscience, affect relationships with others, cause physical harm, or last more than a year, talk to your pediatrician. If there are multiple tics occurring over a year, like sniffing and head turning with vocalizations, your child may have a more severe tic disorder called Tourette syndrome.

Also contact your child’s pediatrician if you:

  • Have a family history of Tourette’s, or if these symptoms occur while your child is taking medication for ADHD (Attention Deficit Hyperactivity Disorder).
  • Can’t figure out why your child is stressed nor how alleviate it.

Both tics and habits can get worse during times of stress. Explore whether there is underlying stress for your child by talking with them about whether anything is going on at school, such as:

  • Is your child feeling inadequate or bullied?
  • Is homework adding to the stress? Help your child be organized about schoolwork to avoid the pressure of completing projects at the last minute.
  • Is your child overscheduled? Look for ways to simplify their schedule.

Sometimes habits and tics that start under stressful situations may continue even after the stress is removed. The good news is that most will still self-resolve if gently addressed and mostly ignored.

Resources for parents:

My Doctor Online
Tics and Tic Disorders
Tics in Children: Online Class
Stress Management Resources

American Academy of Pediatrics:  Habits

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