Tics in Teenagers on the Autism Spectrum

By Mark Hutten, M.A.
"My son is 16 years old and has developed a severe tic. He shakes his head and moves his shoulder up and makes a grunting noise. This has only happened in the last few weeks. Could this be stress due to us having to move to another city in  few months [he will be changing schools]?? He is becoming extremely anxious about it as everyone notices it!"
 
 
ASD  (high-functioning autism) can have many complications such as tics. Tics are rapid sudden movements of muscles in your body, or tics can be sounds. Both kinds of tics are very hard to control and can be heard or seen by others. However, some tics are invisible (e.g., toe crunching or building up tension in your muscles).

Simple tics involve just one group of muscles and are usually short, sudden and brief movements (e.g., twitching the eyes or mouth movements). Some simple tics can be head shaking, eye blinking or lip biting. Simple vocal tics can be throat clearing, coughing or sniffing. 
 

Complex tics involve more than one muscle group and are longer movement, which seem more complex (e.g., jumping, hoping, touching people, hitting yourself or pulling clothes). Other complex vocal tics can be repeating words of others or yourself all the time, or repeating out loud what you have read.

Tics may increase as a result of negative emotions (e.g., stress, tiredness or anxiety), but positive emotions as well (e.g., excitement or anticipation). These emotions are often experienced in those diagnosed with ASD. Therefore, tics in kids and teens with autistic disorders can be more common. A strong urge can be felt before the tics appear. 
 
With intensive therapy, these urges can be suppressed. When tics or urges to have tics are suppressed, there can be a build-up of other tensions - or even stress. Often when the tic is gone, those who suffer from it feel a sense of relief.

Whenever kids with ASD focus their energy on something else (e.g., computer games or watching TV), their tics tend to decrease due to the resultant relaxation effect.

My 8 year old grandson with autism has several simple tics and a few complex ones. His tics appear mainly in his face and are very visible to others. He twitches his mouth and eyes all the time. He bites his lips in various ways so the skin around it is always red and irritated. 
 
Even though he feels the urge to do so, he seems unable to control the movements. He is in tic therapy for this, and as a grandfather, it is painful to see this expression of anxiety or stress in your own grandson.

Bottom line: Try not to worry about it too much. It will go away once the child grows older or is able to express his feelings in another way. Most kids with tics will be "tic free" sooner than later. 
 
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