Some children feel empowered by presenting a peer awareness program to their classmates. It can be helpful to educate teachers and school staff about typical tics, how they fluctuate during the day, how they impact the child, and how to distinguish tics from naughty behavior. By learning to identify tics, adults can refrain from asking or expecting a child to stop ticcing, because "tic suppression can be exhausting, unpleasant, and attention-demanding and can result in a subsequent rebound bout of tics".Adults with TS may withdraw socially to avoid stigmatization and discrimination because of their tics. Depending on their countrys healthcare system, they may receive social services or help from support groups. Behavioral
Behavioral therapies using habit reversal training (HRT) and exposure and response prevention (ERP) are first-line interventions in the management of Tourette syndrome, and have been shown to be effective. Because tics are somewhat suppressible, when people with TS are aware of the premonitory urge that precedes a tic, they can be trained to develop a response to the urge that competes with the tic. Comprehensive behavioral intervention for tics (CBIT) is based on HRT, the best researched behavioral therapy for tics. TS experts debate whether increasing a childs awareness of tics with HRT/CBIT (as opposed to ignoring tics) can lead to more tics later in life.When disruptive behaviors related to comorbid conditions exist, anger control training and parent management training can be effective. CBT is a useful treatment when OCD is present.
The severity of tics early in life does not predict their severity in later life. There is no reliable means of predicting the course of symptoms for a particular individual, but the prognosis is generally favorable. By the age of fourteen to sixteen, when the highest tic severity has typically passed, a more reliable prognosis might be made.Tics may be at their highest severity when they are diagnosed, and often improve as an individuals family and friends come to better understand the condition. Studies report that almost eight out of ten children with Tourettes experience a reduction in the severity of their tics by adulthood, and some adults who still have tics may not be aware that they have them. A study that used video to record tics in adults found that nine out of ten adults still had tics, and half of the adults who considered themselves tic-free displayed evidence of mild tics. Quality of life
People with Tourettes are affected by the consequences of tics and by the efforts to suppress them. Head and eye tics can interfere with reading or lead to headaches, and forceful tics can lead to repetitive strain injury. Severe tics can lead to pain or injuries; as an example, a rare cervical disc herniation was reported from a neck tic. Some people may learn to camouflage socially inappropriate tics or channel the energy of their tics into a functional endeavor.A supportive family and environment generally give those with Tourettes the skills to manage the disorder.