The Link Between ADHD and Tics

If your child has ADHD and suddenly starts blinking excessively, humming, or jerking their limbs, you’re not alone in wondering what’s going on. These repetitive, involuntary behaviors called tics are surprisingly common in kids with ADHD. In fact, research shows that about 1 in 5 children with ADHD also have a tic disorder, and the connection between the two is well-established.

So what causes tics in people with ADHD, and what can be done about them? Here's what to know.

What Are Tics?

Tics are sudden, repetitive, and uncontrollable movements or sounds that can vary in intensity and frequency. While they may seem voluntary at first glance, people with tics describe the experience as similar to a hiccup resisting them might work briefly, but the urge usually wins.

Tics are classified as:

Motor tics (involving movement), such as:

• Blinking or squinting

• Nose twitching

• Jerking limbs

• Grimacing

• Shrugging shoulders

Vocal tics (involving sound), such as:

• Throat clearing

• Coughing

• Grunting or humming

• Repeating words or phrases

Tics may be simple (involving just one area of the body) or complex (involving multiple muscle groups or behaviors).

Tics vs. Stimming

Both tics and stimming (self-stimulatory behavior) can involve repetitive movements or sounds, but they’re not the same.

• Tics are involuntary: The person can’t control when they happen.

• Stimming is usually voluntary: It’s a self-soothing behavior common in both ADHD and autism.

Think of stimming as an emotional regulation tool and tics as something the brain insists on, whether you like it or not.

Why Do People With ADHD Have Tics?

While ADHD itself doesn’t cause tics, the two often coexist. Research suggests overlapping genetic factors may be at play. Both ADHD and tic disorders like Tourette’s syndrome tend to run in families, and people with one are statistically more likely to have the other.

• About 20% of kids with ADHD also have a tic disorder.

• Over 50% of kids with Tourette’s syndrome also meet criteria for ADHD.

It’s not entirely clear why, but scientists believe that certain shared genetic pathways and brain differences may increase the likelihood of both conditions developing in the same person.

Can ADHD Medication Trigger Tics?

One of the biggest concerns parents and adults have is whether stimulant medications for ADHD will cause or worsen tics. The answer is nuanced:

• Methylphenidate-based meds (like Ritalin or Concerta) may temporarily increase tics at first, but typically don’t make them worse long-term.

• Amphetamine-based meds (like Adderall or Vyvanse) have a slightly higher risk of making tics more persistent or severe.

Still, many people with ADHD and tics respond well to medication, especially when the treatment plan is customized and closely monitored.

Treatment Options for Tics

Managing tics involves a combination of strategies, tailored to the individual’s needs. The goal is usually to reduce the impact of tics on daily life, rather than eliminating them completely.

1. Behavioral Therapy
The gold standard is Comprehensive Behavioral Intervention for Tics (CBIT). This therapy helps people recognize the pre-tic urge and substitute a competing response. It’s considered the first-line treatment for most tic disorders.

2. Medication (When Necessary)
In more severe cases, medication may be prescribed specifically for tics. These could include antipsychotics, alpha-agonists, or even botulinum toxin injections in specific cases.

3. Lifestyle and Emotional Support
Tics often worsen with stress, excitement, boredom, or fatigue. Supportive routines, mindfulness techniques, and managing emotional triggers can help reduce tic frequency.

4. School Accommodations and Parent Training
Behavioral parent training and 504 plans at school can provide structure and support for kids navigating both ADHD and tics. Understanding and accommodations go a long way in helping a child thrive.

When to See a Specialist

Tics are common in childhood and often resolve on their own. But if tics are:

• Persistent or worsening

• Interfering with school or social life

• Accompanied by ADHD, anxiety, or OCD

…it’s time to see a healthcare provider with experience in neurodevelopmental disorders.

The Takeaway

Tics and ADHD often go hand in hand but that doesn’t mean they can’t be effectively managed. While ADHD medications may temporarily increase tics, most children respond well to a tailored treatment plan that combines behavioral therapy, emotional support, and school accommodations.

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