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Question 29: My son is almost 7 and has been diagnosed with TS. The doctor says now he does not need medication. He has "mild TS". What is considered "mild". Also, how common is TS? And what are his chances of out growing it? N.W., ON, Canada.

Hello N.W.

To be diagnosed with TS a person, at bare minimum, needs to have multiple motor tics and one or more phonic (noises: either using the vocal cords, like a hum, or not, like a sniff) tics. Further, these tics need to have been present for at least a year. Beyond that, though, there is considerable variability. A person may just barely make criteria in terms of number of tics, or they may have innumerable ones. A person may tic frequently, or only more under periods of stress. A person's tics may be very intense (strong, loud, involving considerable exertion, forceful, exaggerated) or barely noticeable. Tics may be very complex (lengthy, bizarre, orchestrated behaviour or speech possibly appearing purposeful) or simple (sudden, brief, and purposeless). Finally, given the dimensions mentioned, TS has the potential to interfere in one's actions and communications greatly, causing extreme life impairment (in school, at home, with friend-making, etc.) or to be of very little impact.

If indeed your son has only a mild form of the disorder, I applaud your doctor for recognizing that medications could be a greater hazard than help. Tic symptoms, even severe ones, can be managed or coped with well without the need for pharmaceutics.

In short, TS seems to have a prevalence of approximately 1% (1 of every 100 people). Again in general, research shows that approximately one third of individuals 'grow out of it' (although associated disorders such as OCD or ADHD may still be present or increase as the TS symptoms decrease). Another one third remain at the same level of symptoms throughout life, and the final one third experience a reduction (but not a disappearance) of the tics.

Hope this helps!
Dr. Dunc.

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