The first tics are generally motor and will appear around age 6, but they may be noticeable as early as six months old. Often, tics will appear after a trigger event such as the death of a loved one, the arrival of other children in the family, a conflictual situation at home, or a stressful significant event. School, as early as kindergarten, may be an event stressful enough to trigger tics.
Symptoms will usually worsen and complexify (start of complex tics) as the person reaches his/her early teens, around age 11 to 13, but may diminish as a young adult. The symptoms may fluctuate in number and in intensity. Periods of calm may follow periods when the syndrome is more active.
At the end of adolescence, up to 8 to 30% (depending on the studies) of people with TS will stop having tics during complete periods of times, and another 30% will see a significant decrease in the number of symptoms. As an adult, the person with TS will learn to better control his / her environment and will be able to modify his / her tics to make them more socially acceptable and less apparent.
The adult must learn to face the reality of the work environment and relationship dynamics. Looking for work may be more difficult because tics can be wrongly interpreted by potential employers. Learning disorders, obsessive-compulsive disorder, and impulsive reactions in the face of authority can make adaptation difficult in the work environment.
While the majority of people with TS will be able to have a love relationship, the partner’s understanding is crucial. The fear of passing the syndrome to children may motivate the person to research the hereditary aspects of the condition.
A better self acceptance and a good communication with one’s close circle are essential factors in the quality of life of an adult with TS.
Because TS is complex with multiple aspects and each symptom can be little to very disabling, parents with a child that has recently been diagnosed with TS are overwhelmed. In fact, the most frequently asked question is: “if my child does this, will he/she do that next?”
We cannot stress enough the fact that each case is specific to the person. The only certainties that we have are that the syndrome will worsen under stress and that tics will change with time and will worsen in a cyclical fashion.