The Practical Parent’s Holiday Handbook for Tourette Syndrome
For children with Tourette Syndrome (TS), the holidays are packed with the very things that can intensify tics: excitement, travel, late nights, crowded rooms and broken routines. If your child’s tics seem busier in December, you’re not imagining it.
This guide explains why tics tend to rise over the holidays, how to prepare, and what to do when things get overwhelming. It draws on current research and clinical guidance, but it’s written for busy parents. And as we all know, we’re never busier than during a holiday we’re told is a break.
Why tics often rise over the holidays
Tics naturally wax and wane, and they tend to climb whenever emotions run high, whether those feelings are good or bad. Clinical patient guides list stress, fatigue, illness, boredom and excitement about a fun event among the most common triggers (HealthLink BC).
December has a way of stacking all of these at once, just as the usual routines fall away. The anticipation of gifts and parties can raise tics as much as worry does. Late nights, travel and disrupted sleep leave bodies tired, while unfamiliar houses, new faces and the feeling of being watched add another layer.
Being around others can also play out in a less obvious way. Many children hold their tics back in new places or when they know someone is watching, then have a burst of tics once the pressure is off (HealthLink BC). A child who seemed fine at the party may tic much more on the drive home, and that’s to be expected.
Without a school schedule, days become long and unstructured, meals drift, and the steady rhythm many children rely on disappears.
It isn’t all pile-on, though. The holidays also bring the conditions that help tics settle. Tics often ease when a child is absorbed in something they love, like building with a new toy or baking with a grandparent in a low-stress environment (HealthLink BC). A break from school can also mean a chance to catch up on sleep, which helps more than almost anything.
It also helps to remember that tics are rarely the whole picture. Most children with TS also live with at least one co-occurring condition, such as ADHD, obsessive-compulsive disorder (OCD) or anxiety. In one large study of 1,374 people with TS, 86% had at least one co-occurring condition (Hirschtritt et al., JAMA Psychiatry, 2015). For many families, holiday pressure shows up as much in meltdowns, worry or a tight grip on routines as it does in tics.
All of this is normal, and knowing that can take away some of the sense that you’re doing something wrong. A little planning goes a long way, and the guiding idea is simple: plan for the whole child, not just the tics.
Before the holidays: plan together
The best holiday plans are made with your child, not for them. Even young children can tell you what feels hard and what helps, so start by sitting down with the calendar. Walk through who you’ll see, where you’ll go and how long you’ll stay (Tourettes Action).
- You don’t need a rigid schedule, but it helps to protect two or three anchors: a regular wake-up time, a calm bedtime routine and meals at roughly the usual hours.
- Sleep in particular deserves special care, because fatigue is one of the most consistent tic triggers (HealthLink BC). If you know a late night is coming, plan a quiet morning after it. Where you can, space out the big events, too. A calm day between two busy ones gives your child’s nervous system time to settle.
- Together, agree on a signal, a word or gesture your child can use when they need a break, and figure out where the quiet spot will be at each place you visit (Tourettes Action). It’s worth mentioning this to your hosts ahead of time, so asking for a quiet room doesn’t feel awkward in the middle of hugs and hellos at the door.
- Talk in advance about what your child wants shared. Some children are happy for relatives to know about their TS; others would rather keep it private. Older children and teens especially deserve a say in who knows.
Finally, keep up with treatment. If your child sees a health-care provider for TS, stick with the plan you’ve agreed on through the break, and don’t stop or change medication without talking to them first. Some TS medications, such as clonidine, need to be tapered rather than stopped suddenly (Current Psychiatry). If you’re travelling, pack enough medication for the trip plus a few extra days.
Family gatherings: preparing the people who love your child
Most uncomfortable moments at family events come from relatives who mean well but don’t understand tics. A short, calm message a few days before a visit, by text or a quick call, prevents a lot of misunderstanding and heartache (Tourettes Action).
People often comment simply because they don’t know what else to do, so give them a way to support you. Be clear with close friends and relatives: ignore the tics, don’t tease, don’t ask your child to stop, and don’t finish their sentences (NHS West Suffolk).
Even with good preparation, someone will probably say something in the moment. It helps to have a line ready so you can answer briefly, calmly, and as if everything you’re saying is totally normal:
- “That’s a tic. They can’t simply stop it, so it’s best to ignore it.”
- “We’ve got it handled, thanks. Can you pass the potatoes?”
- For a curious cousin: “Sometimes [name]’s body makes movements or sounds all by itself. It’s called a tic. It’s not on purpose.”
When your child needs a break, help them slip away to the quiet room without having to explain. And if the day is getting to be too much, leaving a little early is a success, not a failure. The holidays are a marathon of events, not a sprint, so play the long game and head home when it’s right for your family, not when Uncle Steve thinks it’s polite.
Plan some quiet time for after a gathering, too. Because many children hold their tics in around guests, extra tics once you’re home or the next morning are common and give your child a chance to let go.
Some traditions are worth rethinking, too. Because being watched can increase tics, gathering everyone to watch gifts opened one at a time may be hard for some children. Opening presents together, or spreading them out over the day, can take the spotlight off.
Out and about: travel, shopping and events
Public places add noise, crowds and strangers who may stare, but a few small steps make outings easier. Shop when it’s quiet. Early weekday mornings are far calmer than weekend afternoons, and let online orders or curbside pickup replace the busiest trips entirely.
Try to keep outings to a manageable length. We know that isn’t always possible in December, but a good rule is to plan for what your child can handle on a good day, then trim a little. If you have to push past that, build in breaks along the way.
A wallet-sized card that explains TS can save a lot of explaining at airport security, in restaurants or at a holiday concert (Tourette Association of America). For flights, worship services, theatres and performances, a quiet word with staff in advance about vocal tics can prevent misunderstandings (Tourette Association of America), and seats near an aisle or exit give you an easy way out.
When people stare, respond calmly. Your child takes their cues from you, and a simple “It’s a tic,” or just carrying on, shows them that tics are nothing to be ashamed of.
Looking after yourself and the rest of the family
A holiday break is meant for rest and time together, but it’s easy to mistake obligations for necessities. If a non-essential event is likely to wear everyone down and drag on the whole season, it’s okay to let it go.
Children notice when their parents are stressed, and a calm parent helps a child stay calm. That doesn’t mean being perfect. It means giving yourself permission to do less: fewer events, simpler meals, and an earlier exit. Looking after your own stress is one of the best things you can do for your child (Ruhrman et al., Frontiers in Psychiatry, 2017).
You don’t have to do it alone, either. Ask a partner, grandparent or trusted friend to be your “tic ally” at gatherings, the person who redirects comments and walks your child to the quiet room so you can take a breath.
Remember your other children, too. Brothers and sisters may feel embarrassed, overlooked or fiercely protective (Sibs / Tourettes Action). Give them simple words to explain tics to their friends, and set aside a little one-on-one time for each of them over the break.
Most of all, decide what success looks like for your family. A good holiday isn’t a tic-free holiday. It’s one where your child felt safe, accepted and part of the fun.
When to reach out for more support
You may notice tics settle once routines return in January, but if you don’t, no need to panic. Tics wax and wane unpredictably for numerous reasons. However, if you notice any of the following, contact your child’s doctor:
- Tics that cause pain or injury, or new tics that involve hitting or harming themselves
- Tics that stay much worse for several weeks after routines return
- Big changes in mood, anxiety, sleep, anger or behaviour
- Signs that your child is withdrawing, very distressed or feeling hopeless
Looking for additional advice, support or a network of people to share your experience? Tourette Canada is here to help. Visit our website’s information pages, call our national office toll-free at 1-800-361-3120, or email admin@tourette.ca.
A final thought
Every family finds the holidays stressful at times, and a hard moment doesn’t mean yours is getting it wrong. Be as kind to yourself as you are to your child.
Tics are part of your child, and so is everything else: their humour, their curiosity, the way they light up at the things they love. Planning ahead isn’t about hiding tics. It’s about making room for your child to enjoy the season as fully as everyone else.