Changing Landscape of Childhood Tic Disorders following COVID-19

 

          Fig; Pyramidal style of management of tics in children

 

Introduction

The COVID-19 pandemic has had a significant impact on various aspects of our lives, including the landscape of childhood tic disorders. Tic disorders are neurodevelopmental conditions characterized by the presence of involuntary, repetitive movements or vocalizations known as tics. These disorders can range from mild to severe and can have a profound effect on a child's daily functioning and quality of life.

Understanding Tic Disorders

What Are Tic Disorders?

Tic disorders are conditions that involve the occurrence of tics, which are sudden, rapid, and repetitive movements or sounds. Tics can be classified into two main categories: motor tics and vocal tics. Motor tics involve movements, such as eye blinking, facial grimacing, or shoulder shrugging, while vocal tics involve sounds, such as throat clearing, sniffing, or grunting.

Types of Tic Disorders

There are several types of tic disorders, including:

1. Transient Tic Disorder: This type of tic disorder involves the presence of tics that last for less than one year.
2. Chronic Tic Disorder: Chronic tic disorder is diagnosed when tics persist for more than one year.
3. Tourette's Syndrome: Tourette's syndrome is a more severe form of tic disorder characterized by both motor and vocal tics, which have been present for at least one year.

Impact of COVID-19 on Childhood Tic Disorders

The COVID-19 pandemic has brought about numerous changes in our daily lives, and these changes have had a significant impact on children with tic disorders. Here are some ways in which the landscape of childhood tic disorders has been influenced by the pandemic:

Increased Stress and Anxiety

The uncertainty and disruptions caused by the pandemic have led to increased stress and anxiety levels among children and their families. Stress and anxiety can often exacerbate tic symptoms, leading to an increase in the frequency and intensity of tics. The emotional toll of the pandemic can also contribute to the development of new tic symptoms in children who did not previously exhibit tics.

Disruption of Routine and Treatment

The pandemic has disrupted the regular routines of children, including their school schedules and access to healthcare services. Many children with tic disorders rely on structured routines and consistent therapy sessions to manage their symptoms effectively. The sudden changes brought about by the pandemic have made it challenging for these children to maintain their routines and access necessary treatments, potentially impacting their tic management.

Social Isolation and Reduced Support

The implementation of social distancing measures and lockdowns has resulted in increased social isolation for many individuals, including children with tic disorders. Limited social interactions and reduced support systems can further contribute to feelings of loneliness and emotional distress, which can, in turn, worsen tic symptoms.

Increased Screen Time

With the shift to online learning and remote work, children have spent more time in front of screens than ever before. Prolonged screen time has been associated with increased stress levels and can negatively impact overall well-being. For children with tic disorders, excessive screen time may exacerbate tic symptoms and affect their ability to manage their condition effectively.

Lack of Physical Activity

The closure of schools and restrictions on outdoor activities have limited opportunities for physical exercise and movement. Regular physical activity is essential for overall health and well-being and can help manage tic symptoms. The lack of physical activity during the pandemic may contribute to increased restlessness and heightened tic expression in children with tic disorders.

Adapting to the Changing Landscape

While the landscape of childhood tic disorders has undoubtedly been affected by the COVID-19 pandemic, some steps can be taken to adapt and support children with tic disorders during these challenging times:

Establishing Routines and Coping Strategies

Creating a structured daily routine can help provide a sense of stability and predictability for children with tic disorders. This includes regular meal times, sleep schedules, and designated periods for academic activities, leisure, and relaxation. Teaching coping strategies, such as deep breathing exercises, mindfulness techniques, and stress management skills, can also empower children to better manage their tic symptoms.

Utilizing Telehealth Services

Telehealth services have become increasingly popular during the pandemic, providing a convenient and accessible way for children with tic disorders to receive necessary healthcare support. Telehealth allows for virtual consultations with healthcare professionals, including therapists and doctors, ensuring continuity of care and the ability to address concerns without physical contact.

Encouraging Physical Activity

Despite the limitations imposed by the pandemic, it is crucial to prioritize physical activity for children with tic disorders. Encouraging regular exercise within the confines of social distancing guidelines can help reduce restlessness, promote overall well-being, and potentially alleviate tic symptoms. Indoor exercises, yoga, or even short walks in safe outdoor areas can make a positive difference.

Supporting Emotional Well-being

Recognizing the emotional impact of the pandemic on children with tic disorders is essential. Providing emotional support and creating opportunities for social interactions, even virtually, can help alleviate feelings of isolation and foster a sense of belonging. Engaging in activities that promote emotional well-being, such as hobbies, creative outlets, or virtual support groups, can also be beneficial.

Conclusion

The COVID-19 pandemic has undoubtedly brought about significant changes in the landscape of childhood tic disorders. The increased stress, disrupted routines, and limited access to healthcare services have posed challenges for children with tic disorders and their families. However, by adapting to the changing circumstances and implementing strategies to support emotional well-being, establish routines, utilize telehealth services, and encourage physical activity, we can navigate through these difficult times and ensure the best possible outcomes for children with tic disorders.

Download the PDF of changing landscape of childhood tic disorders following COVID-19 published in October 2022 in Pediatrics and child health UK