Occupational Therapy’s Role in Treating Tics

Written by Thaila Schug, OTS

Occupational therapists are healthcare professionals that aid patients across the lifespan, from birth through adulthood, with daily activities they want and need to do. These could include toileting, bathing and dressing. It can also include driving, returning to work and participating in school or play. Occupational therapists are well educated on a range of diagnoses and work in many different settings. They are not always recognized as health professionals that treat patients living with tics, but they have a large role to play with this population.

The evidenced-based approach to treating tics and Tourette’s is through the Comprehensive Behavioral Intervention for Tics (CBIT) protocol (Rowe et al., 2013; Piacentini et al., 2010). This behavioral treatment program includes eight sessions over a ten-week period that works with both children and adults to manage their tics (Woods, 2018). As we know, tics are a neurological condition that can wax and wane throughout a person’s lifetime. This program allows patients to better manage their tics, so they are not as bothersome or painful during a waxing period. Occupational therapists across the country are trained to deliver CBIT in a variety of settings including schools, outpatient clinics, private practice and tele-CBIT (virtual).

There are other ways occupational therapists can help patients with tics and Tourette’s outside of CBIT too. Below are some of the areas that OTs can assist patients with tics/Tourette’s (OTPF-4, 2020): 

  • Activities of Daily Living (ADLs)
  • Education
  • Social Participation
  • Health Management
  • Recreation
  • Leisure
  • Play
  • Rest/Sleep

You can see that these domains align nicely with the iceberg image from the Tourette Association of America. Motor and vocal tics are only the tip of the iceberg. Occupational therapists who are not trained in CBIT can still address many of these co-occurring conditions that interfere with someone’s participation in the above areas.

Occupational therapists work in schools, outpatient clinics, private practice, hospitals, tele-health and community-based locations. Examples of areas they can help with include emotional regulation, handwriting, sleep hygiene, sensory processing, executive functioning and more. See the chart comparing the services of occupational therapy, physical therapy, and speech language pathology for more details.

Examples of how this could translate into classrooms for school-aged children are teaching methods to manage stress and anxiety when taking tests, offering alternatives to handwriting (typing, recording notes), and creating a pre-determined area for rest/work (Tourette Association of America [TAA], 2021). This YouTube series by the Tourette Association of America (2021) is a very informative resource about occupational therapists’ role with tic disorders.

In addition to this, occupational therapists can play a role in advocacy both for the child/adult and their families (TAA, 2021). Locations that are often taken for granted to attend, such as school, work, the gym, church, and airport, can feel uncomfortable and stressful to go to with tics. They should never leave these places due to their tics as this can make them worse (Woods, 2018). However, an occupational therapist can work on environmental modifications such as going to the gym early in the morning with less people or calling the airport airline ahead of time to educate them on Tourette Syndrome. There are many resources on the Tourette Association of America website, such as this medical information card, which can bring comfort to someone with this condition. By empowering the individual to advocate for themselves- with the correct education- this allows the creation of a better environment to help them manage their tics.

All in all, occupational therapists play a crucial role in assisting those living with tics.

How can you find an occupational therapist near you?

Resources for further study: 

  1. https://tourette.org/
  2. https://www.cdc.gov/ncbddd/tourette/index.html
  3. Continuing Education on TS in schools: https://fixel.ufhealth.org/2023/05/30/ts_course/
  4. OT for Tourette Syndrome: https://tourette.org/benefits-occupational-therapy-tourette/
  5. OT CBIT Providers: https://tourette.org/find-a-provider/?fwp_providers_clinical_expertise=occupational-therapy


  • Occupational therapy practice framework: Domain and process-fourth edition. (2020). The American journal of occupational therapy: official publication of the American Occupational Therapy Association74(Supplement 2), 7412410010p1–7412410010p87. https://doi.org/10.5014/ajot.2020.74S2001 
  • Piacentini, J., Woods, D. W., Scahill, L., Wilhelm, S., Peterson, A. L., Chang, S., Ginsburg, G. S., Deckersbach, T., Dziura, J., Levi-Pearl, S., & Walkup, J. T. (2010). Behavior therapy for children with Tourette disorder: a randomized controlled trial. JAMA303(19), 1929–1937. https://doi.org/10.1001/jama.2010.607 
  • Rowe, J., Yuen, H.K., Dure, L.S. (2013). Comprehensive behavioral intervention to improve occupational performance in children with Tourette disorder. American Journal of Occupational Therapy, 67, 194-200. http://dx.doi.org/10.5014/ajot.2013.007062 
  • Tourette Association of America. (2021). Why students with Tourette Syndrome need an occupational therapist [Video]. Youtube.
  • Woods, D. W. (2008). Managing Tourette Syndrome: A behavioral intervention. Oxford University Press.