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Specialist Clinics

Tics

  • Introduction

    This guideline relates to tics in paediatric patients. For more information please see: Kids Health Info:Tics.

    When to refer

    • Most children with tics do not require specific treatments or interventions for tics following appropriate parental education and reassurance
    • Patient is referred by a paediatrician (the Department of Neurology does not accept referrals for tics unless the patient is under the care of a paediatrician)
    • First line management strategies have failed

    Wait time for appointments

    Specialist Clinic wait times

    Services available closer to home

    Alternative paediatric services available in Victoria:

    • Monash Children’s Hospital

    Pre-referral work up/management

    The following may be useful to clarify if other health professionals should be involved in the management of children with tics.

      Refer to a general community paediatrician if:

    • The child has or is suspected to have ASD, ADHD, learning difficulty, or intellectual disability
    • Tics have been present for more than 12 months
    • Tics cause significant impairment and/or patient has failed first line of therapy
    • You’re worried

      Refer to a psychologist with a GP Mental Health Care Plan for:

    • Cognitive behavioural therapy, if anxiety, obsessive compulsive behaviours, anger management issues or impulsivity are present
    • Comprehensive Behavioural Intervention for Tics (CBIT) or Habit Reversal Therapy if the child is above 10 years old and is interested and motivated to engage in tic-specific interventions

      Refer to child psychiatry if the child or adolescent:

    • Is at significant risk of self-harm or shows psychotic symptoms
    • Has a depressive episode or suicidal ideation
    • Has significant anxiety disorder
    • Is a victim of trauma or abuse

      Refer to a neurologist if:

    • The presence of abnormal neurological signs or developmental regression suggests an alternative cause for the movements

    Referral criteria/required information

    • Children with the above red flags with details clearly included in the referral letter

    How to refer

    Specialist Clinics referral

    Please complete the above and submit via:

    • Facsimile (03) 9345 5034 or
    • Email screferrals@rch.org.au
    • Clinical queries call the Neurology department (03) 9345 5661

    Information for families

    Consider providing education to families regarding pre-referral management

    Resources and links

    Acknowledgements

    The development of this guideline was coordinated by the Department of Neurology. Guideline reviewed in July 2026.