What are the key diagnostic criteria for Tourette Syndrome in children and adolescents?

The provided UK guidelines do not explicitly detail the specific diagnostic criteria for Tourette Syndrome in children and adolescents. However, for related neurodevelopmental conditions such as autism and attention deficit hyperactivity disorder (ADHD), the National Institute for Health and Care Excellence (NICE) guidelines refer to the diagnostic criteria outlined in the DSM-5 or ICD-11 ²,³. It is generally understood that the diagnosis of Tourette Syndrome also relies on these international classification systems, which are used in clinical trials involving children and adolescents with the condition ((Jankovic et al., 2021); (Andrén et al., 2022)).

Based on the UK guidelines, key considerations for tic disorders, including Tourette Syndrome, involve:

• Presence of Tics: Tics are involuntary movements ¹. While simple motor tics that are not troublesome to the child do not routinely require referral, a tic disorder that significantly impacts a child's quality of life warrants specialist assessment ¹.
• Referral Pathways: For children with a tic disorder that has a significant impact on their quality of life, referral should be considered according to local pathways ¹. This may include referral to mental health services if associated with anxiety or obsessive-compulsive behaviour, to the neurodevelopmental team if associated with symptoms suggestive of autism or ADHD, or for neurological assessment if the tic disorder is severe ¹. Tics and stereotypies are also noted to be more common in children with autism or a learning disability ¹.
• Coexisting Conditions: When assessing for neurodevelopmental conditions like autism, tics or Tourette Syndrome are considered as potential coexisting conditions, alongside ADHD, anxiety disorders, and obsessive-compulsive disorder (OCD) ².

International expert consensus also contributes to the understanding and diagnosis of tic disorders, including the differentiation of functional tic-like behaviours from Tourette Syndrome ((Pringsheim et al., 2023)).