Tourette's and tic disorders in Malaysia

What it is

Tics are quick, repeated movements or sounds that are hard to control: blinking, head jerking, coughing, repeating a word.^{Source [2]} They are common in childhood, usually first appear around the age of five, and most improve over time; some last a few months, others come and go for several years.^{Source [2]}

Tourette’s syndrome is diagnosed when both movement and sound tics have lasted more than a year and began before the age of 18.^{Source [1]} It usually starts around the age of six, is often most noticeable around ten, and is more common in boys. There is no cure, but treatment helps when tics cause problems, and many people with Tourette’s also have OCD or ADHD.^{Source [1]}

Common signs

Movement tics^{Source [1]}

• blinking or rolling the eyes; shrugging
• jerking or twitching; tensing the stomach muscles
• jumping

Sound tics^{Source [1]}

• sniffing or clearing the throat; whistling
• animal noises
• repeating a sound, word or phrase

Stress, excitement and tiredness make tics more likely.^{Source [1]} Swearing tics are rare, despite their fame.^{Source [1]} Many children have tics at some point without having Tourette’s.^{Source [1]}

Common misconceptions in Malaysia

• “Tourette’s means shouting rude words.” Swearing tics are rare.^{Source [1]}
• “They could stop if they tried.” Tics are hard to control. Telling someone off adds stress, and stress makes tics worse.^{Source [1]Source [2]}
• “It is a spiritual problem, or bad upbringing.” The cause is not known, but Tourette’s runs in families and is a condition of the brain, not of character.^{Source [1]}
• “All tics need treatment.” Mild tics that cause no problems often need none. See a doctor if they are frequent, painful, cause embarrassment or bullying, or interfere with school or work.^{Source [2]}

What an assessment involves here

A doctor asks when the tics started, how often they happen, whether anyone in the family has them, and whether there are other conditions such as OCD or ADHD. There is no test for Tourette’s; a specialist may order a scan or a blood test to rule out another cause.^{Source [1]}

Public route. Start at a Klinik Kesihatan. The Ministry of Health’s child health service refers children on to paediatricians and other specialists; for tics the referral is to a paediatrician or a neurologist, a brain and nerve specialist.^{Source [1]Source [3]}

Cost, indicative as of November 2026. At government facilities the outpatient visit is RM1; the first specialist visit is free with a government referral and RM5 a visit after that, or RM30 with a private referral.^{Source [4]} Private fees are set by each practice; ask for the total.

Who to see

A paediatrician or a neurologist diagnoses Tourette’s. Because ADHD and OCD so often come with it, a child psychiatrist is frequently involved too, and the choice of any medicine depends on which conditions are present.^{Source [1]} Behavioural therapy, the first treatment, is delivered by trained therapists.^{Source [2]} Who’s who explains how to check a registration.

Find them in the directory: Developmental paediatrician · Psychiatrist

Support available

• Treatment. Behavioural therapy comes first: habit reversal, comprehensive behavioural intervention for tics (CBiT) or exposure with response prevention. Medicine is offered if that has not helped, and the choice takes ADHD or OCD into account.^{Source [1]Source [2]}
• School. Tell the school after a diagnosis so staff can offer support.^{Source [1]} Where needs are greater, the Special Education Integration Programme (PPKI) or the Inclusive Education Programme, registered through the idMe portal with a certification.^{Source [5]}
• OKU card. Tourette’s is not named in the OKU categories; ask the assessing doctor.^{Source [6]}
• Routine. A consistent daily routine with plenty of physical activity, and a calm bedtime without screens.^{Source [1]}

Supporting someone

• Reduce stress rather than policing tics; stress and tiredness make them worse.^{Source [1]}
• Keep routines, sleep and exercise steady.^{Source [1]}
• Tell teachers what tics are, so they are not mistaken for misbehaviour.^{Source [1]}
• Ask the person what helps; some prefer to be left alone during a bout of tics.

Read more

• NHS: Tourette syndrome (opens an external site) and tics (opens an external site)
• MyGovernment: health of children with special needs (opens an external site)