Comprehensive Multidisciplinary Team Assessment for Tic Disorders/Tourette Syndrome

What are tics?
Tics are repetitive and involuntary movements or vocalizations such as blinking, nose twitching, throat clearing, or sniffing. You might have heard that tics are all about swearing or using inappropriate language, especially in Tourette Syndrome (TS). Science says that is wrong! In Tourette Syndrome most tics do not involve swearing at all.
What is Tourette Syndrome (TS)?
Tourette Syndrome (TS) is a neurobiological brain difference—which means it is a neurodevelopmental condition—where tics are a symptom. Tourette Syndrome occurs when a child has had both movement and vocal tics for more than a year.
Will the tics stop by making my child more aware of them and by just saying “stop”?
No. Tics, by definition, are involuntary. Some children and teens may have some control over their tics, but not 24/7. And saying “stop!” or providing rewards and consequences will not be effective either. In fact, the more people talk about tics or point them out, the more likely the tics will get worse! Treating tics requires a highly specialized treatment plan. It also requires a therapist with highly specialized training in treating tics. A clinician who does more general forms of therapy will not be effective when it comes to reducing tics that are stressful for your child or teen.
What treatments are available if Tourette Syndrome is diagnosed?
If your child or teen wants to reduce specific tics, then there are options such as specialized behaviour therapy or medication. A scientifically-supported treatment called CBIT (Comprehensive Behavioural Intervention for Tics), done with a therapist trained in this technique, can help your child or teen learn techniques to lessen tics. At the Possibilities Clinic, we have clinicians trained in this approach.
Are tics the only symptom or concern that might need treatment in Tic Disorders or Tourette Syndrome?
No. In people with persistent tics, there is a very high chance (86%!) that other difficulties are present, too. These added challenges can include ADD/ADHD, Learning Disabilities, Anxiety, Obsessive-Compulsive Disorder (OCD) and self-regulation difficulties that can affect actions and behaviours. Often, these coexisting conditions can cause more difficulties for people with Tic Disorders than the tics themselves! If treatment is only focused on tics, other concerns could be missed and get worse over time. Early diagnosis and treatment are key!
How can I figure out if my child or teen has a Tic Disorder like Tourette Syndrome?
A detailed assessment of tics and coexisting conditions can help you figure that out. And no, this is not something you need to figure out on your own. We can help! We have assessed thousands of children and teens at the Possibilities Clinic. We are specialists, not generalists. That means we have expertise in Tic Disorders, like Tourette Syndrome, and in the conditions that often go along with tics. We stay up-to-date with the latest research and follow current guidelines for assessing and treating these disorders.
Is diagnosing Tourette Syndrome hard to do?
Yes. Diagnosing Tourette Syndrome and any coexisting condition is complicated. No two people with Tourette Syndrome are alike, and symptoms that look like Tourette Syndrome might not be. Figuring out what is going on takes time, detailed investigation, and expert knowledge. Bottom line: It cannot be done with a simple checklist. It cannot be done in 15 minutes.
Does that mean treating Tourette Syndrome is complicated, too?
Yes. Treating Tourette Syndrome is complicated, and any coexisting condition requires scientifically-supported treatments as well! There are many therapies and medication options out there, some have scientific support and others do not. How do you know what is right for your child? How do you know what is going to make real change happen? We will devise a Treatment Plan that helps your child achieve bigger goals and better outcomes.
What if I hear about a great treatment for Tourette Syndrome, or for any condition that exists along with it, but you do not offer it at Possibilities?
We only offer treatments that are supported by science. If you have heard about a treatment and we do not offer it, ask us why. Most likely, the science is not strong enough for us to offer it to our patients. A treatment might sound scientific, but that does not mean it is. Scient-iffy: that is our word for science-sounding claims and treatments that have minimal to no support to back them up. So, they are “iffy”, meaning full of uncertainty and unproven. We stand by science and all things scientific. We never settle for “scientiffy” and neither should you!
What do Tourette Syndrome Assessments look like at the Possibilities Clinic?
At Possibilities we offer a Comprehensive Assessment for Tic Disorders/Tourette Syndrome that looks at more than just tics. We take a detailed medical and developmental history to see how long your child has experienced any tics or associated difficulties. Questionnaire ratings—from people you give us permission to contact, like teachers—give us more information about your child in different settings and situations. Beyond that, we do direct testing of attention to assess brain functioning, and investigate mood, social-emotional functioning, self-regulation and obsessive-compulsive behavior through clinical interviews and questionnaires. Once strengths and needs are identified, our team can recommend targeted and scientifically-supported treatments.
How are your Tic Disorders/ Tourette Syndrome Assessments at the Possibilities Clinic different from others?
At Possibilities we approach assessments from a unique team perspective. That means we involve experts from multiple health fields—like psychology and medicine—in every single assessment that we do. Our expert team can look at a full range of concerns—from tics to Attention Deficit Disorders and Learning Disabilities to mental health challenges like anxiety, depression, and obsessive-compulsive behavior. We call our approach the Comprehensive Multidisciplinary Team Assessment for Tic Disorders/Tourette Syndrome.
At what age should I consider obtaining this assessment for my child?
At any age! Good outcomes can happen with the right Treatment Plan, but a comprehensive assessment comes first. Currently, Possibilities only offers Tic Disorders/Tourette Syndrome assessment and treatments for children and adolescents up to the age of 17 years. We can, however, assess and treat commonly co-occurring ADD and ADHD in adults.
Will the assessment help the team develop the right Treatment Plan?
Yes! Recommendations cannot be general, and they cannot be vague. Recommendations must be targeted, specific, and supported by science, and they must be personalized for your child or teen. For students who struggle to get work done, we can offer programs like SMARTS-EF or individual therapy to support initiative and persistence. We also have individualized therapies for tics, anxiety and OCD. For the person requiring medication support, we can determine the right medication at the right dose. At Possibilities, our team works with you to coordinate therapies and medication treatments in one clinic.
What is the cost of the assessment?
The cost for our Comprehensive Multidisciplinary Team Assessment for Tic Disorders or Tourette Syndrome is $1750. This cost is often covered by private insurance plans.
I do not live in the GTA. Do I need to come into the city for the assessment?
No! Our Tic Disorder/Tourette Syndrome Assessment is now available throughout Ontario over secure video sessions. If you have a computer and a high-speed internet connection, all your appointments and testing can be done from the comfort of your home. This option may not always be practical with younger children, but this can be determined at the intake appointment. Some tests may require an in-office visit.
I do not live in Ontario. Can I still be tested remotely?
Unfortunately, at this time, all our physicians and psychologists are only licensed to see people in Ontario. If you live anywhere in Ontario, you can be accessed remotely.
Do I need a doctor’s referral to start the assessment?
Yes. A specialized physician is involved in all our assessments, so a doctor’s referral is required. If you cannot obtain a referral, especially during COVID-19, please contact our office to explore other options.
How do I get started?
Fill out the intake forms on our website at https://possibilitiesclinic.com/age-3-17/ for children and https://possibilitiesclinic.com/age-18/ for adults. Once we have this form and the physician referral, our Coordinator will call you to set up an appointment.

For any questions, email us at info@possibilitiesclinic.com or call 1-833-482-5558 to speak to one of our Clinical Coordinators.