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A tic is a rapid, involuntary, and apparently meaningless movement or vocalization. Most simple tics go unnoticed or fail to reach a level of conscious awareness. Many children are not bothered by their motor tics and frequently display some indifference toward them. Vocal tics are frequently disruptive and distressing. Often these are inaccurately described as disruptive habits. In general, tics are sensitive to stress and fatigue. They wax and wane in severity, but for most children, they are not progressive (Walkup et al. 2006; Table 21–27).

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