Book Review

Tics and Tourette Syndrome: Key Clinical Perspectives by Roger Freeman

Book Review by Tammy Hedderly

Paediatric Neurosciences, Evelina London Childrens Hospital, Guy’s and St Thomas’ NHS Foundation Trust, King’s Health Partners, London, UK

Published in Developmental Medicine and Child Neurology, August 2015

Tics and Tourette Syndrome, Freeman, cover


The arrival of this excellent book is timely as it has coincided with increasing general awareness and recognition of tic disorders and often more importantly, the presence of associated issues for the affected children and their families. This book is written primarily for professionals working both in neurodisability and neurodevelopmental clinics, so is likely to appeal and be a useful resource to a wide range of clinicians and allied health professionals. Psychiatrists, neurologists, and paediatricians working in generic and specialist services would certainly benefit from reading this interesting and insightful book. It also provides a valuable resource for psychologists, speech and language therapists, occupational therapists, and clinical nurse specialists with an interest in this area. I would also recommend it to professionals working in the field of education who have contact with children who have tics and related difficulties.

Although the book is written primarily from a clinical perspective, it still manages to incorporate an informative and easily accessible discussion about current scientific literature that is both topical and of clinical interest. Helpfully, the book stretches beyond a simple discussion about tics and chooses to tackle clinically relevant issues that may cause a huge amount of diagnostic uncertainty and high specialist referral rates. These issues include the differentiation of tics and stereotypies, as well as how to effectively manage these different movement disorders.

The illustrative case histories allow for reflection of one’s own practice and challenge some areas of standard thinking. They are interesting, brief, and engaging. The cases cover unusual topics such as misophonia, functional movement disorders, coprophenomena, infantile gratification, intense imagery with compulsive fantasy, and sleep disorders.

Tics and Tourette Syndrome then provides analysis of aspects of neuropsychology, treatment, and intervention. The management recommendations go beyond that of just approaching and focusing on the motor aspects of these presentations. There is a helpful guide on management of attention-deficit–hyperactivity disorder, behavioural difficulties, obsessive-compulsive disorder, and lifestyle issues, with an excellent focus on improving quality of life.

In my opinion, the text provides interesting and thought-provoking aspects, especially the discussions surrounding common misconceptions in the field, for example challenging the notion that Tourette syndrome is the severe end on a spectrum of tic disorders. Instead, the philosophy of labelling is explored, which has proved highly useful for discussions with families. Such controversies are not avoided but tackled head on.

The book ends with an Appendix that contains useful guides for teachers, web resources for all, and helpful tips on service structure and provision.

As a neurologist receiving ever-increasing volumes of referrals into a specialist dedicated multidisciplinary clinic, I highly recommend this book to my colleagues in the field of neurodevelopmental medicine, paediatrics, and beyond. The families we serve are keen to meet professionals who not only have a good knowledge base and experience, but who will also be able to help them understand and manage issues that impact on day-to-day functioning. As such, this is an excellent resource in which to invest. It will undoubtedly help individuals working with these complex cases obtain a better understanding of the skill base required to discuss aspects of tics, Tourette syndrome, and developmental movement difficulties with families, thereby helping them manage the wider issues of this patient group in the most optimal way.