I have motor tics , I ' ve been tested for Tourette ' s as a child but I was not diagnosed with it for whatever reason I ' m 22 F btw . As a kid I had vocal and physical tics , and had the same patterns of breaks your son has . I had issues with a nodding motion and wrist snapping . I can control them somewhat now when I ' m in public , by channeling the energy into other more acceptable fidgeting leg bopping , foot tapping . I scrunch my nose a lot as well , if I get embarrassed when someone points it out I just claim I ' m trying not to sneeze . To sit completely still is out of the question , it feels like a build up of energy and it ' s very uncomfortable . I don ' t know how else to explain it . That seems to help . From my personal experience , they get worse when I am tired or under stress . Maybe help your son identify what sets them off how old is he ? I had trouble controlling them until I was 1314 . I was diagnosed with ADD last year . I ' ve never been on medication for it and I struggled a lot in school . My grades where always great because I made up for it in other ways I found ways to compensate . For example , I excelled at biology , anatomy and earth sciences because these are things I could study and see in person and work with my hands . I can ' t tell you whether to medicate your kid or not . There are pros and cons to both sides . For every part of me that wishes I was medicated to make life easier , another part of me is glad I got to work through this on my own . It makes you challenge yourself . My advice would be to help your son identify what triggers the tics , find his own ways to cope with them , and to use any hyper focusing to his advantage to excel at whatever he enjoys .