抽动症会跟着孩子长大吗？不同年龄段的这些变化，家长要了解！

当孩子第一次出现眨眼、清嗓子、甩头晃肩这些不自主的动作或声音时，许多父母的心瞬间揪紧：“孩子怎么了？这会不会一直跟着他长大？” 面对抽动症，担忧和困惑是人之常情。别怕，让我们一起来了解抽动症在孩子成长路上的模样，以及科学研究的发现。

抽动症常在3-8岁之间悄然出现[1]。孩子可能突然频繁眨眼、做鬼脸，或者发出“吭吭”声、清嗓子声。这些症状往往时轻时重，有时甚至暂时消失[2]，让人误以为“好了”。

这时父母最容易陷入焦虑：症状怎么来的？孩子是否故意为之？需要明确的是，抽动症并非孩子故意调皮，更非管教失当所致，它是一种神经发育性障碍[3]。此时最需要的是及时就医诊断，排除其他可能。切忌过度关注孩子的抽动表现，频繁提醒或指责只会雪上加霜[4]。

进入学业逐渐加重的阶段，抽动症状可能表现得更明显、更复杂。

简单的动作可能发展为甩头、扭动身体，甚至突然蹦跳；声音抽动也可能变为词语重复或突然叫喊[5]。此时孩子自我意识增强，容易因同伴的异样眼光而感到尴尬、自卑，甚至逃避社交或课堂发言[6]。

课业压力、疲劳、兴奋都可能让症状暂时加剧[7]。同时，抽动症孩子可能伴随注意力不集中（ADHD）、强迫观念或行为（OCD）等共患状况[8]。家长需积极与老师沟通，争取理解与支持。更重要的是，持续为孩子提供安全、接纳的家庭氛围[9]。

这是抽动症发展的一个重要分水岭。

相当一部分孩子的抽动症状（约50%-70%）会在青春期后逐渐减轻，甚至明显缓解或消失[10][11]。

然而，也有一部分孩子的症状可能持续，甚至因青春期激素变化、学业压力剧增、人际关系复杂化等因素而经历波动[12]。

这个阶段的孩子对自身形象更敏感，持续的抽动可能带来显著的心理负担，增加焦虑、抑郁风险[13]。家长的支持重点应转向帮助孩子学习压力管理技巧（如规律运动、放松训练）、建立健康的自我认同感、必要时寻求专业心理支持[14]。

总体而言，进入成年期后，抽动症状进一步减轻或稳定是主流趋势。许多成年人即使有轻微抽动，也能通过自我调节较好地融入工作和社会生活[15]。然而，对少数症状持续较明显（约10%-20%）的成年人，抽动仍可能带来挑战[16]。

持续的理解、包容的环境，以及必要时（如症状严重影响生活时）的医疗干预依然重要[17]。成年后，自我接纳和掌握应对策略是关键[18]。

抽动症在孩子成长过程中确实如影随形，但并非一成不变。它可能起伏波动，也可能随岁月流逝而渐渐隐退。研究一致表明，家庭的理解、接纳和支持性环境，是帮助孩子应对抽动症、促进其心理健康和社会适应的最关键因素[19][20]。对孩子而言，成长的路上，真正能融化困境坚冰的，唯有亲人无条件的信任与陪伴。

父母最有力的行动，是放下焦虑，用平静的接纳为孩子筑起遮风挡雨的港湾。当你不再紧盯每一次抽动，孩子才能学会与自我和解；当你传递出坚定的信任，孩子才能积蓄穿越风雨的勇气。

参考资料:

[1] Singer, H. S. (2019). Tics and Tourette Syndrome. Continuum (Minneapolis, Minn.), 25(4), 936–958.

[2] Leckman, J. F., Bloch, M. H., King, R. A., & Scahill, L. (2006). Phenomenology of tics and natural history of tic disorders. Advances in Neurology, 99, 1–16.
[3] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. (DSM-5 criteria for Tourette's and other tic disorders)
[4] Woods, D. W., Piacentini, J., Chang, S., Deckersbach, T., Ginsburg, G., Peterson, A., ... & Wilhelm, S. (2008). Managing Tourette Syndrome: A Behavioral Intervention for Children and Adults Therapist Guide. Oxford University Press.
[5] Robertson, M. M. (2008). The prevalence and epidemiology of Gilles de la Tourette syndrome. Part 1: The epidemiological and prevalence studies. Journal of Psychosomatic Research, 65(5), 461–472.

[6] Storch, E. A., Murphy, T. K., Geffken, G. R., Sajid, M., Allen, P., Roberti, J. W., & Goodman, W. K. (2005). Reliability and validity of the Yale Global Tic Severity Scale. Psychological Assessment, 17(4), 486–491.

[7] Conelea, C. A., & Woods, D. W. (2008). The influence of contextual factors on tic expression in Tourette's syndrome: A review. Journal of Psychosomatic Research, 65(5), 487–496.
[8] Hirschtritt, M. E., Lee, P. C., Pauls, D. L., Dion, Y., Grados, M. A., Illmann, C., ... & Tourette Syndrome Association International Consortium for Genetics. (2015). Lifetime prevalence, age of risk, and genetic relationships of comorbid psychiatric disorders in Tourette syndrome. JAMA Psychiatry, 72(4), 325–333.

[9] Sukhodolsky, D. G., Scahill, L., Zhang, H., Peterson, B. S., King, R. A., Lombroso, P. J., ... & Leckman, J. F. (2003). Disruptive behavior in children with Tourette's syndrome: Association with ADHD comorbidity, tic severity, and functional impairment. Journal of the American Academy of Child & Adolescent Psychiatry, 42(1), 98–105.

[10] Pringsheim, T., Okun, M. S., Müller-Vahl, K., Martino, D., Jankovic, J., Cavanna, A. E., ... & Roessner, V. (2021). Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders. Neurology, 96(24), 1140-1150.

[11] Bloch, M. H., & Leckman, J. F. (2009). Clinical course of Tourette syndrome. Journal of Psychosomatic Research, 67(6), 497–501.

[12] Groth, C., Mol Debes, N., Rask, C. U., Lange, T., & Skov, L. (2017). Course of Tourette Syndrome and Comorbidities in a Large Prospective Clinical Study. Journal of the American Academy of Child & Adolescent Psychiatry, 56(4), 304–312.

[13] Cutler, D., Murphy, T., Gilmour, J., & Heyman, I. (2009). The quality of life of young people with Tourette syndrome. Child: Care, Health and Development, 35(4), 496–504.

[14] McGuire, J. F., Piacentini, J., Brennan, E. A., Lewin, A. B., Murphy, T. K., Small, B. J., & Storch, E. A. (2014). A meta-analysis of behavior therapy for Tourette Syndrome. Journal of Psychiatric Research, 50, 106–112.

[15] Eapen, V., & Črnčec, R. (2009). Tourette syndrome in children and adults: A guide for the general practitioner. Australian Family Physician, 38(11), 876–880.
[16] Cavanna, A. E., David, K., Bandera, V., Termine, C., Balottin, U., Schrag, A., & Selai, C. (2013). Health-related quality of life in Gilles de la Tourette syndrome: A decade of research. Behavioural Neurology, 27(1), 83–93.

[17] Verdellen, C., van de Griendt, J., Hartmann, A., Murphy, T., & ESSTS Guidelines Group. (2011). European clinical guidelines for Tourette syndrome and other tic disorders. Part III: Behavioural and psychosocial interventions. European Child & Adolescent Psychiatry, 20(4), 197–207.

[18] Müller-Vahl, K. R. (2013). Treatment of Tourette syndrome with cannabinoids. Behavioural Neurology, 27(1), 119–124.

[19] Nussey, C., Pistrang, N., & Murphy, T. (2014). How does psychoeducation help? A review of the effects of providing information about Tourette syndrome and attention-deficit/hyperactivity disorder. Child: Care, Health and Development, 40(5), 617–627.

[20] Wadman, R., Tischler, V., & Jackson, G. M. (2013). ‘Everybody just thinks I'm weird’: A qualitative exploration of the psychosocial experiences of adolescents with Tourette syndrome. Child: Care, Health and Development, 39(6), 880–886.