Arizona Tourette Syndrome and Tic Disorder Center

Arizona Tourette Syndrome and Tic Disorder Center

Rose Medical Pavilion operates a dedicated Tourette syndrome and tic disorder program for children and adolescents across Arizona. Care is led by Dr. Tamara Zach MD, a board-certified pediatric neurologist, and built around Comprehensive Behavioral Intervention for Tics (CBIT) — the treatment guidelines name as first-line for most children — with medication management available when tics are disabling.

What a dedicated tic program provides

Most children with tics are seen in a general pediatric or general neurology clinic where tics are one item on a long list. A dedicated program differs in what it can offer:

• Diagnostic clarity. Distinguishing Tourette syndrome from provisional tic disorder, persistent tic disorder, stereotypies, and functional tic-like behaviors — a distinction that changes treatment entirely.
• CBIT as first-line care. Behavioral treatment offered first rather than after medication has been tried and failed.
• Co-occurring condition management. Roughly 60% of children with Tourette syndrome also have ADHD, and OCD, anxiety, and learning differences are common. Treating tics without addressing these rarely improves a child's daily life.
• School advocacy. Written documentation supporting 504 plan and IEP accommodations, and education for teachers and classmates.
• Continuity through adolescence. Tics typically peak between ages 10 and 12 and often improve after puberty. Long-term follow-up prevents unnecessary escalation of treatment during the peak years.

Comprehensive Behavioral Intervention for Tics (CBIT)

CBIT is a structured, evidence-based behavioral therapy, not talk therapy or a suppression technique. It teaches a child to recognize the premonitory urge that precedes a tic and to perform a competing response that is incompatible with it, alongside functional analysis of the situations that worsen tics. It is typically delivered in eight sessions over ten weeks. CBIT works for both motor and vocal tics and carries none of the side effects associated with tic medications.

Your first visit

The initial evaluation runs about 60 minutes and includes a full developmental and neurological history, direct observation and characterization of the tics, screening for ADHD, OCD, and anxiety, review of any video you have recorded at home, and a discussion of whether treatment is needed at all. Many children with mild tics need reassurance and monitoring rather than active treatment, and saying so is part of the job.

When medication is appropriate

Medication is considered when tics cause pain, physical injury, significant social impairment, or interfere with school. Options include alpha-2 agonists such as guanfacine and clonidine, which are often tried first and can also help co-occurring ADHD, and antipsychotics for more severe or refractory tics. Dr. Tamara Zach MD reviews the full trade-off of benefit against side effects with every family before starting any medication.

Serving families across Arizona

The program sees families from Phoenix, Scottsdale, Mesa, Chandler, Gilbert, Glendale, Peoria, Tempe, Surprise, Tucson, Flagstaff, Prescott, and communities throughout the state. For families outside the Phoenix metro, visits are often scheduled to combine the initial evaluation and the first CBIT session in a single trip.

Referrals

Referrals are accepted from pediatricians, psychiatrists, psychologists, school psychologists, and directly from families — no physician referral is required to schedule. Referring providers can use our patient referral form. For condition-specific detail, see Tourette syndrome treatment in Phoenix and tic disorders in children.