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I have to agree with Madimi that tics, especially at early ages effect the parents far more than then the child. A long as it's not because of extra stress or anxiety, I don't very actively try to remove triggers anymore. ( I still sometime do selectively) i.e. My doughtier had a very certain tic when we were playing volleyball but I kept on practicing with her (she eventually got to a point she is better than me now) and that particular tic went away quickly. Btw, after a very steady decline we have seen an increase starting one week ago (we are at vacation , traveling new places ) not as bad as our 'worst' times, but still far worse than our average for the last two years. I hope that this temporary but I also know puberty may increase the symptoms. I really wish I could stop worrying.