FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Making Movement and Communication Safer

Original entry 6: Motor and vocal safety and communication planning.

For the Person With FND
For Family, Friends, and Other Supporters
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For the Person With FND

Two different needs

A sudden movement can interrupt a practical task. A sudden sound or phrase can interrupt the message you meant to give. A safety and communication plan looks at both. It aims to reduce preventable harm and help you be understood while symptoms are present. These are worthwhile goals in their own right. [1]

Vocal tics can include words that do not express what you want to say. The important distinction in a conversation is between the involuntary interruption and your intended message.

Make a risky task easier

Think about one task where movements create a hazard: carrying a hot drink, cutting food or reaching near a hard edge. Ask whether the task can be changed, shared or temporarily handed over. A different cup, cooler drink or help preparing food may be worth discussing with an occupational therapist. The right choice depends on how your movements affect the task.

If repeated movements cause injury or significant pain, seek assessment. Protective equipment needs individual advice about fit, comfort and function. Do not bind a limb or use restraint as a home tic treatment.

Keep your message available

You can agree a simple approach before a conversation: “Please give me a moment; I will tell you when I have finished.” If speaking becomes difficult, you might prefer typing, writing, pointing or asking someone to read a prepared note. Choose an option that works with your motor, vision and cognitive needs too.

A short note for unfamiliar people could say, “I have involuntary movements and sounds. Please give me time to communicate.” This is an example you can adapt, not something you must disclose.

At a healthcare appointment, agree how you will indicate pain, ask for help and confirm a decision. An involuntary word should not be treated as your consent or refusal. The team should establish your intended answer using an accessible method.

Breathing or swallowing danger, significant injury or a new neurological change requires medical assessment; it should not be assumed to be a familiar tic.

For the Person With FND
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For Family, Friends, and Other Supporters

Listen for the intended message and ask how to check it if you are unsure. Offer a communication option without taking the person’s voice away. Speak directly to them, even when someone else helps convey the answer.

Agree how to respond to involuntary offensive words privately. Protect dignity and the safety of everyone present without punishment or demands for an apology for an involuntary utterance.

For the Person With FND
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For Clinicians and the Care Team

Assess the actual motor hazard and communication barrier, with occupational therapy or speech-language input as appropriate. Distinguish vocal tic-like symptoms from dysphonia, language impairment and airway symptoms; they may coexist and require different assessment. [1]

Document an accessible method of communicating intent and consent. The task adaptations above are practical examples, not validated tic interventions. Review injury, pain and equipment-related harm rather than judging success solely by tic reduction.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
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Research and Sources

Safety and communication access are supporting care. Expert guidance supports individualized multidisciplinary input; it does not establish that a particular cup, writing method or protective device treats functional tics.

Citation Figure Full citation and scope
[1] — Malaty IA, Anderson S, Bennett SM, et al. Diagnosis and management of functional tic-like phenomena. Journal of Clinical Medicine. 2022;11(21):6470. Source. FND-CIT-0110.

Evidence checked September 24, 2026. Human review pending. No new community quotations have been verified.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —