• A habit cough is like a tic, it is a repetitive muscular contraction but it involves the chest muscles.

• It usually starts with a genuine chest infection or bad viral cold/flu.

• The cough can persist for months.

• It is a very loud harsh short repetitive cough which can happen several times a minute throughout the day. It usually drives parents and teachers mad!

• The child can usually demonstrate it when asked.

• It never occurs when the child is asleep and this is the key to making the diagnosis. It is important to be sure that any coughing heard in the night is not occurring when the child has woken briefly, perhaps to go to the toilet.

• It can sometimes be accompanied by a repetitive throat clearing noise.

• Examination of the chest is normal. Investigations are rarely necessary.

• By the time I see the children, they have often been given antibiotics and anti-ashma inhalers, which have had no effect.

• It may be associated with stress but not necessarily.

• A clear and honest explanation is usually enough to make the cough disappear. This must be combined with defusing the tenion the cough has caused and ignoring it.

My publication of follow up of 55 children with a habit cough. Print paper