Posted by Elizabeth McDuffie
Educating Students with Tourette’s Syndrome
There are a wide range of characteristics associated with Tourette’s syndrome (TS) but four criterion used to diagnose it.
The first criterion is known as motor tics and refers to any twitch, shake, blink, or involuntary movement. Motor tics are repetitive motions by the same voluntary muscular group over and over again.
The second criterion is known as vocal tics and refers to any noise or words that come out of the child beyond the normal range. This could be a repetitive throat clearing, teeth clicking or whatever sounds or motions that are repetitive and abnormal coming from the mouth.
Unfortunately Tourette’s syndrome is well known for coprolalia, the vocal tic that causes the affected person to repeatedly use inappropriate language. This often takes the form of cursing but can also be characterized by insults or silly phrases that would otherwise be embarrassing to yell out in public.
The third criterion is known as waxing and waning and refers to the constant changing of tics. Likewise, tics can increase and decrease in severity, and are affected by stress and anxiety. The forth criterion is that the symptoms begin in childhood.
A Syndrome, not a Disease
Tourette's syndrome is a neurobiological disorder and is proven to be hereditary, often running in families. Scientists are getting closer to finding a cause and a cure but at this time the only way to diagnose TS is with the criteria listed above. What researchers do know is that TS tends to get worse during puberty because of the increase of hormones and stresses but tends to level off and sometimes decreases as adolescents reach their twenties.
Many Tourette’s syndrome children are placed in emotionally disturbed classrooms where they do not belong. Often times they are reprimanded for actions they can not control. When this happens, the stress level of the child rises and the tics begin to get worse. In fact, stress of any kind can agitate the symptoms of TS, whether it is related to home, school, or life issues.
Many children that have TS also have ADHD. Some times they are prescribed Ritalin which makes the symptoms much worse. Likewise many children with TS are also shown to have obsessive compulsive disorder (OCD). Sometimes the TS symptoms become intertwined with the OCD symptoms and it’s difficult to tell the two apart as OCD can sometimes be described as “tics of the mind”.
Furthermore, many Tourette’s syndrome children struggle with fine motor skills and have difficulty in writing. Sadly, it is often overlooked and the student receives poor grades for something they are physically unable to do. Likewise, tics can take from the student’s ability do complete work quickly as they interfere with what they student is trying to accomplish.
Teacher Interventions: What we can do to help
Oftentimes simple interventions can help students that suffer from Tourette’s syndrome. For example, if your student doesn’t transition well, be sure to give them the “two minute warning” when wrapping up an activity. To avoid over stimulation in the hall, allow the student to walk to the next class, or whatever destination, a few minutes early so that they don’t become overwhealmed.
Or if your student struggles to write, allow them to use the computer. If the student has TS and lacks fine motor skills, handwriting is a skill that they will more than likely never master. The computer can allow them to be successful at writing instead of frustrated, also due to the fact that their writing may by very slow.
Timed tests can increase anxiety levels and therefore make the tics worse and handwriting slower. Therefore, make accommodations for the student during testing. Also, if there is an occupational therapist available, get them involved to invent adaptations to help the student.
Most importantly try to see the child and not the symptoms. The child doesn’t want to be known as the kid with the twitch, they just want to be a normal kid.
To learn more about Tourette’s syndrome check out [http://www.tsa-usa.org
S.P. Chamberlain 2003. Susan Conners: an educator’s observations about living with and educating others about Tourette’s syndrome. Intervention in School and Clinic
Vol. 39, No. 2