Overcoming the Social Struggles of Tourette’s Syndome Ethical Dilemma Case Study

1. Overcoming the Social Struggles of Tourette’s SyndomeEthical Dilemma Case Study Presented By: Lindsey Vines, Jennifer Dupler, Melissa Nack, Stephen Tilson, Lauren Mickwee INED 3304 Fall 2011 Dr. Bell

2. Demographic Information West Side Elementary School Kennesaw, GA

3. West Side Elementary School Basic Information: • Serves grades k-5 • Enrollment Total: 596 • Year Opened: 1994 School Demographics: • Students of color: 14.6% of total enrollment • English Language Learners: 4.7% • Special Education: 15.7% • Free or Reduced-Price Meals Eligible: 20.1%

4. Case Study • Michael is a new 2nd grade student at West Side Elementary School in Kennesaw, GA. Michael has Tourettes Syndrome, a disability that is “...a neurobiological disorder marked by a wide range of involuntary motor and vocal movements and sounds called tics.”(Christner 2008). Motor tics can cause spastic, random, and repetitive bodily movements and behavior, while vocal tics include loud outbursts of noise from the person suffering from the disorder. A person with Tourette's is unable to control their outbursts and body tics, it is completely involuntary. This disability can range from very mild to extremely severe. “Other psychiatric problems that are reported to occur more frequently in children with Tourette's syndrome than in children without Tourette's syndrome include rage attacks, depression, bipolar disorder, impulse-control problems, and anxiety, although their prevalence and the exact nature of their relationship to Tourette's syndrome remain unclear. For example, some behavioral problems may arise from difficulties in living with Tourette's syndrome.”(Kurlan 2010) • Michael is currently in a mid range of severity with his Tourette's Syndrome. He already suffers from loud and uncontrollable outbursts of noise fairly often, such as barking, screeching, and yelling. Not to mention the physical effects of the disorder which involve violently blinking his eyes and randomly jerking his legs. Michael's parents have home schooled him up until this point due to his disability, but have decided that he needed the social interaction and experience of being enrolled in the local public school.

5. Case Study Cont. • Michael is very nervous about being around other students his own age, and his nerves are causing his tics to be even more severe than usual. His teacher, Mrs. Knight has never had a student with Tourette's in a class of hers, but sees right off the bat how important it is for Michael to be accepted by his peers and knows that, “... it is very important for the child’s self-esteem and emotional well-being that treatment for TS symptoms be sought as early as possible.”(Brown University 2010) When she is one on one with Michael she is able to get him comfortable enough to get him to laugh and joke around, and she is able to see how fun and kind he is. When put in a situation with his peers, however, he is unable to come out of his shell. • The students in the class do not understand his disorder and upon meeting Michael are laughing at him and mocking him causing Michael to be introverted and extremely nervous. They do not seem to want to accept or even speak to Michael do to his differences and the fact that they know nothing about his disorder and do not understand what he is going through. Mrs. Knight knows it is vital to step in and do everything she can to help Michael and teach the other students in the class to never laugh at someone different from themselves. She wants to go about the situation correctly and without making Michael uncomfortable, but she knows it is vital that she step in and do something to help Michael's peers understand his disability. Mrs. Knight is weighing her options and trying to figure out how best to go about this situation. She knows how great a personality Michael has and how many great traits he has to share with others, she just needs to get the other students to see past his disability and see who Michael truly is.

6. Stakeholders • Michael: New 2nd grade student suffering from Tourette’sSyndome. • Mrs. Knight: Michael’s second grade teacher who feels the need to step in and create a positive social experience for Michael, and a peaceful environment in her classroom. • Michael’s Peers: Michael’s classmates are uninformed about Michael’s condition, and therefore creating a hostile environment in the classroom.

7. Questions Pertaining to the Dilemma • Because Michael is a new student and also dealing with Tourettes syndrome, how could the teacher better help him fit in, make friends, and feel accepted? Teachers today have to deal with problems similar to this every day. What are some ideas for teachers who face difficulty with their students? • Along with finding a way to help Michael fit in, are there any ways the teacher could help him with his involuntary movement and other side effects of Tourettes syndrome? If not, should it be overlooked when it happens during class? How should the situation be handled? “Remember that individuals with TS may be aware of the onset of a tic and yet cannot control these involuntary behaviors. [Students may be able to restrict the tics for a period of time, but eventually need to be released.] These releases ultimately can lead to self-esteem issues as well as academic or behavioral issues” (Christner 2008) • How should the teacher address the other students in the class about Michael’s disability? Or should she? If not, how should the teacher respond when students pick on or use negativity towards Michael? “Also remember that students who are aware oftheir label of TSmay not be able to control their tics but are very capable of sharing ideas to help deal with their tics if the tics are uncomfortable to them or distracting to others.” (Christner 2008)

8. Possible Resolutions to the Ethical Dilemma • Have the student or his parents come in and explain to the students in the class what Tourette's is. Explaining a little about Tourette’s in a way that the other students can connect or relate to, may help the students find a common ground with Michael.  • Provide the student with a "buddy“, preferably in a younger grade to begin socializing with. This may help Michael with his social skills by setting him up with a younger student to help him or her with reading or another subject. Also, this may boost Michael’s confidence. “Although withdrawn students may not call as much attention to themselves as conduct-disordered students, they nonetheless may require intensive interventions.” (Boles 2010) • Provide the students with a get to know you activity to promote socializing. This may help Michael and the other students to find commonalities with each other, so that the students will get to know Michael for who he is, and not for his disorder. It will also promote communication with the entire class.  “In … discussions with children and adolescents about their school experiences, they frequently express their wish that people would understand that they cannot help what they are doing.” (Packer 1995)

9. References • Boles, Patrick F. Education: INED 3304 Exceptional Students Kennesaw State University (New York: Pearson Custom, 2010), 96. • Christner, Beth, and Lisa A. Dieker. "Tourette Syndrome." Teaching Exceptional Children 40, no. 5 (May 2008): 44-51. Academic Search Complete, EBSCOhost (accessed November 28, 2011). • Kurlan, Roger. "Tourette's Syndrome." New England Journal Of Medicine 363, no. 24 (December 9, 2010): 2332-2338. Academic Search Complete, EBSCOhost (accessed November 28, 2011). • Packer, Leslie E. "Educating Children with Tourette Syndrome: Understanding and Educating Children With a Neurobiological Disorder." Disseminated to all schools in NYS by the NYS Dept. of Education. (1995). • "What is Tourette syndrome?." Brown University Child & Adolescent Behavior Letter (September 2, 2010): 1-2. Academic Search Complete, EBSCOhost (accessed November 28, 2011).