Tourette’s Syndrome

1. Let’s Talk Tourette’s Tourette’s Syndrome

2. Videos • Brad Cohen Video http://www.youtube.com/watch?v=insu46QDTeY • Front of the Class http://www.youtube.com/watch?v=EuhyVHLlfXE

3. What is Tourette’s Syndrome? • Dr. Georges Gilles De La Tourette. The person who the syndrome is named after. the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman. • TS is one of a number of tic disorders. Before a physician can make the • differential diagnosis of TS, the following criteria from the DSM-IV must all be met: • 1. Both multiple motor and one or more vocal tics have been present at some time • during the illness, although not necessarily concurrently. (A tic is a sudden, • rapid, recurrent, non-rhythmic, stereotyped motor movement or vocalization.) • 2. The tics occur many times a day (usually in bouts) nearly every day or • intermittently throughout a period of more than 1 year, and during this period • there was never a tic-free period of more than 3 consecutive months. • 3. The disturbance causes marked distress or significant impairment in social, • occupational, or other important areas of functioning. • 4. The onset is before age 18 years. • 5. The disturbance is not due to the direct physiological effects of a substance • (e.g., stimulants) or a general medical condition (e.g., Huntington’s disease or • Post-viral encephalitis).

4. HOW SCHOOLS ADDRESS THE NEEDS OF STUDENTS WHO HAVE IT? • First off teachers are encouraged to learn as much as possible about each individual learning disorder and what works and what does not work. Teachers should also obtain information from parents of students with TS to find out about the kids specific tics. • A lot of schools will set up and IEP or a 504 plan for these students with TS. Although just having TS does not guarantee that the student will be on one of these plans. • Schools basically are treating Tourette’s syndrome similarly as they would treat kids with ADHD. • Here are some more tips for dealing with ADHD/TS in the classroom: • Try not to over stimulate the child or children with ADHD/TS in your class • Avoid long tests if possible and instead give frequent, short quizzes • Give the kids more than one choice in activities • Give children with ADHD/TS extra time to complete activities • Keep all rules simple and to the point. Dealing with ADHD/TS in the classroom will be much easier if you do not have to keep punishing your students for extravagant rules that they may have broken. Besides, it is much easier for children with ADHD/TS to follow and focus on simple rules. • Give children activities that are more hands-on or involve more visual work • Be aware of any medication that your children with ADHD/TS may be on… there could be possible side effects to that medication • Keep the format of your worksheets simple • Keep your lessons short • Do your best to treat these students as normal

5. Following is a listing of specific disabilities or symptoms that may be manifested in • the classroom by a student with TS. This is part of a short handbook for teachers to have before they work with students with Tourette’s • Disability/Symptom • Motor tics/vocal tics • Stress increases tics • Mental tics (need to silently repeat words, numbers, phrases) • Waxing and waning of symptoms of tics • Program Implications • May be offensive and disruptive. Provide for a private expression of tics; consider safety issues in all classes including those using dangerous chemicals or tools. Explain student’s inability to control actions to classmates if student and parents approve • Teach coping skills to handle stress; may need to avoid competition. Intensive involvement in enjoyable activities (sports, music) decreases tics and stress and calms. • Allow extra time to complete responses, assignments, and to refocus attention; provide a structured school environment with minimal distraction • Explain to parents, peers, teachers that student has very limited control and that expression of tics and other symptoms are involuntary as well as ever-changing and coming and going.

6. Teaching Techniques For Tourette’s • Ignore The Tics • Free Pass To “Get The Tics Out • Model Acceptance • Reduce Stress • Provide time for physical activity • Dysgraphia

7. Accommodations • Provide testing accommodations: • A longer testing period, perhaps away from other peers. • Use of computers • Test with oral exams • Meet with the Special Ed. Teacher and OT (if possible) about how to grade the student fairly…grading on quality and not quantity of appearance of work. • Environmental Accommodations: • Place by door where student can leave to tic if needed. • If a student has a touching tic or compulsion, allow a “buffer zone” where there is a second desk or library carrel where they can work at when tics are bad. • Allow them to work in whatever position is comfortable. • Encourage the student to let you know what supports he or she feels are needed to work around the tics.

8. The Faces of Turrets Syndrome… • Average people just like us have Turrets. It manifests in childhood and may be present in 1.6% of all children. • Brad Cohen An award-winning teacher, author of the book “Front of The Class” and motivational speaker. There is a movie based on this book as well. • Tim Howard Famous goal keeper Manchester United of England. Tim says it's just a battle of the will, he just constantly fights what his mind tells his body to do, he has been capable of shutting out Turrets. • Michael Wolff An American jazz pianist, composer, and actor. Wolff has Tourette syndrome he serves on the Board of Directors of the Tourette Syndrome Association (TSA), and is involved with mentoring children with Turrets. Other well known people with Tourette’s include: • Dan Ackroyd • Howard Hughes • Dr. Samuel Johnson • Mozart

9. Difficulties in the school setting? Student with Tourette’s suffer from: - tics interfere with academic performances or social- bright lights- loud or particular noises- certain smells- the feel of some fabrics- very poor handing writing- copy wrong from textbooks and boards- quickly go into "overload" which causes student to become out of control- Sensory Defectiveness- side noises/sides ruins attention span- crowded hallways/cafeteria/play ground/school bus- suddenly touched- poor motor skills- hands cramp- cursive/regular handwriting

10. Implications Student with Tourette’s suffer from: • - educational settings NEED to meet individual needs- tutoring- smaller or special classes or even special schools- tolerant and compassionate setting that encourages to work to their full potential and is flexible- private study areas- exams outside regular classroom or even oral exams- untimed testing- stick to a schedule- give a copy of notes- use an Occupational Therapist

11. Technology • Software for transcription and sentence generation (e.g., spelling checker, speech synthesis, word prediction, and grammar and style checkers). • Applications for cognitive and planning processes (e.g., prompting programs, outlining and semantic mapping software). • Computer networks for collaboration and communication.