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Tourette’s

Tourette’s. By Mary Lou Batty and Aaron Bourque. Overview. What is Tourette’s Syndrome? Risk Factors/Strengths Academic Concerns/Interventions Social, Emotional Concerns/Interventions Mental Fitness Questions?. When you think of Tourette’s. What comes to mind?. Myths.

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Tourette’s

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  1. Tourette’s By Mary Lou Batty and Aaron Bourque

  2. Overview • What is Tourette’s Syndrome? • Risk Factors/Strengths • Academic Concerns/Interventions • Social, Emotional Concerns/Interventions • Mental Fitness • Questions?

  3. When you think of Tourette’s • What comes to mind?

  4. Myths • Perpetuated by inaccuracies in media (e.g. South Park) • Tics can be controlled • Controlling tics can lead to “build up” and “explosion” • Use of profanity is a common tic • Tourette’s is a mental illness • Children outgrow tics or Tourette’s

  5. Tourette’s • Factual Information Onset: 6-7 Years of age, peaks early teen years Prevalence: 1-4%, 3x boys vs. girls/ crosses all cultures DSM V: Neurodevelopmental Disorders: Motor

  6. Key Features: What does Tourette's look like? Simple Tics: • Motor Skills: Eye Blinking, Head or Shoulder Jerking • Vocal: Throat Clearing, Barking Noises Complex: • Motor Skills: Jumping, Twisting • Vocal: Words or Phrases Other Features: “Bursts” or sporadic; +/- warning, triggers; Genetic, stuttering also a result of gene http://video.tourette.ca/index.php?entry_id=5879

  7. Evidence Based Interventions First Line Behavioural: • Habit reversal training (HRT) • Exposure with response prevention (ERP). Second line or add-on behavioural treatments: • Contingency management, • Function based interventions • Relaxation training. • Neurofeedback is still experimental. • Psychosocial interventions, e.g., psycho-education and group work.

  8. Risk Factors • 90% Co-Morbidity (ADHD (48%), OCD, Impulsivity, sleep deprivation, LD, anxiety, depression • Risk of Poor Relationships and Social Withdrawal • Substance Abuse, Conduct Disorder, Oppositional Defiant Disorder (chicken or egg – we don’t know)

  9. Strengths • Channel the energy in a positive way (Energetic, Enthusiastic) (2ndary to ADHD) • Often excel in creativity and intellect • Can be hyper-focused (OCD) • Great attention to detail and accuracy (2ndary to OCD)

  10. Sensitivity Awareness Application • Children with Tourette’s Syndrome follow the same normal curve model for intelligence as the general population. In fact, some parents think that children who have Tourette’s Syndrome may be more intellectually or creatively gifted than the general population. Can the same process that disinhibits motor activity also disinhibit creativity? It’s an interesting question. Children who have tics may need accommodations in the classroom. If you are having trouble reading this small passage, can you imagine how you’d feel if you had to spend a lot of time reading while you had tics? • Source: http://www.schoolbehavior.com/index.php?s=Tic+sensitivity+and+

  11. Academic Concerns • illegibleor poor quality of written work • incomplete work • inattentive and/or distractible in class • disorganizationof work and work space • difficulty obtaining and understanding verbal instruction • difficulty reading aloud (Vocal Tics) • looping (written, oral)

  12. Academic Interventions • Break down assignments and give the student work in smaller sections • Allow the student to use a computer to complete written work • Oral tests • Give the student flexible seating • Minimize extraneous distractions in the environment by creating student or subject workstations within the classroom

  13. Academic Interventions • Pair verbal instruction with visualsto enhance the student’s understanding. • Set reasonable time limits for assignments. • Provide structured, predictable scheduling to reduce stress and ensure adult supervision in group settings. • Break times for onset of tics (Relaxation Space). • Incorporate movement and physical activity into classroom activities on a regular basis (class wide).

  14. Social/Emotional Concerns • Relationships- Conflict- Misunderstanding of Tourette’s • Alienation from Peers • Self-Efficacy Challenges • Depression and Anxiety

  15. Social Interventions • Educate peers and school personnel about TS. • Use the student’s strengths and interests to facilitate a connection with peers. • Friendship Groups (Class Wide). • Conflict Resolution and Problem Solving (Class Wide). • Praise and encourage all positive behaviors and efforts to encourage independence, develop self-confidence, and promote self-efficacy. • Ensure ongoing communicationwith student & family. • Comprehensive Approach to school norms and procedures including modeling and peer support.

  16. Mental Fitness • How do you build relatedness, competency and autonomy support in the classroom? • Relatedness- Connection with others (Reciprocity, Genuineness, Coming along Side) • Competency- Strengths of student with Tourette’s (Affirmation, Short-Term Success, Universality) • Autonomy Support- Strengths are celebrated and supported by others • http://video.tourette.ca/index.php?entry_id=5881

  17. Summary • What is Tourette’s Syndrome? • Risk Factors/Strengths • Academic Concerns/Interventions • Social, Emotional Concerns/Interventions • Mental Fitness • https://www.youtube.com/watch?v=mEGlp_7dTbg • https://www.youtube.com/watch?v=gmrlqh3Pt8o

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