Category — 2.1 Children with Nervous System Disorders: Tourette Syndrome (TS)

Tourette syndrome is a brain disorder. It involves involuntary verbal and/or motor tics (a tic is an involuntary oral or motor movement). The child has very little or no control over the tics. If the child tries to control the tics, they will come back with more intensity, so it is recommended to just let the tics happens. Tourette syndrome is much more common in boys than in girls. Tourette syndrome can be a lifelong condition. There is no cure. In some children, Tourette syndrome disappears early in the adult years. It usually starts in the middle childhood or teen years.

The tics in Tourette syndrome are not always the same. They sometimes change. A child whose tics are mainly eye blinking might suddenly start to clear his or her throat. Also, tics can be verbal (please see below) and then become motor (please see below). Tics can occur a few times a day or many times a day. Their intensity also varies. Tics can get worse if the child is under stress or emotional distress. Although emotional distress does not cause Tourette syndrome, it can make it worse.

Some of the symptoms of Tourette syndrome are:

• Verbal tics:
  • Clearing the throat;
  • Barking;
  • Making funny and unusual noises;
  • Blurting out obscenities (for example, cursing);
  • Repeating words over and over again.

  Motor tics:

  • Blinking the eyes over and over;
  • Jerking (or moving) the head;
  • Shrugging the shoulders;
  • Touching others;
  • Smelling objects;
  • Flapping hands.

Some children with Tourette syndrome take medication that seems to make the tics happen less often  and makes them less severe. Others may need psychotherapy  if they are experiencing unusual stress in their lives. Another reason a child might require psycho-therapy is because Tourette syndrome often occurs with other disorders, including ADHD, autism and anxiety-based disorders.

Most children with TS have average intelligence. TS can sometimes exist alongside other disorders, such as:

• ADHD;
• Learning disabilities;
• Obsessive-compulsive disorder;
• Anxiety-based disorders;
• Sleep disorders.

Most children with TS lead perfectly typical lives. They attend school and participate in sports (Fig. 1) . They engage in all sorts of extra-curricular activities.

Some children with TS can benefit from the following services:

• Special education services: if children with TS are also diagnosed with ADHD, or a learning disability, they may benefit from specialized instruction. This specialized instruction will be provided to them, by the regular education and special education teachers, through the Individual Education Plan (IEP) team;
• Counseling: some children with TS have a negative self-esteem and low self-confidence (Fig. 2). Those who do could benefit from counseling sessions from the school counselor;
• Psycho-therapy: some children with TS have an anxiety-based disorder, such as obsessive-compulsive disorder (OCD). Those who do benefit greatly from psychotherapy sessions with a clinical psychologist. Some may also benefit from anti-obsession medication that is usually prescribed by a psychiatrist;
• Behavior intervention: children with TS could benefit from relaxation techniques that could help lower the frequency and intensity of their tics. Such techniques could include learning how to breathe deeply.
• Sensory integration therapy: some children with TS have sensory integration difficulties. Those who do could benefit from the services of an OT with specialization in sensory integration therapy.

Children with Tourette syndrome are not usually placed on an Individual Education Plan (IEP) at school, unless they are diagnosed with another condition (please see above). But there are some things that the teacher can do, in order to make the child as happy as possible in the classroom. These are:

• Making sure the child feels welcome and safe in the classroom;
• Explaining Tourette syndrome to everyone in the classroom, and mentioning that tics are beyond the control of the child;
• Allowing the child to leave the classroom for a bit if he or she feels that a serious tic is about to happen;
• Making sure the child has enough space for complex motor tics he or she may have like jerky leg movements;
• Letting the child to take exams in a separate room so he or she can concentrate and also so his or her classmates can concentrate.

For more information about Tourette syndrome, please visit the BC Ministry of Education’s Tourette syndrome website.

Most individuals with Tourette syndrome grow up to lead happy, healthy and fulfilling lives (Fig. 1). They are usually well-adjusted people who hold all types of jobs.

Figure 1. Happy life

see References

http://www.bced.gov.bc.ca/specialed/awareness/67.htm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001744/

http://www.tsa-usa.org/