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Georges Gilles de la Tourette Tourette’s Syndrome: Overcoming the Myths
An informational presentation designed to raise awareness in the educational community about Tourette Syndrome. The artwor...
What we think we know about Tourette’s 1.  A student with Tourette’s Syndrome will make obvious and disfiguring physical m...
Some of the Myths and Fallacies About Tourette’s Syndrome (TS) Fallacy #1: Tourette Syndome is rare. Fallacy #2: Shouting ...
<ul><li>Diagnostic Criteria for Tourette’s Syndrome </li></ul><ul><li>Both multiple motor and one or more vocal tics have ...
Simple Tics   Motor  Phonic <ul><li>Eye Blinking </li></ul><ul><li>Nose Wrinkling </li></ul><ul><li>Jaw Thrusting </li></u...
Complex Tics   Motor  Phonic <ul><li>Hand Gestures </li></ul><ul><li>Jumping/Squatting </li></ul><ul><li>Touching/Pressing...
Click here to listen to presentation by Susan Conners, TSA Education Specialist
Susan Conners, M.Ed., Education Specialist, Tourette Syndrome Association
Comordid Conditions that Complicate the Management of Tourette Syndrome <ul><li>Attention Deficit Hyperactivity Disorder (...
Dispelling Some of the Fallacies About Tourette’s Syndrome Fallacy #1: Tourette Syndome is rare. Fact:  Tourette’s occurs ...
Fallacy #4: Primary presenting complaint is always tics. Fact:  Presenting complaint is often complications from a  comorb...
TS in the Educational Environment
“ Red Flag”  Indicators of  Possible TS in Students <ul><li>Motor and phonic Tics. </li></ul><ul><li>Poor academic perform...
 
Physical Manifestations <ul><li>Understanding tics: </li></ul><ul><ul><ul><li>Tics are an irresistible urge </li></ul></ul...
Tics are an irresistible urge!
Vocal Manifestations <ul><li>Understanding vocalizations/verbalizations:   </li></ul><ul><ul><li>Uncontrollable. </li></ul...
Psychological Manifestations <ul><li>Related disorders/issues: </li></ul><ul><li>Learning Disabilities </li></ul><ul><li>A...
Susan Conners, M.Ed., Education Specialist, Tourette Syndrome Association
Social Manifestations <ul><li>Possible related issues: </li></ul><ul><li>Fine motor and and visual motor deficits </li></u...
 
Evaluation and Assessment of TS <ul><li>Complete medical physical (after age 9) </li></ul><ul><li>Complete medical history...
Understanding a TS Student in the Classroom/School Environment Click here to listen to interview with a 16 year-old with T...
Excerpt from interview with Kevin, a 16 year-old with Tourette Syndrome
Recommendations  for Teachers <ul><li>Look at the whole child not the disorder! </li></ul><ul><li>Tics can increase in fre...
Modifications in Classroom Setting <ul><li>Create and sustain a positive, accepting attitude in the classroom. </li></ul><...
5. The use of a computer or word processor (alternatives to hand writing). 6. Frequent breaks out of the classroom to rele...
10.  Allow opportunities for physical movement  throughout day school day. 11.  Lower classroom stress levels as much as  ...
Excerpt from interview with Kevin, a 16 year-old with Tourette Syndrome
The Most Important Factor:   Parental Involvement in the Educational Process <ul><li>Open lines of communication between s...
Resources: <ul><li>It’s Not Just The Tics: Classroom Learning and Behavioral Issues with Tourette Syndrome  ; Linda Abbott...
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Overcoming The Myths About Tourettes 2

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Transcript of "Overcoming The Myths About Tourettes 2"

  1. 1. Georges Gilles de la Tourette Tourette’s Syndrome: Overcoming the Myths
  2. 2. An informational presentation designed to raise awareness in the educational community about Tourette Syndrome. The artwork used in this presentation are actual drawings and descriptions created by children with Tourette Syndrome. Designed by Paul Biron For Lynn Siegel
  3. 3. What we think we know about Tourette’s 1. A student with Tourette’s Syndrome will make obvious and disfiguring physical movements. 2. A student with Tourette’s Syndrome will shout obscenities. 3. A student with Tourette’s Syndrome will have tics that are uncontrollable and disruptive. 4. A student with Tourette’s Syndrome will have serious psychological and behavioral problems .
  4. 4. Some of the Myths and Fallacies About Tourette’s Syndrome (TS) Fallacy #1: Tourette Syndome is rare. Fallacy #2: Shouting obscenities is a defining characteristic. Fallacy #3: Patients are easily recognized by their tics. Fallacy #4: Primary presenting complaint is always tics. Fallacy #5: Diagnosis is catastrophic for most patients.
  5. 5. <ul><li>Diagnostic Criteria for Tourette’s Syndrome </li></ul><ul><li>Both multiple motor and one or more vocal tics have been present at sometime during the illness, although not necessarily concurrently. </li></ul><ul><li>The tics occur many times a day (usually in bouts) nearly every day or intermittently throughout a period of more than one year. </li></ul><ul><li>The onset is before 18 years. </li></ul><ul><li>The disturbance is not due to the direct physiological effects of a substance (e.g., stimulants) or a general medical condition. </li></ul>
  6. 6. Simple Tics Motor Phonic <ul><li>Eye Blinking </li></ul><ul><li>Nose Wrinkling </li></ul><ul><li>Jaw Thrusting </li></ul><ul><li>Facial Grimacing </li></ul><ul><li>Shoulder Shrugging </li></ul><ul><li>Wrist Snapping </li></ul><ul><li>Neck/Limb Jerking </li></ul><ul><li>Abdominal Tensing </li></ul><ul><li>Sniffing/Coughing </li></ul><ul><li>Grunting/ Snorting </li></ul><ul><li>Throat Clearing </li></ul><ul><li>Blowing </li></ul><ul><li>Chirping </li></ul><ul><li>Clicking </li></ul><ul><li>Sucking Sounds </li></ul><ul><li>Screaming </li></ul>
  7. 7. Complex Tics Motor Phonic <ul><li>Hand Gestures </li></ul><ul><li>Jumping/Squatting </li></ul><ul><li>Touching/Pressing </li></ul><ul><li>Stomping </li></ul><ul><li>Facial Contortions </li></ul><ul><li>Repeatedly Smelling an Object </li></ul><ul><li>Deep Knee Bends </li></ul><ul><li>Retracing Steps </li></ul><ul><li>Twisting When Walking </li></ul><ul><li>Singing Words or Phrases </li></ul><ul><li>Speech Blocking (e.g. stuttering </li></ul><ul><li>or other interruption to speech) </li></ul><ul><li>Meaningless Changes in Pitch, Emphasis, or Volume of Speech </li></ul><ul><li>Palilalia (repeating one’s own sounds or words) </li></ul><ul><li>Echolalia (repeating the last-heard sound, word, or phrase) </li></ul><ul><li>Coprolalia (inappropriate expression of a socially unacceptable word or obscenity) </li></ul>
  8. 8. Click here to listen to presentation by Susan Conners, TSA Education Specialist
  9. 9. Susan Conners, M.Ed., Education Specialist, Tourette Syndrome Association
  10. 10. Comordid Conditions that Complicate the Management of Tourette Syndrome <ul><li>Attention Deficit Hyperactivity Disorder (ADHD) </li></ul><ul><li>Obsessive Compulsive Behaviors or Disorder (OCD) </li></ul><ul><li>Oppositional Defiant Disorder (ODD) </li></ul><ul><li>Mood and Sleep disorders </li></ul><ul><li>Executive dysfunctions </li></ul><ul><li>Self-injurious behaviors </li></ul><ul><li>Personality disorders </li></ul>
  11. 11. Dispelling Some of the Fallacies About Tourette’s Syndrome Fallacy #1: Tourette Syndome is rare. Fact: Tourette’s occurs in about 1% of child population. Fallacy #2: Shouting obscenities is a defining characteristic. Fact: Relatively few TS patients yell obscenities (Caprolalia). Fallacy #3: Patients are easily recognized by their tics. Fact: Tics can be suppressed.
  12. 12. Fallacy #4: Primary presenting complaint is always tics. Fact: Presenting complaint is often complications from a comorbid condition ( i.e. ADHD, OCD, LD, ODD). Fallacy #5: Diagnosis is catastrophic for most patients. Fact: Diagnosis for most patients is a relief and the understanding it brings after a prolonged period of uncertainty.
  13. 13. TS in the Educational Environment
  14. 14. “ Red Flag” Indicators of Possible TS in Students <ul><li>Motor and phonic Tics. </li></ul><ul><li>Poor academic performance. </li></ul><ul><li>Very poor or sloppy handwriting. </li></ul><ul><li>Appears disorganized. </li></ul><ul><li>Difficulty sustaining attention. </li></ul><ul><li>Difficulty copying things correctly from board, no matter how hard they try. </li></ul>
  15. 16. Physical Manifestations <ul><li>Understanding tics: </li></ul><ul><ul><ul><li>Tics are an irresistible urge </li></ul></ul></ul><ul><ul><ul><li>Tics change over time </li></ul></ul></ul><ul><ul><ul><li>Often there are periods with no tics </li></ul></ul></ul><ul><ul><ul><li>Control of tics varies from day to day </li></ul></ul></ul><ul><ul><ul><li>Control of tics varies from child to child </li></ul></ul></ul><ul><ul><ul><li>“ Being nervous” does not cause tics, although stress can make them work. </li></ul></ul></ul>
  16. 17. Tics are an irresistible urge!
  17. 18. Vocal Manifestations <ul><li>Understanding vocalizations/verbalizations: </li></ul><ul><ul><li>Uncontrollable. </li></ul></ul><ul><ul><li>Explicit verbal outbursts of words or phrases. </li></ul></ul><ul><ul><li>Outbursts of sounds, quiet or explosive. </li></ul></ul><ul><ul><li>Outbursts erupt without warning. </li></ul></ul><ul><ul><li>Include palilalia (repeating one’s own words), echolalia (repeating the words of others), or caprolalia ( uncontrollable uttering of obscenities or socially unacceptable words). </li></ul></ul>
  18. 19. Psychological Manifestations <ul><li>Related disorders/issues: </li></ul><ul><li>Learning Disabilities </li></ul><ul><li>ADD and ADHD </li></ul><ul><li>OCD and ODD </li></ul><ul><li>Mood and sleep disorders </li></ul><ul><li>Personality disorders. </li></ul><ul><li>Self-injurious behaviors. </li></ul>Click here to listen to presentation by Susan Conners, TSA Education Specialist
  19. 20. Susan Conners, M.Ed., Education Specialist, Tourette Syndrome Association
  20. 21. Social Manifestations <ul><li>Possible related issues: </li></ul><ul><li>Fine motor and and visual motor deficits </li></ul><ul><li>Behavioral disorders </li></ul><ul><li>Aggressive behavior </li></ul><ul><li>Explosive reactions/temper </li></ul><ul><li>Social isolation </li></ul><ul><li>Impulsive </li></ul>
  21. 23. Evaluation and Assessment of TS <ul><li>Complete medical physical (after age 9) </li></ul><ul><li>Complete medical history </li></ul><ul><li>Complete scholastic history </li></ul><ul><li>Psychological, cognitive, and behavioral evaluation </li></ul><ul><li>Separate parent and student interviews (especially with adolescents) </li></ul>
  22. 24. Understanding a TS Student in the Classroom/School Environment Click here to listen to interview with a 16 year-old with Tourette Syndrome.
  23. 25. Excerpt from interview with Kevin, a 16 year-old with Tourette Syndrome
  24. 26. Recommendations for Teachers <ul><li>Look at the whole child not the disorder! </li></ul><ul><li>Tics can increase in frequency if attention is drawn to them (suggestibility). </li></ul><ul><li>Try to ignore the tics if possible. </li></ul><ul><li>Don’t scold or correct for tics! </li></ul><ul><li>Educate other children (and staff) in classroom about Tourette’s Syndrome. </li></ul><ul><li>Children with TS need intellectual stimulation! </li></ul>
  25. 27. Modifications in Classroom Setting <ul><li>Create and sustain a positive, accepting attitude in the classroom. </li></ul><ul><li>Foster a sense of competence and accomplishment. </li></ul><ul><li>Preferential seating for close teacher attention (take types of tics into consideration of placement). </li></ul><ul><li>Consider testing privately and waive time limits. </li></ul>
  26. 28. 5. The use of a computer or word processor (alternatives to hand writing). 6. Frequent breaks out of the classroom to release tics. 7. Assignments broken into more manageable pieces. 8. Use of a daily assignment sheet verified by teacher. 9. Mandatory in-service for all teachers and staff working with child.
  27. 29. 10. Allow opportunities for physical movement throughout day school day. 11. Lower classroom stress levels as much as possible. 12. Establish a moderately structured learning environment. 13. Work on socialization skills with child. 14. Caution should be used in interpreting I.Q. scores as estimates of cognitive potential. Click here to listen to interview with a 16 year-old with Tourette Syndrome.
  28. 30. Excerpt from interview with Kevin, a 16 year-old with Tourette Syndrome
  29. 31. The Most Important Factor: Parental Involvement in the Educational Process <ul><li>Open lines of communication between school and home (parents) </li></ul><ul><li>Frequent calls, letters, and daily notes to parents about child’s progress </li></ul><ul><li>Educate yourself about Tourette’s Syndrome and its related components </li></ul><ul><li>Frequent visits by parents to school/classroom </li></ul>
  30. 32. Resources: <ul><li>It’s Not Just The Tics: Classroom Learning and Behavioral Issues with Tourette Syndrome ; Linda Abbott, RN, MSN, Barbara Baron, Ph.D., </li></ul><ul><li>Louise S. Kiessling, MD, FAAP; Department of Pediatrics, Memorial Hospital of Rhode Island; Pawtucket, Rhode Island </li></ul><ul><li>Tourette Syndrome Association (TSA); http://tsa-usa.org </li></ul><ul><li>Learning Problems and the Student with TS ; Susan Conners, M.Ed., Education Specialist, TSA,Inc. </li></ul><ul><li>Teaching Children with Tourette Syndrome ; ERIC Digest E570 </li></ul><ul><li>Tourette Syndrome in the Classroom ; Judy Wertheim, M.S.; A TSA </li></ul><ul><li>Education Publication </li></ul><ul><li>Interview with Susan Conners, M.Ed.,TSA Education Specialist </li></ul><ul><li>Taped Presentation by Susan Conners, M.Ed.,TSA Education Specialist </li></ul><ul><li>Taped interview with Kevin Siegel, 16 year-old with Tourette Syndrome </li></ul>
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