Tips for the Classroom
What is it?
Tourette Syndrome (TS) is a “neurological
disorder characterized by tics.” (Nielsen, p.
A tic is an “involuntary, sudden, rapid,
recurrent, nonrhythmic, stereotyped motor
movement or vocalization. It is experienced
as irresistible, but can be suppressed for
varying lengths of time.” (Nielsen, p. 175)
Types of Tics
Motor tics can include eye blinking, nose twitching, lip
smacking, leg jerking or flapping, hitting self or
others, clapping, pinching, kissing, squatting, or any
other combinations of movements done repeatedly.
Vocal tics can include grunts, sniffs, snorts, screams,
stammers, laughs, guttural sounds, clicking, or even
fully formed understandable words. (Nielsen, p. 178)
Other vocal characteristics may include repeating the
speech of others, repeating self, or involuntary speech
of obscenities or socially taboo phrases. (Nielsen, p.
Contrary to the popular portrayal of TS, less than 1/3 of
clinic patients involuntarily shouts obscenities.
(Robertson, p. 427)
The first case was documented in 1825.
(Robertson, p. 426)
Gilles de la Tourette was a French
neurologist who first described it in
1885 with its current definition revolving
around muscle tics. (Robertson, p. 426)
It is estimated that 100,000 Americans have
been diagnosed with Tourette Syndrome, and
three times as many males as females are
affected. (Neilsen, p. 176)
In Special Education classrooms, as many as
12% of students have been diagnosed with
Tourette Syndrome, and up to 28% have
been characterized as having some sort of
tics. (Robertson, p. 426)
Connection with Other
Individuals with TS usually also have
other disabilities or symptoms of other
disabilities. (Nielsen, p. 178)
These most commonly include obsessive
compulsive behaviors, Attention
Deficit/Hyperactive Disorder (ADHD),
anxiety, and depression (Robertson, p.
In order to be diagnosed with Tourette
Syndrome, an individual must meet these 5
requirements. (Nielsen, p. 177)
Both motor and vocal tics have been present at
some time (not necessarily concurrently)
Tics occur multiple times per day throughout a
period of one year.
The disturbance causes marked distress in social,
or occupational functioning.
The onset is before age 18.
The disturbance is not due to direct bodily effects
of the use of a substance or a general medical
Thus far, treatment is purely symptomatic, and there
is no known cure for TS.
Tics are believed to be caused by problems with
neurotransmitters in the brain, so dopamine receptor
blockers are sometimes used to try and alleviate
These blockers can cause severe side effects, and
there is some research to see if tics can be treated
using magnesium and vitamin B6 supplements, which
are safer than stronger drugs.
Trials among children have been rare, due to
necessary legal protection for minors. More trials,
especially among children, are needed to verify the
usefulness of this addition. (Garcia-Lopez et. al, p. 2-9)
First and foremost, what must be understood
is that tics displayed by students are not
voluntary or an attempt to take control from
Keeping this in mind, tics must be
approached differently from other classroom
disruptions. This is mainly because
encouraging a child to suppress his or her
tics will often only have the opposite effect.
Classroom Strategies, cont.
It is important that other students in the class
understand TS and know why the student
makes the noises he/she does. The tics will
be less disruptive when they’re better
understood, and more easily ignored by the
rest of the class.
The best way to approach these tics as a
teacher, unless they become especially
disruptive, is to ignore them completely.
Continually singling the child out will result in
lowered self-image and harm the student’s
learning environment. (“Ask TSA”)
Tic Management Strategies
Tics are often brought on by stressful
environments, and can be alleviated by
allowing the student to take frequent breaks.
Sending the child on an errand to the school
office or library, or even just allowing trips to
get a drink of water or use the restroom can
be enough to help the child relax.
In assigning homework, particularly long-term
assignments, the teacher should make sure
the student is keenly aware of expectations
and exactly when the assignment is due.
(Nielsen, p. 179)
Tic Management Strategies,
Timed tests can also present a problem for
students with TS, so it is always better to
allow the student to work at his or her own
pace. Setting aside a separate time for the
student to take the test might work well to
help the student be successful.
Transition times between activities and
classes can also be stressful, and allowing a
student with TS to leave class a couple
minutes early in order to reduce stress could
also be a successful tactic. (Nielsen, p. 179)
Students with TS
Tourette Syndrome is not a degenerative
disease, and brain function is not affected. A
student with TS may achieve just as highly as
a student without TS.
This allows the teacher to have the same high
expectations for that student as all the other
students in the classroom. These high
expectations will help the child achieve highly.
Garcia-Lopez, R., Perea-Milla, E., Garcia, C. R., Rivas-Ruiz, F.,
Romero-Gonzales, J., Moreno, J., Faus, V., Aguas, G. C.,
Diaz, J. C. R. (2009). New therapeutic approach to
Tourette Syndrome in children based on a randomized
placebo-controlled double-blind phase IV study of the
effectiveness and safety of magnesium and vitamin B6.
Trials, 10(16). doi:10.1186/1745-6215-10-16
Nielsen, L. B. (2009). Brief Reference of Student Disabilities…
With Strategies for the Classroom. Thousand
Oaks, California: Corwin Press.
Robertson, M. M. (2000). Tourette Syndrome, Associated
Conditions and the Complexities of Treatment. Brain,
123(3), 425-462. doi: 10.1093/brain/123.3.425
(2013) Ask TSA. Retrieved from http://www.tsa-