This document provides information about Tourette syndrome from a children's newsletter. It describes the characteristics of Tourette's such as vocal and motor tics. It discusses simple and complex tics as well as serious tics involving inappropriate words. It also outlines co-occurring conditions, possible causes, prevalence, diagnosis, treatment options, and accommodations that can help children with Tourette's in the classroom.
Tourette syndrome (TS) is a neurological
disorder characterized by repetitive, stereotyped, involuntary movements and
vocalizations called tics. The disorder is named for Dr. Georges Gilles de la
Tourette, the pioneering French neurologist who in 1885 first described the
condition in an 86-year-old French noblewoman.
The early symptoms of TS are typically
noticed first in childhood, with the average onset between the ages of 3 and 9
years. TS occurs in people from all ethnic groups; males are affected about
three to four times more often than females. It is estimated that 200,000
Americans have the most severe form of TS, and as many as one in 100 exhibit
milder and less complex symptoms such as chronic motor or vocal tics. Although
TS can be a chronic condition with symptoms lasting a lifetime, most people
with the condition experience their worst tic symptoms in their early teens,
with improvement occurring in the late teens and continuing into adulthood.
School Project I presented in November 2009. Brief description: "Tourette Syndrome (TS) is a neurological disorder characterized by tics: involuntary, rapid, sudden movements or vocalizations that occur repeatedly in the same way. The cause has not been established and as yet there is no cure."
Tourette syndrome (TS) is a neurological
disorder characterized by repetitive, stereotyped, involuntary movements and
vocalizations called tics. The disorder is named for Dr. Georges Gilles de la
Tourette, the pioneering French neurologist who in 1885 first described the
condition in an 86-year-old French noblewoman.
The early symptoms of TS are typically
noticed first in childhood, with the average onset between the ages of 3 and 9
years. TS occurs in people from all ethnic groups; males are affected about
three to four times more often than females. It is estimated that 200,000
Americans have the most severe form of TS, and as many as one in 100 exhibit
milder and less complex symptoms such as chronic motor or vocal tics. Although
TS can be a chronic condition with symptoms lasting a lifetime, most people
with the condition experience their worst tic symptoms in their early teens,
with improvement occurring in the late teens and continuing into adulthood.
School Project I presented in November 2009. Brief description: "Tourette Syndrome (TS) is a neurological disorder characterized by tics: involuntary, rapid, sudden movements or vocalizations that occur repeatedly in the same way. The cause has not been established and as yet there is no cure."
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7. Characteristics
People with Tourette’s make involuntary movements
or noises. These are called tics.
Simple Tics: sudden, brief, repetitive movements that
involve a limited number of muscle groups
Complex Tics: distinct, coordinated patterns of
movements involving several muscle groups
Vocal Tics: noises that a person makes with their voice
Motor Tics: tics involving movement of the body
8. Simple Tics Complex Tics
Vocal Tics Throat-clearing,
Sniffing
Grunting
Snorting
Barking
Hiccupping
Yelling
Using different tones of
voice
Repeating one’s own words
Repeating others’ words
Using swear words
Motor Tics Blinking
Facial Movements
Shrugging the shoulders
Arm jerking
Head jerking
Shoulder jerking
Sticking the tongue out
Finger flexing
Touching objects
Hopping
Jumping
Bending
Twisting
Touching the nose
Touching other people
Obscene gesturing
Flapping the arms
9. Serious Tics:
Coprolalia: uttering socially inappropriate words such
as swearing
Echolalia: repeating the words or phrases of others
Self-harming tics: scratching oneself, punching
oneself, hitting one’s head on hard objects.
10. Things to keep in mind
No case is typical.
Tics can change over time.
Tics can worsen and get better over time.
Often worst during adolescence.
Certain things can worsen tics.
Stress, anxiety, excitement, shirts with tight collars,
hearing someone else cough or clear their throat.
11. Holding in Tics
Tics are often preceded by a premonitory urge.
Trying not to tic:
Can feel like holding your breath
Trying not to hiccup
Trying not to blink
12. Behavioral Therapy
It was a common opinion that any suppression of tics
would produce more in the future, so professors
recommended not to ever encourage suppressing tics.
Now people have been working with cognitive
behavior therapy and have seen some improvements.
Tic-detector experiment
13. Co-Occurring Conditions
79% diagnosed with at least one additional mental
health, behavioral, or developmental condition
64% ADHD
43% Behavioral or conduct problems (ODD or CD)
40% Anxiety problems
36% Depression
Over 1/3 also have OCD
14. Causes
No one knows.
It is thought to be genetic.
Genes may just increase susceptibility for the disorder.
Monozygotic twins show a 50-70% concordance.
Dizygotic twins show a 9% concordance.
Some studied noted abnormal frontal lobe discharges.
15. Prevalence
3 of every 1,000 children 6 through 17 years of age and
living in the United States.
Other studies using different methods have estimated
the rate of TS at 6 per 1,000 children.
27% are reported as having moderate or severe forms
of the condition.
Tourette’s affects all racial and ethnic groups.
Males are affected 3 times more than females.
More common in children.
Tourette’s often decreases or goes away with age.
16. How is Tourette’s Diagnosed
Diagnosis is fairly subjective.
Patients must have a case history of at least 1 year.
Facial tics are usually the first ones displayed.
Patients explain and show doctors their tics, and the
doctor diagnoses them with Tourette’s.
19. 1825 – First Recorded Case
Jean – Marc Gaspard Itard
(1774 – 1838), perhaps most
remembered for his work
with the ‘Wild Child of
Aveyron’, noted the
characteristics of Marquise
de Dampierre.
20. Marquise de Dampierre
26 years of age
Noble, intelligent young lady
“In the midst of a conversation that interests her
extremely, all of a sudden, without being able to
prevent it, she interrupts what she is saying or what
she is listening to with bizarre shouts and with words
that are even more extraordinary and which make a
deplorable contrast with her intellect and
distinguished manner.”
21. Georges Gilles de la Tourette
In 1885, Tourette published
a detailed report of nine
patients who exhibited a
condition with the
characteristics of
twitching, jerking
uncontrollably, crying out,
grunting, or swearing
involuntarily.
22. Maladie des tics convulsifs avec coprolalie
Tourette argued in his report that it was distinct from
other known diseases and disorders of the time.
Cited first example as Marquise de Dampierre.
Because a set of signs and symptoms, a course of
illness, and a predisposing cause had been identified,
Tourette argued that a disease had been described.
This was challenged by Parisian colleagues.
23. Early 20th Century
The psychoanalytic influence on Tourette’s was that it
was a psychiatric problem.
Patients and families were often told that their own
psychological maladjustments were to blame for their
treatments.
Tics were attributed to sexual impulses and/or conflict
between parent and child, resulting in deficits of will
and character.
24. New Research
In 1968, Arthur K. Shapiro
and his wife, Elaine,
treated a patient with
haloperidol. Seeing the
effects the medication had
on the patient, the
Shapiros argued that
Tourette’s was a
neurological rather than a
psychological disorder.
25. Today
Tic disorders are considered to be an inherited
neuropsychiatric disorder.
There are many places in which individuals with
Tourette’s can receive treatment and support.
www.tsa-usa.org
Medical and scientific research
Newsletter for individuals of all ages
Educational strategies and advocacy
Many other features
26.
27. I Have a Chicken
in My Pants
“…Attitude and
knowledge were
everything!! And the
chicken lived happily
ever after.”
29. Ignorance causes…
Stress
Frustration
Task Avoidance
When the stress builds
up within a student, the
tics become much more
prevalent and difficult to
control.
31. Accommodations & Adaptations
Seat children with Tourette’s in the front of the
classroom to enhance attention.
Time-out passes can help to relieve tension and tics.
Eliminate unnecessary items from the student’s desk.
Designate a specific item or two for the student to be
able to fidget with.
Have a private place that the student can go to calm
down and release tics.
32. Accommodations & Adaptations
A buddy system can help provide security and
educational support.
Distribute instructions rather than having the
students write them down.
Reduce the length of homework assignments,
remembering that quality is more important that
quantity.
Allow the student to take tests in a private room and
waive or give an extended time limit.
33. The Best Way to Help
1. As a teacher, be patient
and persevering.
2. Provide the
opportunity for the
child to explain about
Tourette’s to his
classmates.
36. Resources
Article on Special Education Needs
http://www.senmagazine.co.uk/articles/410-how-to-
manage-tourettes-in-the-classroom
Teacher’s Guide to video on Tourette’s – Explores how to
address Tourette’s to an entire classroom
http://www.hbofamily.com/programs/tourettes-
teachers-guide.pdf
CDC page on prevalence of Tourette’s in U.S.
http://www.cdc.gov/ncbddd/tourette/research.html
37. Resources (cont.)
National Tourette Syndrome Association
http://tsa-usa.org/
Site on the special needs of children, page specific to
Tourette
http://www.kidneeds.com/diagnostic_categories/artic
les/teach_child_tourette.htm
Catalogue of accomodations
http://teacherweb.com/NY/ValleyStream13/howellroa
dpbis/CatalogOfAccomidations.pdf
38. Resources (cont.)
Classroom Strategies and Techniques
http://pacfamilyresourcecenter.pbworks.com/f/TS%20
classroom%20strategies%20and%20techniques.pdf
Pamphlet for school on Tourette’s
http://www.tourettes-
action.org.uk/storage/Education%20Issues%20and%2
0Tourette%20Syndrome.pdf
Link to full HBO program
http://vimeo.com/58887624
