As a teacher and adolescent mental health therapist, I spent over 15 years working with students with a variety of disorders. One of the most dramatic neurological/mental health disorders I encountered in working with this population was Tourette’s disorder. Tourette’s disorder is a very complicated disorder and treatment usually involves working with both mental health practitioners and neurologists. About 65% of students who have Tourette’s disorder will have another diagnosis. Usually the other diagnosis is a condition such as: Attention Deficit/Hyperactivity Disorder, obsessive-compulsive disorder, learning difficulties, trouble processing sensory information, depression and poor impulse control.
While research has advanced regarding Tourette’s disorder, it is still often under diagnosed. In fact, most people are not diagnosed until after they (or those close to them) become aware of the disorder through the media. Scientific research has found Tourette’s is linked to a single gene abnormality. This gene abnormality causes a person to have unusual dopamine and neurotransmitter functioning within their brain chemistry. Research has also found males to be more predisposed to Tourette’s disorder than females.
Tourette’s disorder is marked by frequent bouts of “tics”. Tics are defined as repetitive, unusual vocalizations or body movements. In a situation where a person has Tourette’s disorder these behaviors may include (but are not limited to) things such as: facial twitching, barking, snorting, hopping, arm/leg jerking or twitching, rapid blinking, grunting, finger movement, fist clenching, yelling out various words (including profanities and vulgarities), imitating others, rolling or shrugging shoulders, and/or biting or licking lips. When a person has Tourette’s, these tics will be so severe that they will impair a person’s ability to function in social, academic and/or occupational situations. The impairment is even greater when the person is under stress. The episodes of tics may occur every day or intermittently depending on the severity of Tourette’s a person has. The onset of Tourette’s disorder occurs before a person turns 18.
In working with students who are dealing with Tourette’s disorder, it is important to remember some people are aware of their tics and some are not. So, telling a student to “stop” or “be quiet” may not be helpful because the student may not be aware of what they are doing. Also, some students can control their tics for a few hours and some cannot. For those who can control them, it means that when they do have an episode of tics it will be more intense. For those who cannot, the urge to carry out their tics is all-encompassing. They may want to stop ticing but may be unable to do so.
Since tics are more apparent when a student is under stress, it can be helpful to reduce stressful situations. For example, allowing a student with Tourette’s to take a test in a quiet secluded place without time limits may help lessen their tics prior to and during testing.
Educating other children about Tourette’s may help decrease instances of bullying and teasing for the student with Tourette’s disorder. The more accepting and calm classroom is the less likely a student is to display tics as a result of stress and/or frustration.
It may be helpful, to get permission to speak with any mental health practitioners who are involved with the child. These professionals can help you gain a better understanding of the disorder, and work with you to develop effective interventions for the student in you classroom. Work with them and families to learn the warning signs that a student is being overcome with frustration or stress and about to experience a bout of tics. In turn, you provide to the mental health professional beneficial insight into how the child acts in and academic setting, which can help the professional treat the child in a more holistic manner.
