Tourette Syndrome Script

Jenna Mirand & JoEllen Nemeth

Slide 1:

Tourette Syndrome is a condition that affects the nervous system, causing people to make
movements and sounds (also known as motor and vocal tics) that they cannot control.
Individuals with Tourette Syndrome, which is also known as TS, have had at least two motor tics
and at least one vocal tic in some combination over the course of more than a year.

Slide 2:

Motor tics are movements. Simple motor tics include eye blinking, mouth movements,
head bobbing/jerking, shoulder shrugging, neck stretching, nose twitches, and arm jerking.
Complex motor tics include touching or smelling objects, repetitive movements, patterned
walking, gesturing obscenities, hopping, and twisting or bending movements.

Slide 3:

Vocal (phonic) tics produce a sound. Simple vocal tics include, but are not limited to
sniffing, throat clearing, grunting, hooting, and shouting. Complex vocal tics are words or
phrases that may or may not be recognizable but that consistently occur out of context and self
repetition. Coprolalia is the involuntary outburst of obscene words or socially inappropriate and
derogatory remarks.

Slide 4:

Tics can also worsen if one is stressed, excited, anxious or if they are ill. They can occur
during sleep, change over time and can get worse in the early teenage years, but can improve
during adulthood. These tics can also vary in type, frequency and severity.

Slide 5:

About 50% of people with Tourette Syndrome also have symptoms of ADHD, also
known as Attention Deficit Hyperactivity Disorder. These individuals may also have issues
paying attention, sitting still, and finishing tasks. Tourette Syndrome can also cause problems
with anxiety, learning disabilities and Obsessive Compulsive Disorder.

Slide 6:

OCD is a common, chronic and long-lasting disorder in which a person has excessive
thoughts and behaviors they can't control. For example, washing your hands over and over again.
These symptoms can interfere with all aspects of life, such as work, school, and personal
relationships.
Slide 7:

Although exact causes are unknown, medical professionals state there are genetic and
environmental factors. Genetic studies have indicated that TS is inherited as a dominant gene,
with about a 50% chance of parents passing the gene on to their children.Tourette Syndrome is
possibly influenced by dopamine & serotonin passed through neurotransmitters in the brain.

Slide 8:

Risk factors for Tourette syndrome include Family history. Having a family history of
Tourette syndrome or other tic disorders might increase the risk of developing Tourette
syndrome. Also, males are about three to four times more likely than females to develop Tourette
syndrome.

Slide 9:

Some complications of Tourette syndrome frequently involves behavioral and social

challenges that can harm your self-image. These conditions associated with this disorder are
ADHD, OCD, Autism spectrum disorder, learning disabilities, sleep disorders, depression,
anxiety disorders, pain related to tics, especially headaches and anger-management problems.

Slide 10:

Five essential things teachers must know about Tourette Syndrome are co-occurring
conditions. These conditions, as I mentioned before are OCD, ADHD, LD and Sensory
Integration Dysfunction. This gives teachers a better understanding on how to help meet these
student’s needs. Teachers should also know that stress increases tics. Some examples of this are
transitioning from one activity to another, crowded hallways, timed activities, depending on co-
occurring conditions, additional stressors may include condition-specific triggers.

Slide 11:

A great idea is offering students a quiet place to prevent stress or de-escalate such as a
reading corner, access to headphones with music or allow a trip to the nurse or counseling office
is great idea. Stay positive. Don’t penalize for sloppy work, instead encourage the use of
assistive technology and graphing paper. Waiving time limits and testing separately can best
serve your student with TS.

Slide 12:

Also important for teachers to note, is that tics are involuntary and blame should not be
placed on the student. A student may be able to temporarily control a tic (like a sneeze) but the
tension may build up until the action is completed and tension released. As always, be very
patient, understanding and calm with students.
Slide 13:

Praise and positive feedback is very important. Bring positive attention to the student's successes
and praise specific actions or behaviors. Do not bring negative attention to the tic- Remember it
is involuntary. Having Sub-folders is also a good idea. Note in the folder which student has TS
and explain what behaviors are to be expected.

Slide 14:

Student assistance is available in several ways. Tablets can be used for writing
assignments and applications such as talk-to-text can assist with other needs. Graphic organizers
are good way to help students organize their thoughts while writing. Daily planners help to
prioritize assignments and graph paper can help keep school work neater.

Slide 15:

Keep an Open Door. It is very helpful to communicate with the student openly about
situations, allowing for student involvement in the resolution. Involve the parent if needed. Be
available for the student when they need you. Create a hand-signal for the student to use to
eliminate embarrassment and decrease stress. This will help the student to become more
comfortable in the classroom.

Slide 16:

Currently there is no cure for Tourette Syndrome. Minor tics are rarely treated and often
dissipate after adolescence. Severe and injury-causing tics may find relief in medication such as
Abilify, but may not help everyone the same. A new drug, Ecopipam has shown to decrease tics
with little side effect. Medicinal Cannabis is also being researched for symptom relief.

Slide 17:

Comprehensive Behavioral Intervention for Tics (CBIT) ,a form of Behavioral Therapy

can be as effective as medication in some cases. The patient is taught to recognize the urge to tic
(like a scratch needs itching). Once aware of the urge, a new behavior is practiced and
eventually replaces the tic. Deep Brain Stimulation is another Treatment by implanting an
electrode in the brain to alter activity.- currently FDA approved for patients with Parkinson's
Disease.

Slide 18:

Knowledge is Power. Educating the public and those within the school about Tourette
Syndrome is essential to a student who suffers from tics. Teaching sensitivity and awareness to
conditions caused by TS will decrease embarrassment, stop teasing and bullying while
promoting inclusion, raise acceptance and academic success and increase the self-image of the
person with Tourette Syndrome.
Slide 19:

Those children with severe symptoms or a co-occurring disability should have an IEP or
Building 504 reflecting their individual needs, accommodations and or modifications. What are
some other ways, You might be able to increase academic success or decrease stressors for a
student with Tourette Syndrome in your classroom?

Slide 20:

Tourette Syndrome is found across all ethnic groups affecting 1 in 360 children with an
average onset during elementary school affecting more boys and than girls. Often co-occurring
with other disorders and learning disabilities, knowledgeable teachers can make the learning
environment a positive one for all in the classroom. Be aware, Be patient, be understanding and
continue to be supportive.

Resources

Center for Disease Control. (2018, June 05). Tourette Syndrome (TS). Retrieved September 12, 2018,
from https://www.cdc.gov/ncbddd/tourette/index.html

Hasan, S. (Ed.). (2016, October). Tourette Syndrome. Retrieved September 12, 2018, from
https://kidshealth.org/en/parents/tourette.html

Mayo Clinic. (2018, August 08). Tourette syndrome. Retrieved September 14, 2018, from
https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/symptoms-causes/syc-20350465

National Institute of Neurological Disorders. (2012, January). Tourette Syndrome Fact Sheet. Retrieved
September 14, 2018, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-
Sheets/Tourette-Syndrome-Fact-Sheet

Roberson MD, W. C. (2018, August 30). Tourette Syndrome and Other Tic Disorders Clinical
Presentation: History, Physical Examination. Retrieved September 16, 2018, from
https://emedicine.medscape.com/article/1182258-clinical

Tourette Association of America. (n.d.). What is Tourette Syndrome? Retrieved September 12, 2018,
from https://www.tourette.org/about-tourette/overview/what-is-tourette/

Tourette Association of America. (2017). Progress in Scientific and Medical Research. Retrieved
September 14, 2018, from http://www.tourette.org/media/TAAresearch6panelfinalINORDER.pdf

WebMd. (n.d.). Tourette's Syndrome. Retrieved September 14, 2018, from

https://www.webmd.com/brain/tourettes-syndrome#1