Tanya Alvarez SUM2016-CONT505 Tourette Syndrome Tanya Alvarez SUM2016-CONT505

Overview of the Topic Tourette Syndrome or TS is a neurological disorder characterized by involuntary movements and sounds called tics. Reference for Infographic

Associated Issues TS is a disorder of the nervous system. 90% of people with TS have another disorders which makes it hard to diagnose. Here are some common related issues: Attention Deficit Hyperactivity Disorder (ADHD) Obsessive-Compulsive Disorder (OCD) Anxiety Depression Reference for Infographic

Online Resources/References Tourette Syndrome Foundation of Canada CHEO Tourette Syndrome Fact Sheet-National Institute of Neurological Disorders and Stroke Tourette Syndrome-MedinePlus from the US National Library of Medicine Tourette Foundation of Canada-Ottawa Chapter Tourette SYndrome Fact Sheet-National Institute of Neurological Disorders and Stroke Kids Health -Information for kids, teens and parents from Nemour Foundation Tourette Syndrome-Children’s Mental Health Ontario Classroom Strategies and Techniques for Students with Tourette Syndrome Tourette's syndrome -- why it doesn’t define me | TEDxAlbertopolis eMentalHealth.ca Mental Health Services, Help & Support in Your Community Basic Concepts of CBIT - Comprehensive Behavioral Intervention for Tics Catalog of Accommodations for Students with Tourette Syndrome, Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Disorder

Information About the Syndrome Definition: TS is a brain disorder where people make involuntary repeated movement or sound called tics. Tics appear in childhood. People who have tics can not stop it! There are 2 types of Tics & they can be simple or complex. Reference for InfoGraphic

Information About the Syndrome Causes: The cause of TS is unknown. 3X more males are affected than females. It’s a chronic condition. It is worse during the teen years & improves into adulthood. Research shows that it’s inheritable. Research shows that the area of the brain affected has to do with movement & control of behavior. Tics are caused by a hypersensitivity to dopamine, the neurotransmitter that carries messages about movement. Researchers continue to study the brain and genetic basis of TS to gain a better understanding of the causes.

Information About the Syndrome Diagnosis: There is no single test. A physician can refer you to a neurologist if necessary. TS can be diagnosed if a person has both motor & vocal tics, and has had tic symptoms for at least a year. Click here to view the DSM-5 Diagnostic Criteria for TS

Information About the Syndrome Medical Information: No medication is needed unless the tics interfere with daily routines. Behavioral treatment & training can help people with tics manage them. First, there is the Habit Reversal Therapy, where people identify their tics outloud & learn a new behaviour that cannot happen at the same time as their tics. Then, there is the Comprehensive Behavioral Intervention, which includes the habit reversal, education about TICS & relaxation techniques. Therapy can help with social & emotional problems.

Information About the Syndrome Support for Parents: There are many services available for parents such as walk-in Clinics (Counselling, treatment & support services), private practices (individual or family counselling) and counselling & therapy (assessment services). Here is a link to finding mental health services & support in your community. I would share the following resources with parents in my community: Tourette Syndrome Foundation of Canada (Parent Forum) (CHEO (Parents can borrow books) Children’s Mental Health Ontario (Info on how to access mental health information & support for children in Ontario) Kids Help Phone 1-800-668-6868

Information About the Syndrome Behaviour Characteristics The Tics vary in different contexts, types, severity & frequency. The Tics usually start in the head & neck area and progress to the extremities. Motor tics usually precede vocal tics, and simple tics usually precede complexe tics. Tics are worse when the person is tired, stressed, anxious or excited. Tics can also occur during sleep. Common Tics Seen in TS: Simple Motor Tics Eye blinking Head jerking Nose twitching Complex Motor Tics Touching or smelling objects Repeating observed mouvement Hopping, jumping, kicking a leg out Simple Vocal Tics Grunting Coughing.throat clearing Barking Complex Vocal Tics Repeating one’s own word/sentence Repeating others words/sentence

Great Video Explaining What is TS! This is a great 8 minutes video explaining what TS is. It was produced by khanacademymedicine.

Role of Community Agencies That support family, school professionals in educating the students with the syndrome. The Tourette Syndrome Foundation of Canada gives presentations in the Ottawa region to educators and provides information on TS and related disorders. They will share some strategies that work well with students with TS. Also, they can present to your class and explain TS to your students. In 2005, they sent an Educator’s Resource Kit to schools in the Ottawa area. I wonder if this kit is still available? Children’s Mental Health Ontario represents over 85 community based children’s mental health centres, where parents, families, educator & children can find services in Ontario Tourette Canada offers various services, programs & resources to parents, educators & youth. Volunteers can visit your classroom to raise awareness! Follow them on Twitter @TouretteCanada Special Needs Roadmaps is a great resource to help parents understand the Ontario education system for children with special needs. Follow them on Twitter @ONTSpecialNeeds

Strategies for Successfully Educating the Child with TS In an inclusive or specialized program classroom, it is important to: Include a daily exercise programs & participation in sports. Remember that tics tend to improve when a person is calm or engaged in a focus activity Remember that students with TS need a compassionate & tolerant environment. Teach the class about TS. Include a flexible learning environment (e.g., private room, safe place, stationary bicycle in the class, oral assessments, strategic seating… On-going communication with the family is crucial for the success of the student with Ts. What do you think?

Specialized Training For more example of accommodations click here! Social Skills Training: & Social Acceptability plays an important part in the student's self-esteem and making friends. We must educate other students about TS in order to stop the bullying, teasing, exclusion, depression,… Self-Esteem & Advocacy Skills: Student may need some social stories or role playing games to develop self-advocating, listening skills, organization, manners, cooperation strategies... Literacy & Numeracy Training Motor tics (e.g., eye blinking) may interfere with reading, consider having ebooks for the students and giving oral explication (1 step at a time) instead of written ones. Some student have difficulty learning basic computational math skills, using manipulatives and graphic organizers might help the student. Incorporating hands on and physical activity in math would benefit the student (e.g., Measuring how far in hops is a distance). Use of Technology Training Handwriting difficulties are common. Here are some suggestions for accommodations: using a tablet or a chromebook, providing notes, using extensions like Google Read & Write or Speech to Text… Workplace Preparation Training Educators are encouraged to practice positive responses to the TS symptoms. It’s not a misbehaviour. For more example of accommodations click here!

Cautions For Educators Working With Children With TS Each students with TS has a unique profile, the IEP must meet his/her specific needs Some students may have minor tics & may not need any support yet. They may require support if their tics increase. Be mindful of other coexisting conditions. Accommodations & modifications may be needed in order for the student to be successful. Student may require supports from: Occupational Therapist, Speech Pathologist, Counselor, EA, Social Work… Remember to use the word symptoms when describing the student’s profile. The word behaviour would suggest that the student is doing the symptom on purpose. Keep a list of the students symptoms to help identify patterns. Be attentive to triggers. Ignore the symptoms, he/she is not doing it on purpose. No reward or punishment will help the student control his/her tics.

Think About It... How can teachers ensure that a student with this syndrome reaches their full potential?