Tics are considered involuntary movements. There are a wide variety of tics, ranging in type and severity of expression:

Facial grimacingGrunting or clearing throat, clicking Rapid eye blinking,Shoulder shrugging or a jerk of the head or shouldersShouting, making snort sounds, blurting obscenities

Impact on Learning

Children and teens experiencing Tourette syndrome may be frightened or embarrassed by the disruptive nature of their tics while at school. When Tourette’s is not understood by teachers, school staff and other students, the child with Tourette’s may face rejection or ridicule. A child or teen with Tourette’s may have difficulty focusing and paying attention at school if they are thinking about their tics, and worrying about who may be noticing them. Children and teens with Tourette’s may have difficulty making friends at school. This can be caused by embarrassment felt by the child or teen with Tourette’s, or because other children and teens are unsure of the student with Tourette’s. Fortunately, there is a lot that the student, parents, and teachers can do to ensure that a child or teen with Tourette’s can succeed in school, both academically and socially.

Diagnosis and Treatment

Follow these steps to get help for your child:

  1. See your child’s pediatrician or primary care provider to discuss your concerns. Tourette’s syndrome can impact several areas of a child’s life.
  2. Get a thorough evaluation. People who have Tourette’s syndrome tend to have higher than average rates of other conditions, such as ADHD, dyslexia, dysgraphia, and OCD. A thorough evaluation of your child will provide information about exactly how Tourette syndrome and any other conditions your child may have impacted your child’s life.  Once you understand your child’s unique needs, you will be able to find the right strategies for your child to manage their symptoms. You will also have a report with specifics that you can share with your child’s school to help your child’s teachers understand your child’s needs.
  3. Learn more about Tourette syndrome so you can advocate for your child. The more you know about Tourette syndrome, the better you will be able to explain the condition, and your child’s experience with Tourette’s, to teachers and peers who may know very little about Tourette’s. By providing information about Tourette’s syndrome and how it affects your child, you will be supporting the classroom teacher.
  4. Discuss proper therapies and treatments with your child or teen’s provider. While the tics associated with Tourette’s are involuntary, a number of treatment options do exist. In some cases, vocal tics can be lessened with medication. Getting proper treatment for other conditions your child may have, such as ADHD, OCD or even depression, can help reduce tics. Be sure to discuss any medications prescribed for these conditions with your child’s doctor, as some medications may increase tics. There are also behavioral-based approaches that may help reduce tics. Behavioral approaches often look for situations that trigger or increase tics so that the child or teen can find new ways to cope with or avoid tic triggers. Some behavioral approaches help a child to identify when they will have a tic so that they can move to an area where they will not disturb others with their tic.
  5. Keep in regular contact with your child’s school. Develop a good relationship with your child’s teacher so that you can monitor how your child is doing in school. It may take some time to find the right mix of strategies that are most effective for your child. It will also make you available to quickly answer any questions or concerns that your child’s teacher may have. Be sure to keep a written record of any strategies that are tried at the school. This will help you to remember exactly what was agreed on between you and your child’s teachers.

Strategies and Accommodations

There are many strategies and accommodations available that can help your child, including the following:

Take a Personalized Approach

Your child or teen is unique. Tourette’s does not affect everyone the same way. Different strategies work for different people. Use the results of your child’s evaluation along with your knowledge of your child to develop a plan that will work for them.

Avoid Discipline and Punishment

Discipline and punishment won’t work. Your child or teen cannot stop a tic once the sensation of the tic begins. Tics are often described as an action that must be completed, like a sneeze. While some children may be able to delay a tic for a short period of time, they cannot stop it.

Educate Their Teachers

Make sure the teacher understands Tourette’s and the effects It may have in the classroom. Many people do not have a thorough understanding of Tourette’s and the impact it can have not only on the children and teens with the condition but also on the people around them. The teacher will need to be prepared to give classmates and peers appropriate information about Tourette’s so that peers will be comfortable together with your child. This can prevent rejection and bullying before it has a chance to start.

Designate a Private Space to Have Tics

Schedule a time and place where the student can have tics without disrupting others. Some students with Tourette’s like having time or a place they can go away from others to have their tics. This can provide a place for the tic to happen without disturbing other students and keep a child with Tourette’s from feeling embarrassed. However, other students with Tourette’s may feel like leaving the classroom attracts more attention than the tic itself.

Offer a Separate Testing Location

A child or teen with Tourette’s may be distracted by concern over when they will have a tic to properly focus on a test. Providing a separate test location where the child can tic without disturbing others can let them focus on the test, rather than their tic.

Consider a Behavior Modification Plan

Some older children and teens with Tourette’s are able to reduce the number of tics they experience by using behavior modification techniques. These are strategies that are developed in coordination with a care provider, such as a doctor or a therapist. The child or teen learns when they have tics, or what triggers they have for them. A plan is developed to reduce the tics. Since tics often occur at school it may be necessary to coordinate with the classroom teacher.

Encourage Participation in Extracurricular Activities

Sports can provide more physical activity, which has been shown to help decrease tics in some children and teens with Tourette’s. Extracurricular activities can also provide more opportunities to create friendships and work on social skills, which can be challenging for children and teens with Tourette’s.

When to Seek Help

See a Provider for More Help: If tics increase and become more disruptive, see a provider for more help. Remember that tics can change over time. Tics often increase during the pre-teen years. Your child may need to discuss different treatment and strategies as they go through school. By continuing to seek the support you can help ensure your child’s continued success.