Tourettes Syndrome Definition: Have at least 2 motor tics, 1 verbal tic for at least a year At least 2 motor tics

tics 1 or more verbal tics Tics last for at least a year Onset before the age of 18 Tic-free periods last less than 3 months

Important Statistics: one recent large study (Piacentini et al., 2010), over 50% of children who went through a 10-week training program with a highly skilled therapist showed a significant reduction in their tics and problems caused by their tics. Most of the remaining participants also benefitted, but not enough to say the treatment had clinically meaningful effects.

Causes: genetically based neurological disorder Characteristics/Symptoms: More sensitive to changes in the environment (particually movements and sounds) trigor tics Sometimes can control tics for a short period of time Motor: eye blinking, facial grimacing, jaw movements, head bobbing/jerking, shoulder shrugging, neck stretching, arm jerking Some can be combinations of these and look like they have a purpose. Verbal: sniffing, throat clearing, grunting, hooting, shouts, words or phrases that often appear to be inappropriate In a few cases profane words are uttered.

Teaching Strategies/Treatments: No cure Medication: alphaadrenergic agonists such as clonidine or guanfacine or antipsychotic medications such haloperidol or risperidone. education good for mild cases, teach others what makes the tics better or worse, what to do when disruptive

Comprehensive Behavioral Intervention for Tics (CBIT): a) what makes tics better and worse, (b) how to structure the environment to help the child manage his or her tics, and (c) how the child can react to cues that trigger tics in the environment or even cues that come from inside his or her own body (Woods et al., 2008). Two Parts: A: psychologist determines specifically what triggers tics and recommends changes that can occur in the home and or school environment to decrease or limit these triggers. B: teach child how to manage tics: taught how to recognize when a tics is coming or has started, taught to do a competing response for 1 minute until tic goes away Hard for students do always remember and verbal reminders or praise can make things worse May allow students stretch breaks relieve boredom or tension

Never punish a student for having a tic. They are uncontrollable! Educate staff, teachers, and students on TS so they can be more sensitive to the childs needs. Limit triggers as much as possible when known. Provide preferential seating when necessary. Refrain from praising when a student doesn't tic, as it draws attention to the behavior. Provide modification to assignments such as allowing to videotape a presentation ahead of time. Verbal reminders to not tic can add stress and are not helpful. Allow students stretch breaks to relieve boredom and tension.

Other Useful Information: Tourette Syndrome Association, Inc. 42-40 Bell Boulevard Bayside, NY 11361 Phone #: 718-224-2999 800 #: 888-486-8738 e-mail: ts@tsa-usa.org Home page: http://www.tsa-usa.org

Tourette Syndrome Association, Inc. http://www.tsa-usa.org WE MOVE (Worldwide Education and Awareness for Movement Disorders) http://www.wemove.org NIH/National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov Genetic and Rare Diseases (GARD) Information Center http://rarediseases.info.nih.gov/GARD/AboutGARD.aspx International Parkinson and Movement Disorder Society http://www.movementdisorders.org

Tourette Syndrome Association, Inc. 42-40 Bell Boulevard Bayside, NY 11361 Tel: (888)486-8738 Email: ts@tsa-usa.org Internet: http://www.tsa-usa.org NIH/National Institute of Neurological Disorders and Stroke P.O. Box 5801 Bethesda, MD 20824 Tel: (800)352-9424 Email: me20t@nih.gov Internet: http://www.ninds.nih.gov/ Genetic and Rare Diseases (GARD) Information Center PO Box 8126 Gaithersburg, MD 20898-8126 Tel: (888)205-2311 Internet: http://rarediseases.info.nih.gov/GARD/AboutGARD.aspx WE MOVE (Worldwide Education and Awareness for Movement Disorders) 5731 Mosholu Avenue Bronx, NY 10471 USA Tel: (347)843-6132 Email: wemove@wemove.org Internet: http://www.wemove.org

Christner, B., & Dieker, L. A. (2008). Tourette syndrome: A collaborative approach focused on empowering students, families, and teachers. Teaching Exceptional Children, 40(5), 44-51. Retrieved from http://ezproxy.aacc.edu/login?url=http://search.proquest.com/docview/201146458?accountid=40680 Davis, A. , T. Neal (2006). Tourette's Syndrome. In A. M. Bursztyn (Ed.), The Praeger Handbook of Special Education. Santa Barbara, CA: Praeger. Retrieved from http://ebooks.abcclio.com/reader.aspx?isbn=9780313036620&id=GR3262-729 Healthwise Staff. (2011, July 26). Myths about tourette's disorder. Retrieved from http://www.everydayhealth.com/health-center/myths-about-tourettes-disorder-info.aspx?source=dlp-pdr Larson, J. (2010). Tourette Syndrome. In M. Kehler, R. Munson, L. Cornish, S. R. Steinberg (Ed.), Boy Culture: An Encyclopedia. Santa Barbara, CA: Greenwood. Retrieved from http://ebooks.abcclio.com/reader.aspx?isbn=9780313350818&id=B1879C-1442 National Tourette Syndrome Association. (2013). Retrieved from http://www.tsa-usa.org Pirou, E. (Photographer). Unknown. Gilles de la Touretter (1857-1904)[Plate]. Retrieved from http://commons.wikimedia.org/wiki/File:Georges_Gilles_de_la_Tourette.jpg The National Disorder for Rare Diseases, Inc. (2007, 10 12). Tourette syndrome. Retrieved from http://www.rarediseases.org/rare-disease-information/rare-diseases/byID/2/viewFullReport Woods, D. W., Piacentini, J. C., & Walkup, J. T. (2010). Comprehensive behavioral intervention for tics in children with tourette syndrome. Bethesda: Retrieved from http://ezproxy.aacc.edu/login?url=http://search.proquest.com/docview/762996544?accountid=40680