However it is very rare for the tics to develop to such a degree that a diagnosis of Tourette’s is made.
Tics are involuntary, repetitive noises and movements. Sometimes the child may not even be aware that he/she is having tics as they are often part of the child’s everyday life.
More than 85 per cent of those diagnosed with Tourette Syndrome will also have a co-morbid mental health disorder like ADHD, OCD or anxiety. In some cases children may also have sensory processing disorders or a learning disability like dyslexia or dyspraxia.
In most instances children with Tourette Syndrome and related comorbidities are of normal intelligence.
Very little is known about Tourette Syndrome in New Zealand and in most instances teachers and schools have never knowingly encountered a student with Tourette’s.
In the past tics have often been misinterpreted as bad behaviour; or a child who has struggled with schoolwork because of the impact of his/her tics, for example illegible handwriting, has been mistakenly thought to have a learning disorder.
Much like a fingerprint, each child with Tourette’s will have tics that are unique to them and these can change overnight in frequency, severity and how they present.
The more common motor tics are facial twitches, constant blinking, jaw movements, shoulder shrugging or repetitive movements like tapping a pencil or fidgeting.
Vocal tics can sometimes be harder to differentiate as they can be as simple as a sniff or a cough. These tics may then change over time into stuttering or having to repeat one’s own words or someone else’s.
Please download the attached sheet of the range of tics and the more complex disorders that are related to Tourette’s.
Tics will affect each child differently and sometimes it can be hard to differentiate between a tic and an impairment.
In a classroom situation anxiety and stress tend to exacerbate tics and a child with Tourette’s may appear to have problems with speech for example.
This might be a direct result of a stuttering tic or even a tic that requires the person to hold their breath. It may even be embarrassment or anxiety at having to vocalise in front of other people due to feeling ashamed.
If you may notice that a child’s speech issues come and go – this may be the tic waxing and waning; testing a child in another environment may provide very different results depending on the child’s level of anxiety and stress.
Written school work may appear messy as a result of a twitch or of a symptom of another comorbidity like ADHD or OCD.
TS is not a learning disability, but much like vocal implications, the ability to learn in a classroom situation can be compromised by tics or comorbidities.
Other types of tics might involve:
A child with Tourette Syndrome may try to avoid embarrassment or disturbing those around them by hiding or suppressing their tics. This requires a lot of energy and concentration and as a result the child may miss instructions or not be able to complete their work on time.
Older children can sometimes develop successful strategies to disguise their tics, very similar to techniques used in cognitive behavioural therapy. An eye tic may be concealed by looking around the classroom; a vocal tic by coughing or laughing; a twitching tic by moving or by appearing to be ‘messing about’.
Others may manage to suppression their tics for a long period of time however this is often not ideal as when they can no longer control the tics it results in an explosion of sounds and movements -much like holding your breath and the overwhelming messages to breathe. Eventually you need to let go.
Controlling tics in this manner requires a huge amount of concentration and energy.
Providing support and awareness of Tourette Syndrome to those interacting with a child with TS can significantly reduce the amount of stress or anxiety on the student.
If the child has the confidence to speak about Tourette Syndrome to their classmates this often results in greater tolerance and understanding and reduces the risk of bullying.