pennsylvania training and technical assistance network 2010-2011 special education paraprofessional...
TRANSCRIPT
Pennsylvania Training and Technical Assistance Network
2010-2011 Special Education Paraprofessional Training Series
Supporting Students Who Have Tourette’s Syndrome
January 25, 2011
Dennis CullenPaTTAN
1
PaTTAN’s Mission
The mission of the Pennsylvania Training and Technical Assistance
Network (PaTTAN) is to support the efforts and initiatives of the Bureau of Special Education, and to build the capacity of local educational agencies to serve students who
receive special education services.
PDE’s Commitment to Least Restrictive Environment (LRE)
Our goal for each child is to ensure Individualized Education Program (IEP) teams begin with the general education setting with the use of Supplementary
Aids and Services before considering a more restrictive environment.
Local Policy
Your local school district, IU, preschool or employing agency’s policies regarding paraprofessional job descriptions, duties, and responsibilities provide the final word!
4
Learner Outcomes
Participants will• Develop an understanding of
Tourette’s Syndrome• Identify symptoms and difficulties
associated with Tourette’s Syndrome• Discuss specific ways to respond to
students with Tourette’s Syndrome
5
Agenda
• Introduction• What is
Tourette’s Syndrome?
• Tic Disorders and Their Impact– MotorTics– Vocal Tics
• Associated Symptoms/ Strategies for:– Attention-Deficit
Hyperactivity– Obsessive
Compulsive Disorder– Learning Disabilities
• Recommendations for paraprofessionals
6
Introduction
• Identified by Gilles de la Tourette in 1885
• First reports of a successful drug treatment for TS in the early 1960s
• Current estimates – some 200,000 in the U.S. have the most severe form of TS. – As many as 1 in 100 exhibit milder symptoms
7
What is Tourette’s Syndrome?
8
Tourette’s Syndrome is a neurological disorder characterized by repetitive, stereotyped, involuntary movements, and vocalizations called tics.
9
What is Tourette’s Syndrome (TS)
What is Tourette’s Syndrome (TS)?
• DSM-IV-TRA. Motor and vocal tics need to be present, not
necessarily at the same timeB. Tics occur nearly daily throughout one year,
no more than a 3 month tic-free periodC. Tics cause distress or significant impairment
in important areas of functioningD. Onset before age 18E. Tics cannot be due to effects of a substance
or general medical condition
10
What is Tourette’s Syndrome (TS)
• Precise cause of Tourette’s unknown• Current research points to
abnormalities in certain brain regions including:– Basal ganglia– Frontal lobes– Cortex
11
14
Tic Disorders and Their Impact
Tic Disorders and Their Impact
• What is a tic?
– Sudden, rapid, recurrent, involuntary or semi-voluntary movement (motor tic) or vocalization (vocal tic)
15
Motor Tics
• Simple tics are fast, purposeless movements such as eye-blinking, neck-jerking, shoulder-shrugging, or facial grimacing
• Complex tics may be slower or consist of stereotyped movements, may appear to have purpose, and at some point may be characterized as a “compulsion”
• Echopraxia – involuntary copying of other’s words or behaviors
16
Vocal Tics
• Simple vocal tics are characterized as meaningless sounds and noises such as sniffing, throat clearing, snorting, clicking, screeching and barking
• Complex vocal tics are linguistically meaningful utterances such as words or phrases– palilalia - repeating one’s own sounds or words – echolalia –repeating what someone else has
said– coprolalia - obscene, inappropriate &
aggressive words and statements; it is not very common, occurring in less than 5% of TS patients
17
Impact of Tics
• Tend to “wax and wane” in response to environmental factors
• May change in frequency, type, and location over time
18
Impact of Tics
• May worsen with:– Stress– Anxiety– Excitement– Fatigue– Illness
• May worsen during puberty
19
Impact of Tics
• Controlling Tics– Some can
suppress, camouflage, or manage tics
– May result in substantial buildup in tension
20
23
Associated Disorders
Associated Disorders
• Obsessive-Compulsive Disorder (OCD)
• Attention Deficit Hyperactivity Disorder (ADHD)
• Learning Disability (LD)
24
Obsessive-Compulsive Disorder (OCD)
• Often described as “tics of the mind” • Children rarely discuss for fear of
being thought of as “crazy”
25
Common Obsessions and Compulsions
• Need for symmetry and perfectionism
• Neatness• Counting• Checking
things repeatedly
• Constant doubt• Germ
obsessions• Ritualistic
behaviors• Need for things
to be even
26
Attention Deficit/Hyperactivity Disorder
• May be the most problematic aspect of TS
• Characterized by – Disorganization– Disruptiveness– Impulsivity
28
Attention Deficit/Hyperactivity Disorder
• Likely to have difficulty with the following:– Starting a task– Sequencing information– Organizing materials– Regulating the intensity of their
emotional responses to situations
29
Attention Deficit/Hyperactivity Disorder
• Dysregulated arousal system– “Storms” – uncontrollable rages for what
appear to be absolutely no reason
30
Learning Disabilities
• May affect all the basic skills– Reading– Writing– Spelling– Math
31
33
Working with Students with Tic Disorders
Working with Students with Tic Disorder
• Draw no attention to the tic
• Allow child to leave the classroom to let out the tics
• Explain to substitutes what might happen in the classroom
• Adjust academic and behavioral expectations as necessary
34
Working with Students with Tic Disorders
• The student must know that you are “On his side and not on his back.” – Provide appropriate support – Is the “Safety Net”
35
Working with Students with Tic Disorders
• Consider the tics as “symptoms of the disability”
• Inappropriate comments may be a combination of three common symptoms:– Social skills deficits– Difficulty inhibiting mental responses– Vocal tics
36
Working with Students with Tic Disorders
• Don’t take behaviors personally
• Recognize the student’s strengths and talents
• Behavior modification techniques & negative consequences are not usually effective
37
Working with Students with Tic Disorders
• Know when to step back
• Remember the role of the paraprofessional is to provide educational assistance
• Debriefing sessions at the end of the day
38
Working with Students with Tic Disorders
• Symptoms and difficulties vary dramatically from student to student
• Never generalize one student’s difficulties, symptoms, or successful strategies– The only thing consistent about TS is the
inconsistencies.
39
Resources
42
Tourette Syndrome Association, Inc.http://tsa-usa.org42-40 Bell Blvd.
Bayside, New York 11361
Information from the National Institute of Neurological Disorders and Strokes (NINDS)
http://www.ninds.nih.gov/
Contact Information www.pattan.net
Dennis [email protected] # 610-265-7321 ext. 7232
Commonwealth of PennsylvaniaThomas W, Corbett, Governor
Pennsylvania Department of EducationAmy C. Morton, Acting Secretary
John J. Tommasini, DirectorBureau of Special Education
Patricia Hozella, Assistant DirectorBureau of Special Education