1. Taken from That Darn Tic, a childrens newsletter.

2. Characteristics People with Tourettes make involuntary movements or noises. These are called tics. Simple Tics: sudden, brief, repetitive movements that involve a limited number of muscle groups Complex Tics: distinct, coordinated patterns of movements involving several muscle groups Vocal Tics: noises that a person makes with their voice Motor Tics: tics involving movement of the body 3. Simple Tics Complex Tics Vocal Tics Throat-clearing, Sniffing Grunting Snorting Barking Hiccupping Yelling Using different tones of voice Repeating ones own words Repeating others words Using swear words Motor Tics Blinking Facial Movements Shrugging the shoulders Arm jerking Head jerking Shoulder jerking Sticking the tongue out Finger flexing Touching objects Hopping Jumping Bending Twisting Touching the nose Touching other people Obscene gesturing Flapping the arms 4. Serious Tics: Coprolalia: uttering socially inappropriate words such as swearing Echolalia: repeating the words or phrases of others Self-harming tics: scratching oneself, punching oneself, hitting ones head on hard objects. 5. Things to keep in mind No case is typical. Tics can change over time. Tics can worsen and get better over time. Often worst during adolescence. Certain things can worsen tics. Stress, anxiety, excitement, shirts with tight collars, hearing someone else cough or clear their throat. 6. Holding in Tics Tics are often preceded by a premonitory urge. Trying not to tic: Can feel like holding your breath Trying not to hiccup Trying not to blink 7. Behavioral Therapy It was a common opinion that any suppression of tics would produce more in the future, so professors recommended not to ever encourage suppressing tics. Now people have been working with cognitive behavior therapy and have seen some improvements. Tic-detector experiment 8. Co-Occurring Conditions 79% diagnosed with at least one additional mental health, behavioral, or developmental condition 64% ADHD 43% Behavioral or conduct problems (ODD or CD) 40% Anxiety problems 36% Depression Over 1/3 also have OCD 9. Causes No one knows. It is thought to be genetic. Genes may just increase susceptibility for the disorder. Monozygotic twins show a 50-70% concordance. Dizygotic twins show a 9% concordance. Some studied noted abnormal frontal lobe discharges. 10. Prevalence 3 of every 1,000 children 6 through 17 years of age and living in the United States. Other studies using different methods have estimated the rate of TS at 6 per 1,000 children. 27% are reported as having moderate or severe forms of the condition. Tourettes affects all racial and ethnic groups. Males are affected 3 times more than females. More common in children. Tourettes often decreases or goes away with age. 11. How is Tourettes Diagnosed Diagnosis is fairly subjective. Patients must have a case history of at least 1 year. Facial tics are usually the first ones displayed. Patients explain and show doctors their tics, and the doctor diagnoses them with Tourettes. 12. Famous People With Tourettes 13. 1825 First Recorded Case Jean Marc Gaspard Itard (1774 1838), perhaps most remembered for his work with the Wild Child of Aveyron, noted the characteristics of Marquise de Dampierre. 14. Marquise de Dampierre 26 years of age Noble, intelligent young lady In the midst of a conversation that interests her extremely, all of a sudden, without being able to prevent it, she interrupts what she is saying or what she is listening to with bizarre shouts and with words that are even more extraordinary and which make a deplorable contrast with her intellect and distinguished manner. 15. Georges Gilles de la Tourette In 1885, Tourette published a detailed report of nine patients who exhibited a condition with the characteristics of twitching, jerking uncontrollably, crying out, grunting, or swearing involuntarily. 16. Maladie des tics convulsifs avec coprolalie Tourette argued in his report that it was distinct from other known diseases and disorders of the time. Cited first example as Marquise de Dampierre. Because a set of signs and symptoms, a course of illness, and a predisposing cause had been identified, Tourette argued that a disease had been described. This was challenged by Parisian colleagues. 17. Early 20th Century The psychoanalytic influence on Tourettes was that it was a psychiatric problem. Patients and families were often told that their own psychological maladjustments were to blame for their treatments. Tics were attributed to sexual impulses and/or conflict between parent and child, resulting in deficits of will and character. 18. New Research In 1968, Arthur K. Shapiro and his wife, Elaine, treated a patient with haloperidol. Seeing the effects the medication had on the patient, the Shapiros argued that Tourettes was a neurological rather than a psychological disorder. 19. Today Tic disorders are considered to be an inherited neuropsychiatric disorder. There are many places in which individuals with Tourettes can receive treatment and support. www.tsa-usa.org Medical and scientific research Newsletter for individuals of all ages Educational strategies and advocacy Many other features 20. I Have a Chicken in My Pants Attitude and knowledge were everything!! And the chicken lived happily ever after. 21. Ignorance Leads to Issues 22. Ignorance causes Stress Frustration Task Avoidance When the stress builds up within a student, the tics become much more prevalent and difficult to control. 23. Difficulties Attention/Concentration Impulsive behavior General Fidgeting Ritualistic Behavior 24. Accommodations & Adaptations Seat children with Tourettes in the front of the classroom to enhance attention. Time-out passes can help to relieve tension and tics. Eliminate unnecessary items from the students desk. Designate a specific item or two for the student to be able to fidget with. Have a private place that the student can go to calm down and release tics. 25. Accommodations & Adaptations A buddy system can help provide security and educational support. Distribute instructions rather than having the students write them down. Reduce the length of homework assignments, remembering that quality is more important that quantity. Allow the student to take tests in a private room and waive or give an extended time limit. 26. The Best Way to Help 1. As a teacher, be patient and persevering. 2. Provide the opportunity for the child to explain about Tourettes to his classmates. 27. A Teacher Can Make the Difference 28. I Have Tourettes, but Tourettes Doesnt Have Me Vimeo.com/58887624 29. Resources Article on Special Education Needs http://www.senmagazine.co.uk/articles/410-how-to- manage-tourettes-in-the-classroom Teachers Guide to video on Tourettes Explores how to address Tourettes to an entire classroom http://www.hbofamily.com/programs/tourettes- teachers-guide.pdf CDC page on prevalence of Tourettes in U.S. http://www.cdc.gov/ncbddd/tourette/research.html 30. Resources (cont.) National Tourette Syndrome Association http://tsa-usa.org/ Site on the special needs of children, page specific to Tourette http://www.kidneeds.com/diagnostic_categories/artic les/teach_child_tourette.htm Catalogue of accomodations http://teacherweb.com/NY/ValleyStream13/howellroa dpbis/CatalogOfAccomidations.pdf 31. Resources (cont.) Classroom Strategies and Techniques http://pacfamilyresourcecenter.pbworks.com/f/TS%20 classroom%20strategies%20and%20techniques.pdf Pamphlet for school on Tourettes http://www.tourettes- action.org.uk/storage/Education%20Issues%20and%2 0Tourette%20Syndrome.pdf Link to full HBO program http://vimeo.com/58887624