Tourette Syndrome: A Collaborative Approach Focused on Empowering Students, Families, and Teachers
Christner, Beth, Dieker, Lisa A., Teaching Exceptional Children
On the Friday prior to the first day of school I prepared to meet my new third grade students and their families at our annual open house. As I glanced down the list of student names for the upcoming year, one thing that stood out to me was that over half the students in my general education classroom had some type of special needs. In addition to the usual mix of students with attention deficit disorder (ADD), specific learning disabilities, and emotional and/or behavioral disorders, I noticed that I was assigned not one, but two students with Tourette syndrome (TS). "What are the chances of that?" I wondered. A mother of one of my students who has TS sent me some articles and information about TS over the summer, and therefore I thought I had some idea of what to expect with these two students. I soon learned that my expectations were wrong.
The two boys with TS, Evan and TJ, were very different from each other. In the days and weeks to come, I learned that it is difficult to identify a typical student with TS. In fact, just when I thought I had one of the boys all figured out, his tics changed leading to a resulting change in behavior. I tried instructional strategies that worked for a while and then suddenly become ineffective. Evan was quiet, introspective, extremely talented artistically, and wanted to sit close to the door. At the open house, Evan's mom approached me and told me that Evan also has obsessive compulsive disorder (OCD) and takes medication to help control his symptoms. TJ, on the other hand, was full of energy, gifted athletically, loved to talk incessantly, generally enjoyed his status as the likeable class clown, and liked to sit in the front of the classroom where he could easily get my attention. I knew right away that the intervention techniques that may work for one student may not work for the other, and therefore I needed to quickly establish a collaborative relationship with the families of both boys.
What Is Tourette Syndrome?
TS is a neurobiological disorder marked by a wide range of involuntary motor and vocal movements and sounds called tics (American Psychiatric Association, APA, 2000). This syndrome is frequently misunderstood and difficult to diagnose (Chamberlain, 2003). Recent television shows featuring the topic of TS such as The Oprah Show, Dr. Phil, and an HBO documentary I Have Tourette's but Tourette's Doesn't Have Me have brought national attention to TS, and yet misconceptions about it still persist. This article will (1) present factual information in order to increase knowledge about TS, (2) present TS from the perspectives of a teacher and a family in order to positively change misconceptions, and (3) suggest ways that collaboration can improve the academic and social experience of children with TS.
About Tourette Syndrome
Difficulties In Diagnosis
As the teacher in the opening scenario observed, there is not a "typical child" with TS (Wilson & Shrimpton, 2003). TS is reported to be three to four times more likely to occur in boys than in girls (Robertson, 1994) and usually begins to be observable around the age of 6 or 7 (APA, 2000). The wide variety of vocal or motor tics that may be symptoms of TS and the prevalence of accompanying disorders such as OCD, ADD, or learning disabilities can make TS very difficult to diagnose (Kutscher, 2005). As shown in Table 1, vocal tics may be subtle sounds like clearing of the throat or whistling, or they may take on more complex forms like stuttering or shouting repetitive phrases. Likewise, motor tics can range from simple eye rolling to a more extreme banging of the head. Many individuals have the mistaken notion that TS always includes shouting obscenities, but that type of TS, called coprolalia, is quite rare occurring in only 5% to 30% of TS patients (Bruun, Cohen, & Leckman, 2007). With such a wide range of symptoms and with the ever changing nature of tics, constant …
Questia, a part of Gale, Cengage Learning. www.questia.com
Publication information: Article title: Tourette Syndrome: A Collaborative Approach Focused on Empowering Students, Families, and Teachers. Contributors: Christner, Beth - Author, Dieker, Lisa A. - Author. Magazine title: Teaching Exceptional Children. Volume: 40. Issue: 5 Publication date: May/June 2008. Page number: 44+. © Council for Exceptional Children Jan/Feb 2009. Provided by ProQuest LLC. All Rights Reserved.