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Special Needs: Tourette Syndrome

Sally Castle

If you have a child in your classroom who appears to have problems with muscle and vocal control, it may be Tourette's Syndrome...

Tourette's is an inherited neurological disorder that causes repeated involuntary body movements (tics) such as blinking, twitching, shoulder shrugging, or leg jerking. The vocal sounds can be throat clearing, soft clicking, or sniffing. The cause of Tourette's is a genetic defect.

This is a spectrum disorder which means it can have mild symptoms or very intense symptoms, including loud grunting, barking, meowing, or repeating words or phrases. Yet symptoms usually become milder as the child grows older.

Tourettes Syndrome appears before age 18 and lasts for over one year. It affects three to four times more males than females, and it's estimated that there are nearly 100,000 Americans with full-blown Tourettes. There can be additional problems involving obsessions (sometimes called a mental tic), compulsion/ritualistic behavior, and various learning difficulties.

Children with Tourette's Syndrome have a challenge they can't control. That's the one thing above all other things we need to remember as we minister to these children. After that, establish a classroom environment that'll most help the child with the problems related to the syndrome.

Use these strategies.

  • Give the child permission to leave the classroom whenever tics become overwhelming, so the child can "get the tics out" in private. Create a plan for leaving that ensures the child is supervised.
  • Provide short breaks for the child.
  • Ask the child if he or she feels comfortable reading aloud.
  • Use lots of pictures and graphs for the child to refer back to for direction.
  • Give one or two directions at a time.
  • Use a light touch on the shoulder to redirect listening.
  • Be patient and model acceptance. Ignore the tics as much as possible.
  • Allow the child to sit wherever he or she feels most comfortable; many times the child will choose to be near the door for an easy exit.
  • Allow the child to work in whatever position feels most relaxed.
  • Establish good communication with the child's parents.
  • In most cases, maintain the same expectations for the child as you have for the rest of your class.
  • Be aware of medications the child may be taking and any side effects of the medication.
  • Maintain a classroom environment that's tolerant and accepting. Children can be very helpful if they're brought into the circle of understanding the syndrome.
  • Assess any accommodations you've made to see if they've been effective. Use this information to continue to adapt your setting to help the child.
  • Help the child internalize how God makes each one of us special (Psalm 139:14).

Q: Chelsea is an 8-year-old student with Down Syndrome. She wants to sit on my lap or hold my hand all the time. It's becoming very difficult to do what I need to do for my entire class. Is this Chelesa's behavior, a need, or part of how Down Syndrome is?

A: The first thing you need to do is talk with her parents about the situation. Is the situation just in your classroom or also with other adults? Is this part of Chelsea's personality? Some children are naturally more affectionate then others. Is there a need you meet by holding her hand? Maybe she's afraid of new surroundings, and sees you as her anchor.

Once you understand more, talk with Chelesa to help her understand that you need to be the teacher to all the children in your classroom. This needs to be done gently, so she doesn't feel rejected by you. Point out times that you'd enjoy holding her in your lap or holding her hand. Then follow through with her.


Sally Castle is associate professor of special education at Cedarville University in Cedarville, Ohio. Has a special-needs question got you stumped? Submit your question to questions@cmmag.com for expert advice. Please keep in mind that phone numbers, addresses, and prices are subject to change.

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