If you have a child in your classroom who appears to
have problems with muscle and vocal control, it may be Tourette's
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
- Provide short breaks for the child.
- Ask the child if he or she feels comfortable reading
- Use lots of pictures and graphs for the child to refer back to
- 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
- 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
- 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
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
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
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