School/ Teacher Resources
Tics in School
Despite Tourette's and Autism having almost equal prevalence, many schools and teachers are not aware of the impact Tourettes can have on a child with Tourette Syndrome. Some basic information on Autism is usually learnt within the core foundations of teaching, however, many teachers will know absolutely nothing about Tourette's until the day they end up with a ticcer in their class.
1:1 assessments are available in England; these involve a 1-hour observation and a report. See services for more details.
Please see below some tips for your child's teachers. Downloadable/ printable version and information sheet available in the shop.
Tips for the classroom:
Children with Tourette’s often struggle with accessing the curriculum. However, it’s important to be aware that Tourette Syndrome does not affect a person’s IQ and the barriers to learning come from anxiety around tics, and the tics themselves.
Even if you feel tics are mild or not present, the child is likely suppressing them. If you can’t see them, still be mindful of the challenges they are facing, whether tics are mild or they are being suppressed, this is exhausting and very distracting.
Vocal and motor tics can affect reading, writing, and focus to name a few.
Tics are so much more than motor movements and vocal sounds; other forms of tics include:
contextual/ conversational tics, these tics can be relevant, appropriate, and in context. These can appear to look and sound as though the child is ‘calling out, or ‘answering back’.
visual tics can involve looking at objects differently (squinted eyes, holding an object at an angle), counting patterns, lines on walls, windows, and floors.
Intrusive thought tics, although not visible are a very common tic. Thoughts are on repeat and can often have a negative or inappropriate vibe to them.
Blocking tics is when a person cannot either speak or move (or both) these are due to prolonged tonic or dystonic tics that interrupt motor activity.
Where possible have the child sit at the back or side of the class, where they are not in the direct view of their peers.
Set regular movement breaks throughout the school day, where the child can run an errand, or go to a specific room to allow his tics out. This room should be staffed ideally, so they can remind the child to release their tics for a few minutes before returning to class. If there isn’t a staffed room, consider making a laminated prompt sheet that reminds them of the purpose of being there. Tic release can also be done whilst running errands such as walking to the reception office.
Assemblies can be extremely stressful, thus causing a tic increase. Triggers can include but are not limited to, having to sit still, in silence, amongst peers, fluorescent lighting, and anxiety. Where possible, children with tics should be exempt from the assembly.
Use a traffic light system. This can be done using a red and green laminated square card. Work out a system between you, where the child has the green card showing on their desk when they’re feeling good, then they can turn it over to red if they’re struggling. Have an agreement between you both where the child knows that if they show red, you will support them (discuss with them, what ‘supporting them’ will entail) this may be sending them out to run an errand, having a chat after lesson, etc.
The majority of children with Tourette Syndrome, also have co-occurring conditions that have symptomology of needing to move. These conditions could include but are not limited to ADHD, anxiety, sensory seeking, and lastly a ‘side effect’ from tic suppression. Some strategies that can support this include but again are not limited to:
- Wobble cushion: There has been much research into kids with ADHD and active sitting. In 2003 a study was published in the American Journal of Occupational Therapy that found in students with ADHD, sitting on therapy balls (swiss balls) improves behaviour and productivity. It was discovered that students using ball chairs were better able to sit still, focus, and write more. Then in 2007, the Mayo Clinic in Rochester echoed these sentiments by finding that the ability to move around more while sitting made the students more attentive, the study believing this is due to children being able to burn off excess energy by bouncing or moving.
-Chew toys: chew toys are great not only for sensory issues but also for redirecting vocal tics.
-TheraBand’s: are great for tying around the legs of chairs for the child to lightly bounce their legs upon, causing the feeling of movement throughout the whole body whilst lightly burning energy.
Fidget toys: many children benefit from ‘fidget’ toy’s but these should not be a distraction. Replacing distracting ‘fidget’ toys with less malleable objects such as pieces of blue-tac will give a more fulfilling sensation throughout their hands, without diverting their attention.
As already stated, Tourette’s itself doesn’t affect your intelligence however the tics can be very detrimental to learning, with this in mind your expectations should be altered. This does not mean the level of work should be reduced but instead the quantity of work. Both reading and writing can be hindered dramatically so this can make it almost impossible for some children to get their thoughts on paper.
Other aids: ideally children will be given their own room for exams, with extra time allocated, there should also be a ‘stop the clock’ option. Computers and scribes are also a great aid, these can be used for all areas of work.
Assembly/ Class/ Group presentation to give a brief overview of tics and Tourettes Syndrome - Click to watch on YouTube
Why not use these conversation starters to get a discussion going, and check what they learnt? You could pause after each slide for younger listeners, or wait until the end for other listeners. Adapt as appropriate for your audience.
What percentage of children under 10, experience tics?
Who can tell me a common tics?
who can tell me a less common tic?
What is a mental tic?
What should people with tics NOT be asked to do?
What can make tics worse?
How can you help someone with tics?