Tourette Syndrome: Classroom Inclusion Challenges and Strategies to Improve Social Interaction
What is Tourette Syndrome?
In the United States, about 200,000 people have the most severe type of Tourette syndrome, a neurological disorder in which the patient has tics — vocalizations and movements that are involuntary and repetitive; about one in 100 people have a milder form of the disorder, according to the National Institute of Neurological Disorders and Stroke. The tics can be simple or complex. If the tics are simple, they use few muscle groups and are brief, repetitive and sudden. If the tics are complex, they use several muscle groups and the movements are coordinated and distinct.
The symptoms of Tourette syndrome first appear during childhood, between ages 7 and 10. The Mayo Clinic notes that the symptoms are commonly worse when patients are teenagers. Later on in life, the symptoms are less frequent and milder. Boys have TS more frequently than girls.
Social Interactions for Students with Tourette's
Social skills may be an area of difficulty for some students with Tourette syndrome, which can affect how they interact with other children. Students in a mainstream classroom may not understand Tourette syndrome and that the child cannot control his or her tics. Shaw, Woo and Valo note that children with Tourette syndrome are at risk for several social problems. Possible social characteristics with this disorder include poor peer relationships, becoming aggressive, becoming withdrawn and poor self-esteem. If students with Tourette syndrome have another condition, such as conduct disorder (CD), then they may have additional difficulty with social interactions with their peers. Since the symptoms of Tourette's become more severe during the teenage years, children may have an increase in social interaction problems in high school.
Possible Educational Difficulties
Overall, students with Tourette syndrome have intelligence scores in the normal range, but some students may have a learning disability that can affect their academic performance, notes the Centers for Disease Control and Prevention. Examples of difficulties students with TS may display are trouble processing information, writing, paying attention and staying organized. Sensory problems may be present, which can affect movement, touch, taste and smell.
In addition to learning difficulties that can occur with Tourette syndrome, children with the disorder are at risk for other disorders that may affect school performance. For example, students may also have anxiety, attention deficit hyperactivity disorder (ADHD), depression, oppositional defiant disorder (ODD), CD, developmental delay or obsessive-compulsive disorder (OCD). The Centers for Disease Control and Prevention states that among children with Tourette syndrome, 64 percent have ADHD, 28 percent have a developmental delay, 43 percent have a behavioral problem, 36 percent have depression, and 40 percent have a type of anxiety disorder. If a student also has ADHD, she may have trouble staying still during class, while a student with a co-morbid behavioral disorder may lose her temper often.
Are There Issues with Inclusion?
Whether a student with Tourette syndrome would do better in a mainstream classroom or in a special education classroom depends on her individual needs. The National Institute of Neurological Disorders and Stroke states that students who have TS can function well with education inclusion, but co-morbid conditions can make it difficult. A comprehensive assessment can help the school decide what setting is the best. If the child could be in a mainstream classroom, she may benefit from smaller classes or outside tutoring.
To reduce educational inclusion issues when dealing with Tourette syndrome, the classroom should be a compassionate setting in which students can perform their best. For example, teachers can take class time to explain what the disorder is to other students in the classroom. Teachers may want to go over some of the myths about Tourette syndrome and how they can be hurtful to the people with this disorder. Teachers may need to make certain accommodations to help students with Tourette's in a mainstream classroom. For example, if the child is having trouble writing notes during class, a computer may help. If writing during an exam causes trouble for the student, the teacher may administer it orally. During testing, the child may benefit from using a different location or getting extra time to complete the test. Giving untimed tests can help reduce the amount of stress the student is under, which may help reduce her tics. Teachers can talk with parents to find out what the child’s triggers are. For example, the National Institute of Neurological Disorders and Stroke notes that anxiety or excitement can worsen a student’s tics, but calm activities can improve symptoms.
Other ways to help with these inclusion issues is to allow the student to have a private study area. These inclusion tips can help students succeed in a mainstream classroom while educating other students about Tourette syndrome.