1. PRESENTATION Tourette's Syndrome created by FTTA

2. Disclaimer Please note that FTTA presenters, lectures and staff are not medical professionals. This information is designed to be used for education assistants under the supervision of professionals and some parts may be incorrect, outdated or the authors’ opinion.

3. 90% of people with tics also have a another disability. 3 19 FTTA Tourette's is a neurological condition that is noticeable by the rapid, repetitive and involuntary muscle movements called tics. Tourette’s Syndrome

4. What is Tourette’s Syndrome? /// 1825 Jean Marc Gaspard Itard, a French physician first described the behaviours. 1 In 1885 George Gilles de la Tourette began his research, calling it ‘Mala die des Tics’ 2 The brain sends messages of rapid, repetitive and involuntary muscle movements and vocalisations, called tics 3 Behavioural difficulties can occur 4 4 19 FTTA Does not affect intelligence 5

5. Diagnosis Procedure /// No simple test 1 Over minimum period of 12 months display: 2 1 vocal tic 2 or more motor tics 5 19 FTTA Candid video recordings help with diagnosis as child is less likely to withhold the behaviours 3 Consult with GP who can make a referral to a Neurologist or Psychiatrist 4 Only 20% of children with tics develop Tourette Syndrome

6. SOME FACTS 3 to 4 times more common in boys than girls Usually diagnosed around 8 or 9 Symptoms vary from mere to severe debilitation /// 6 19 FTTA Some behaviours are beyond controllable, providing a supportive and accepting environment is crucial for positive self-esteem

7. Everyone is different and so is the variety and complexity of the tics frequency symptoms number severity location behaviour 7 18 FTTA Tics can be categorised into two types SimpleComplex

8. What are Simple tics? /// 8 19 FTTA eye blinking head or shoulder jerking facial grimacing nose twitching throat clearing barking noises squealing grunting tongue clicking sniffing Simple tics involve a limited number of muscle groups Motor Vocal

9. 9 19 FTTA jumping, hopping, bending, twisting, touching or sniffing other people and things, repetitive movements of the torso or limbs, facial grimacing combined with a head twist and shoulder shrug, pulling at clothing and self harm including hitting or biting oneself uttering words or phrases, coprolalia (involuntary socially inappropriate words), echolalia (repeating back sound, word or phrase just heard) or palilalia (repeating one’s own words) Motor Vocal What are Complex tics? ///

10. Tension Mental exhaustion Possible bigger tic as it is released 10 19 FTTA What happens if you try and stop a tic?

11. 11 18 FTTA Can the frequency of ticks increase? /// Tension and Anxiety 1 Stress (including the good) 2 Hunger 3 Tiredness 4 Change of physical health 5 Excitement 6

12. 12 FTTA 19 Relaxation Concentrating on absorbing task What can help decrease tics? ///

13. What treatment is available? /// Generally no medication for general suppression 1 Family and peers are taught to ignore the actions 2 3 Cognitive Behaviour Intervention where the child is encouraged to voluntarily move in response to a tic is being trialed 4 13 19 FTTA If symptoms interfere with daily function, then medication is given

14. 14 18 FTTA Impacts in the classroom & learning /// 14 19 FTTA Difficulties keeping eyes on the task while reading and writing Handwriting is often slower and maybe messy Anxiety, phobias, panic attacks Difficulty retaining information Difficulty staying still Excessive interruptions from movement Difficulty staying in seat Missing information as suppressing a tic makes concentration on tasks difficult Poor impulse control Calling out Completing tasks in timeframe Poor organisation skills Inconsistency with performance Transferring ideas between mediums Distraction, inattention Slower speed for reading Reactions of peers – bullying, teasing Task avoidance for fear of making tic worse

15. People with Tourette’s are more likely to have other disorders Difficulties with impulse control ( Disinhibition ) ASD Various sleep disorders OCD ADHD Various learning disorders (i.e. Dyslexia) 15 18 FTTA

16. Classroom strategies /// With permission, educate peers and other staff about TS 1 “Distraction Pack” – have substitution / distraction items, like sensory items, elastic bands, stress balls 2 Provide learner with a safe space to go if the tics become severe or must be released 3 Focus and build on strengths to reduce anxiety 4 16 19 FTTA ‘On task’ reminder system 5 Be creative with the strategies!

17. Delivery strategies /// ‘On task’ reminder system 1 Handouts instead of copying instructions 2 Sit student away from distractions like doors and windows 3 Help organise student at the beginning of the day and before activities 4 17 19 FTTA 5 Big tip: Extra breaks for re-focusing. with a physical energy release is calming for the student Visual or non-verbal on-task strategies

18. Assessment strategies /// Extended time for tests 1 Break long tests and exams into smaller parts 2 Consider alternative forms of assessment 3 To reduce wasted energy trying to suppress tics, provide a private room 4 18 19 FTTA

19. 19 FTTA Want to know more? www.tourette.org.au www.tourette.org.au/tsaa%20podcast.html http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm http://tourette13.tripod.com/