1. SCHOOL SUCCESS STRATEGIES Natacha Akshoomoff, Ph.D. Department of Psychiatry and Center for Human Development UC San Diego

2.  Symptoms of attention deficit/hyperactivity disorder (ADHD)  Learning disabilities  Symptoms of obsessive/compulsive disorder (OCD)  Social skill deficits  Anxiety and depression Tic Disorders can affect school success in a variety of ways

3.  Student is having difficulty keeping up with his/her peers in terms of reading, mathematics, and/or writing  Related to the tics themselves? Other factors?  Decline in grades (4 th grade!)  Increased frustration How can you tell?

4.  Difficulty getting along with peers  Negative attitude toward peers, teachers, or school in general  Increased behavior problems  Negative view of self How can you tell?

5. ASSESSMENT What can be done?

6. EDUCATION!  Teach the child about his/her tics and individual strengths and weaknesses  Educate peers about tics  Educate teachers and other school personnel about tics What can be done?

7.  Provide a calm and supportive classroom environment.  Attempt to minimize stressful situations.  Allow the student to doodle, chew gum, alternative seating, etc.  Provide the student with extended time on tests.  Allow the student to take tests in a different classroom.  Provide student with homework modifications Possible Accommodations

8.  Provide the opportunity to complete work using alternative media (e.g., paper and pencil or computer).  Allow the student to answer questions in oral rather than written format, or vice-versa.  Provide the student with copies of notes.  Provide the student with an audio or video of the class.  Provide the student with preferential seating that minimizes attention drawn to tics while allowing active classroom participation. Possible Accommodations

9.  Identify a location where the student can go when his or her tics are particularly distressing.  Allow the student to initiate a brief break.  Provide the student with a nonverbal prompt to take a brief break.  Allow the student to leave the class for an extended break (provided he or she brings along the assigned work).  Allow the student extended time between classes. Possible Accommodations

10.  Assess for strengths and weaknesses early and over time!  Monitor behavioral challenges  Help child with the development of executive functioning skills Assessment

11.  Antecedents – Behaviors - Consequences  Positive reinforcement  Cognitive-Behavioral Therapy support Behavioral Strategies for Success

12. 504 Plan Individualized Education Plan (IEP) Protection and Support