Imagine standing in line at a supermarket, at the next register you see a mom with a child of about nine years old. While unloading your groceries on the belt, you hear the child start to swear using a socially unacceptable word over and over again. You get uncomfortable and stare at the mom who is just standing there and continuing to empty her cart as if nothing is happening. She doesn’t stop him or reprimand him. You are probably thinking what kind of mother doesn’t stop and reprimand the child for speaking like that? What kind of mother allows her child to talk like that?
The answer: A mother with a child who has Tourette Syndrome (Tourette’s)—and she’s so embarrassed she wants the floor to swallow her. When you see children with special needs, your heart melts and if they walk funny, drool, or do anything that would normally be socially unacceptable, it’s acceptable, because it is justified by their special needs. A child/teen with Tourette Syndrome (which is one type of tic disorder) looks and acts normal until they have a tic. So, the parents and child are judged and embarrassed unless the people around them are educated and understand that he suffers from Tourette Syndrome.
Tourette Syndrome is a problem with the nervous system that causes the individual to make movements or sounds called tics, that they can’t control. It often starts in childhood and is usually more common in boys than girls. For most children, symptoms tend to improve by the end of adolescence with a small number becoming symptom free. The main symptom is tics, some are so mild they are not even noticeable, others happen often and are obvious. Stress, excitement, being sick, or tired can make them worse. There are two types of tics, motor tics involve movement, which include, but are not limited to eye blinking, facial grimacing, mouth twitching, head bobbing/jerking, shoulder shrugging, neck stretching, and arm jerking. Complex motor tics involve multiple muscle groups or combinations of movements and tend to be slower and more purposeful in appearance, for example hopping, twirling, and jumping. Vocal/phonics tics produce a sound. They include, but are not limited to sniffing, throat clearing, grunting, hooting, shouting, barking, yelping, coughing, repeating what someone else says, swearing. Complex vocal tics are words or phrases that may or may not be recognizable but that consistently occur out of context. In some cases, the words may be inappropriate, such as swear words, ethnic slurs, or other socially unacceptable words or phrases.
Before a tic occurs, (it has been explained that) the individual gets a sensation that can feel like a tingle or tension. The movement makes the sensation go away. They might be able to hold the tic back for a little while but can’t stop them from happening. Doctors aren’t sure why, but about half of people with Tourette’s also have symptoms of ADHD. (Attention Deficit Hyperactivity Disorder) and may have trouble paying attention, sitting still, and finishing tasks. They may have trouble focusing and paying attention because they are thinking about their tics and worrying about who may be noticing them. Sometimes anxiety, learning disabilities, such as dyslexia and OCD (Obsessive Compulsive Disorder, like washing hands repeatedly) are effects of Tourette’s, as well.
Children/teens experiencing Tourette’s may be frightened or embarrassed by the disruptive nature of their tics at school, in the community, and with extended family. When Tourette’s is not understood by teachers, peers, family or people in the community, the child/teen with Tourette’s may feel rejected or ridiculed, and the impact it could have is devastating.
The teacher or family member needs to prepare the classmates, peers, and other family members with appropriate information about this condition, so they will feel comfortable with the child. This can prevent bullying and rejection before it starts.
People who are not familiar with the condition may believe that the individual is deliberately trying to attract attention or be disruptive. Fortunately, there is a lot that everyone around the individual can do to ensure that he/she can succeed in school or in life in general and have a healthy social life.
Get a thorough evaluation of your child. It will provide information about exactly how Tourette Syndrome (and any other conditions your child may have), will impact his/her life. You will get a report with specifics that you can share with the school, to help the teachers and everyone else that is in contact with your child, understand his/her needs. You must take a personalized approach, because each individual is unique; Tourette’s does not affect everyone the same way. Different strategies work for different people. Use the results of the evaluation, along with your knowledge of your child, to develop a plan that could work for him/her.
While the tics associated with Tourette’s are involuntary, a few treatment options do exist. In some cases, vocal tics can be lessened with medication. Getting proper treatment for other conditions your child may have such as ADHD, OCD, or even depression can help reduce tics. Be sure to discuss any medications prescribed for these conditions with your child’s doctor, as some may increase tics.
There are also behavioral-based approaches that may help reduce tics. Behavioral approaches may look for situations that trigger or increase tics, so that the child/teen can find new ways to cope with or avoid the triggers. Discipline and punishment will not work. The individual cannot stop a tic once the sensation begins. Tics are often described as an action that must be completed, like a sneeze. While some may be able to delay a tic for a short while, they cannot stop it, and unfortunately stress will increase tics in some people. Punishing someone for having a tic may lead to an increase in tics.
Encourage participation in extracurricular activities. Sports can provide more physical activity, which has shown to help decrease tics in some children and teens. It can also provide more opportunities to create friendships and work on social skills, which can be challenging for children/teens with Tourette’s.
Often the hardest part of living with Tourette Syndrome or living with someone diagnosed with it, is dealing with the embarrassment or frustration of having tics that can’t be controlled, and fitting in socially can be very hard for the child/teen. So, if you happen to be somewhere and notice a child with a tic, don’t stare or comment! Either look away as if you didn’t notice anything, or try and comfort the parent with encouraging words.
