Introduction


            Many complex characteristics are being presented by children and youth affected with the Tourette’s Syndrome. Often, even in learning institutions both special and general educators misunderstand them. This is the case children with Tourette’s Syndrome have unique physical, social, emotional as well as academic needs inside the classrooms. This must be investigate since 1 out of every 25.000 individuals have Tourette’s Syndrome with boys being diagnosed with the syndrome more frequently than girls (LinguiSystems, 1999). Even though, the syndrome is not fatal, the ability of children and youth to develop as normal and well functioning individuals can be jeopardized by the presence and failure to address their situation a t an early stage of development. As such, educators must foster a culture and environment of understanding and openness, which will help in making students with Tourette’s Syndrome feel included and thus, part of the whole class. In addition, simple interventions must be applied to make them academically adept.


 


            However, these measures cannot be implemented without recognizing that TOurette’s Syndrome is indeed present in the some students within the regular educational system. This means that the first step towards addressing the learning or academic needs, among others, of children affected by the Tourette’s Syndrome is the acceptance and recognition of the presence of the syndrome. The following sections of this paper will be discussing the nature of Tourette’s Syndrome in order for educators to recognize them in the classroom. In addition, the effects of Tourette’s Syndrome will also be discussed to determine how educators can better facilitate the learning process of students with Tourette’s Syndrome.


 


Tourette’s Syndrome


 


            Tourette’s Syndrome is a neurobiological disorder that is characterized by involuntary motor and vocal actions (American Psychiatric Association, 2000). These involuntary motor and vocal actions are known as tics. According to Bronheim (1991), tics are usually observed in early elementary age children. This suggests that Tourette’s Syndrome occurs at the age of 6 to 7 years (American Psychiatric Association, 2000). Some of the most common motor and vocal tics are head or arm twitching, eye blinking, sniffing and throat clearing (Dornbush & Pruitt, 1995). In comparison to other neurological disorders, people with Tourette’s Syndrome have different tics as well as symptom severity (Ottinger, 2003).


 


            This commons motor and vocal tics can become more complex as the child matures. The tics may develop into facial gestures or movements that replicate others (LinguiSystems, 1999). It can also be the case that completely new tics could develop and manifest. Tourette’s Syndrome is a life long condition that will take an unpredictable course. This means that symptoms as well as behaviors associated with the syndrome will persist throughout the life of the affected person. However, these symptoms and behaviors can change and thus the person may appear to be acting differently. 


 


However, tics can temporarily disappear during a remission period or early adulthood. In addition, tics disappear during sleep as well as intense sexual arousal (Berlin, n.d.). Even though tics are involuntary, some people have the ability to hold the urge to release their tics until they deem that it is the right time and/or they are in the right place. This is believed to be caused by their neurological basis. However, holding the urge to release tics can be extremely difficult and once the tics are released are a period of holding it may cause the tics to intensify.


 


            Unfortunately, people who have been diagnosed with Tourette’s Syndrome have comorbid diagnoses. This means that aside from having Tourette’s Syndrome they have also been diagnosed as having other neurological problems. Some of these other conditions include obsessive-compulsive disorder, Asperger Syndrome, attention-deficit or hyperactive disorder and learning disabilities (Dornbush & Pruitt, 1995; Marriage, Miles, Stokes, & Davey, 1993; Ottinger, 2003). Of the other conditions that comes with Tourette’s Syndrome, attention-deficit hyperactivity is the most common (Kerbeshian & Burd, 2000; Freeman et.al, 2000) followed by learning disabilities and obsessive-compulsive disorder (Pauls, Leckman, & Cohen, 1993; Coming & Comings, 1994; Como, 2001).


 


            It has been demonstrated that the presence of comorbidity overtime is an important factor in severity of the syndrome as well as the level of impairment due to the condition (Burd et al., 2005). This means that the presence of comorbid diagnosis can further the disability of a child most especially if learning disabilities are diagnosed. The symptoms learning disabilities and other neurological disorders associated with Tourette’s syndrome are more challenging for students more than the symptoms of Tourette’s syndrome itself. However, these symptoms do not have an effect on the measurable intelligence of the individual, which suggests that it does not directly affect the intelligence of person with Tourette’s Syndrome. It is even the case that students with Tourette’s Syndrome have average to above-average Intelligence Quotient levels. 


 


            Nevertheless, schooling is still needed to ensure that the peson with Tourette’s Syndrome as well as other condition can meet or achieve their full potential as individuals. It has been suggested that the difficulties that will be faced by a person with Tourette’s syndrome is categorized into three – physical, socio-emotional and academic. Diccussing the three categories of difficulty involved with having Tourette’s syndrome requires the author to delve into a wide range of discussion. For the purpose of this paper, the academic challenges or difficulties will be the focus of the following section of this paper. As such, the effects of Tourette’s Syndrome on the academic ability of children will be highlighted in the next section of the paper.


 


Learning with Tourette’s Syndrome


 


            According to LinguiSystems (1999), about forty percent of individuals who hae been diagnosed with Tourette’s Syndrome also have learning problems. As a result, seventy percent of students who have been found to be affected by Tourette’s syndrome were enrolled in special education. In addition, twelve percent of children in special education programs have Tourette’s Syndrome (Coming et al., 1990).  Coming et. al (1990) added that Tourette’s Syndrome have significant effects on school performance. Nevertheless, they are often misdiagnosed.


 


            Based on the studies conducted by Harris et, al (1993), 3 out 4 children and youth with Tourette’s Syndrome showed spelling and writing as significant problem areas, while 1 out of 4 have problems with word identification  as well a reading comprehension. In addition, half of the participants of the research exhibited difficulty in calculation. This suggests that Tourette’s Syndrome can be associated with difficulties in visual-motor skills as well as spelling.


 


            Aside from the abovementioned academic difficulties presented above, students with Tourette’s Syndrome may also experiences any or all of the following impairments in relation to their academic performance (Prestia, 2003):


 


v     Non-completion of school works


v     Illegible or poor quality of written works


v     Easily distracted in class


v     Disorganization


v     Difficulty in comprehending and thus executing verbal instructions


 


            Once again, it needs to be reiterated that the problems presented by a TOurette’s Syndrome patient in class can vary depending on the severity of the tics as well as the presence of learning problems. It must also be considered that educators have to think about the welfare of the entire class and not just individuals. As such, educators must treat students with Tourette’s Syndrome like a normal student whenever possible.


 


            As stated earlier, student’s with Tourette’s syndrome can be easily distracted or do not pay attention when it comes to lectures and other school activities. This maybe the result of the tics that they need to release. Involuntary jerking of the head, for example, can disrupt the concentration of the student to the lecture being given by the teacher. In addition, reading and comprehending a book can prove to be difficult if one’s eyes keeps on blinking at rate that is beyond normal. This means that the physical manifestations of Tourette’s Syndrome contributes greatly to the inability of students to focus on the learning process.


 


            Moreover, pressure to fit in with all the other student in the school being attend posses as distractions that affects the learning curb of the student with Tourette’s syndrome. It may also be the case that const teasing due to the physical manifestation of the syndrome could lead to a student loosing interest in going to school altogether. As such, aggressive behaviors may arise on the part of the student with Tourette’s syndrome (Berlin, n.d.). Incidents where students with Tourette’s Syndrome are being teased by other children intensifies the socio-emotional effects of the syndrome. Children may develop a kind of thinking that they are not accepted by their peers and the community because of their tics and as such, some might choose to isolate themselves to refrain from experiencing embarrassment and anxiety. In addition being bullied will affect the child’s self- esteem and confidence. 


 


            Aside from this, tics can also provide threats to the safety and well being of the students especially if they are within school grounds. The presence of vocal and motor tics can damage joints, muscles as well as organs due to excessive wear and tear.  Injuries can also accompany tic releases due to accidents. This means that daily routines can also prove to be difficult to some people with Tourette’s Syndrome. The successful completion of physical tasks is affected by impairments in visual perception, sensory processing and motor planning.  


 


Role of Educators


 


            In the midst of the difficulties being faced by students with Tourette’s Syndrome., educator play an integral role in ensuring the all possible interventions be implemented so that the students will be able to meet their full potential within the academic institution as well as in the real world. Therefore, it is one of the roles of educator to ensure that a culture and environment of understanding and acceptance be fostered for benefit of all especially those with disabilities.


 


            Teachers can start be providing information about Tourette’s Syndrome in a child friendly manner. Some of the interventions that can be implemented to ensure a positive environment for all are the following (Prestia, 2003):


 


v     Information dissemination about Tourette’s Syndrome


v     Use the strengths of the student with Tourette’s Syndrome to facilitate peer connection


v      Encourage student with learning disabilities or disorders to form a support


v     Prevent confrontations by providing explanations


v     Praise positive behaviors and efforts of students with Tourette’s Syndrome in order to encourage independence and the promotion of self-esteem and confidence


v     Incorporate social skills in the weekly curriculum


 


In addition, it is important to note that the success of students with neurological disorders is interdependent. This means that each category of difficulty being faced has a direct effect on the others. For example, the academic performance of a student can be affect by bullying, which categorized as social-emotional difficulty. This means that the intervention needs to be formulated based on the challenges that nave been identified. In addition, the interventions to be implemented must use the strengths of the students with Tourette’s synrdrome so make them realize that they do have skills that they are good at and thus increase the students desire to enhance his her skills and abilities.


 


As such, the formation of an environment that is friendly and accepts diversity will allow people with disabilities to function as normal as possible around other people. This will also prepare them for the challenges in life that will require them to go act and interact to more diverse individuals that may or may not accept them due to their disabilities. Schools gives children and youths the basicthat they will be needing to survive the harsh realities of the world. Therefore, students with neurological disabilities will also be able to benefit in the future if they are able to acquire these basic tools.


 


Conclusion


 


            In conclusion, it can be stated that Tourette’s Syndrome affects the academic ability not by decreasing the intelligence of the students affected by the syndrome. Rather, their academic abilities are being affected by other categories of difficulties that they face. It is the case that the ability of the child to learn more is being hindered by the physical manifestation of the syndromes symptoms. This means that distractions, as the results of the symptoms and behaviors associated with Tourette’s Syndrome, contribute greatly to the inability of the students to process and digest information being passed onto them by their educators.  It is also the case that social-emotional difficulties pushes students with Tourette’s Syndrome to view themselves as different from their classmates and peers and thus affect their interest in taking part in school related activities.


 


            However, the effects of Tourette’s Syndrome on the academic ability of student can be minimized through interventions by educators as well as families and friends. Students with Tourette’s syndrome can live a normal live with a little help form the people that they interact with. It is through the proper diagnosis and the formulation and implementation of effective interventions based on the challenges and strengths of the student can the effects of Tourrette’s syndrome on the academic ability of the patient be minimized.


 


Reference


 


American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.


 


Comings D.E. & Comings B.G. (1994). TS, learning, and speech problems.
J Am Acad Child Adolesc Psychiatry.  33, pp. 429-430.


 


Coming, D.E. Himes, J.A. & Coming, B.G. (1990). An Epidemiological Study of Tourette’s Syndrome in a single School Distrct. Journal of Clinical Psychology. 51, pp. 463-469.


 


Como, P.G. (2001). Neuropsychological function in Tourette syndrome.
Adv Neurol. 85, pp. 103-111.


 


Bronheim, S. (1991). An educator’s guide to Tourette syndrome. New York: Tourette Syndrome Association.


 


Dornbush, M. P., & Pruitt, S. K. (1995). Teaching the tiger: A handbook for individuals in the education of students with attention deficit disorders. Tourette syndrome, or obsessive-compulsive disorder Duarte, CA: Hope Press.


 


Freeman R.D., Fast D.K., Burd L., Kerbeshian J., Robertson M.M., & Sandor P. (2000).  An international perspective on Tourette syndrome: selected


 


Kerbeshian J. & Burd, L. (1992). Epidemiology and comorbidity: The North Dakota prevalence studies of Tourette syndrome and other developmental disorders. Adv Neurol 58, pp. 67-74.


 


LinguiSystems, Inc. (1999). The source for syndromes. East Moline, IL: Author.


 


Marriage, K., Miles, T., Stokes, D., & Davey, M. (1993). Clinical and research implications of the co-occurrence of Asperger’s and Tourette syndromes. Australian and New Zealand Journal of Psychiatry, 27, 666-672.


 


Ottinger, B. (2003). Tictionary: A reference guide to the world of Tourette syndrome, Asperger syndrome, attention deficit hyperactivity disorder and obsessive compulsive disorder for parents and professionals. Shawnee Mission, KS: Autism Asperger Publishing Co.


 


 


findings from 3,500 individuals in 22 countries.
Dev Med Child Neurol.  42, pp. 436-447.


 


Pauls D.L., Leckman J.F. & Cohen D.J. (1993). Familial relationship between Gilles de la Tourette’s syndrome, attention deficit disorder, learning disabilities, speech disorders, and stuttering.
Journal of American Acad Child Adolesc Psychiatry.  32, pp.1044-1050.


 


Prestia, K. (2003). Tourette’s Syndrome: Characteristics and Interventions. Intervention in School & Clinic. 39(2),pp. 67+.


 



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