Tourette’s Syndrome

Tourette Syndrome is a Tic Disorder in which multiple motor tics and one or more vocal tics are exhibited. A tic is described as a “sudden, rapid, reoccurring, non-rhythmic, stereotyped motor movement or vocalization that is irresistible but can be suppressed for varying amounts of time.” Tics can be made worse by stress or anxiety. Tics can also be exacerbated by the use of certain types of medication. 

Individuals may display either simple or complex tics. Common simple motor tics include eye blinking and neck jerking. Common, simple vocal tics include throat clearing and sniffling. Common, complex motor tics include facial gestures and grooming behaviors. Common complex vocal tics include repetition of words or phrases and echolalia. While Tourette Disorder is sometimes associated with coprolalia (the use of socially-unacceptable and obscene words), such display is quite rare. 

Tourette Disorder is marked by a combination of both motor and vocal tics. These tics interfere with an individual’s functioning and cause difficulty for him or her in school or in social relationships. Tourette Disorder is commonly seen in individuals who display signs of obsessions and compulsions. Tourette Disorder also commonly co-occurs with Attention Deficit/Hyperactivity Disorder and Anxiety Disorder. 

The symptoms of Tourette Disorder often wax and wane over time. Observations of common complex tics may change. Many individuals display mild signs of Tourette Disorder in which the tics are easily observed but do not cause a significant degree of impairment. 

Recommendations

1. Do nothing. If the tics are not significantly interfering with your child’s functioning, then it may be best to ignore them. Tics will often change frequently and may wax and wane over time. Sometimes, drawing attention to them actually makes them worse, so it may be best to minimize their impact by doing very little. 

2. Educate yourself and other family members about Tourette’s Disorder. This way you will be able to understand what your child is experiencing and can recognize some of the strategies that may benefit your child. 

3. Educate others. Talking with children about their tics may help them to cope with the disorder. In addition, it is often helpful to talk to children’s classroom teachers so as to help them understand the nature of the tics. At an elementary-school level, it may be useful to educate the entire classroom about a child’s tics so that peers do not tease the child about them. 

4. Consult with your child’s pediatrician about medication. There are some medications that may be helpful for youngsters with Tourette Disorder. However, there is not a single medication that completely eliminates the symptoms. In addition, many of these medications have significant side effects, so it is important to carefully consider the risks of medication. 

5. Involve your child in individual psychotherapy. While it is important to note that Tourette syndrome is not caused by psychological problems, anxiety and emotional stress can make the symptoms worse. Psychotherapy may also help a child to cope with peer difficulties and other stressors that may be related to the symptoms of Tourette Disorder. 

6. Alternative treatments may be worth exploring. These include neurofeedback, hypnosis, relaxation training, and habit-reversal training. However, at present, there are limited data supporting these treatments. 

7. Consider other disorders that may accompany Tourette’s. Comorbidities with ADHD, Generalized Anxiety Disorder, and Obsessive Compulsive Disorder are relatively common. 

Websites

Tourette Syndrome “Plus”: This site provides useful information about tics, treatments, and research studies as well as a TS blog. 

National Institute of Neurological Disorders and Stroke: The information found on this site is from the National Institute of Neurological Disorders and Stroke. General information, research, news, and organizations regarding TS can be found at this site. 

Jim Eisenreich Foundation: Jim Eisenreich, a former baseball player for the Florida Marlins, created this foundation in order to help people with Tourette syndrome. This site offers an extensive list of resources on TS, including book resources for people of all ages. 

National Tourette Syndrome Association: The National Tourette Syndrome Association site provides information on research, news, educational strategies, and legislation. 

Medicine Net: A comprehensive website that describes the symptoms and course of Tourette’s. 

School Behavior: A great site that provides a comprehensive look at treatment and diagnostic issues regarding Tourette syndrome. 

Challenging Kids: This site provides many resources and books on Tourette syndrome. 

Books

Buehrens, A. (1991). Hi, I’m Adam: A Child’s Book About Tourette Syndrome. Duarte, CA: Hope Press. (Ten-year-old Adam describes what it was like for him to grow up with Tourette’s, sharing both his positive and negative experiences.) 

Dornbush, M.P., Pruitt, S.K. (1995). Teaching the Tiger: A Handbook for Individuals Involved in the Education of Students with Attention Deficit Disorders, Tourette Syndrome or Obsessive-Compulsive Disorder. Duarte, CA: Hope Press. (This book includes general information about Tourette’s and related disorders as well as possible treatments and interventions in the home and at school.) 

Kutscher, M.L., Wolff, R.R., Attwood, T. (2007). Kids in the Syndrome Mix of ADHD, LD, Asperger’s, Tourette’s, Bipolar, and More!: The One Stop Guide for Parents, Teachers, and Other Professionals. London, NJ: Jessica Kingsley Publishers. (Great information about co-occurring neurological disorders; provides general information on each disorder as well as treatments.) 

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 Company. (This unique book is an A-Z Guide with a great deal of information about how to best approach certain situations in order to help children with neurological disorders succeed in any and all situations.)