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Management
Strategies for TS
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Students with Tourette Syndrome AND a learning disability should have an
Individualized Education Plan (IEP) to address learning needs. When TS
impacts on learning and on the student’s daily functioning, interventions
to address the problems should be included in the IEP. Students who do
not qualify for Special Education may qualify for assistance with a
504 Plan.
Rationale: refer students who are experiencing difficulty in the classroom
for screening and assessment. Remember – the symptoms of Tourette can wax
and wane over time. Hence, a student’s need for school assistance may
vary.
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Students with TS who do not qualify for Special Education or a 504 Plan
can receive help with a school-initiated action plan. With this type of
plan, teachers, parents, administrators, and school nurses work together
to provide the child with help and support.
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In TS
action plans, strategies focus on reducing stress, assessing the quality
of the child’s work (not the quantity), eliminating distractions, and
facilitating success. Some of the following academic strategies may be
considered:
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Break
down student’s assignments into manageable “chunks” or sections.
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Base
homework on student’s rate of task completions, especially if the
student requires more time to finish assignments.
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Use
grid paper for writing and mathematics assignments if handwriting is a
problem.
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Provide oral or computerized assignments if the handwriting problem is
severe.
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Provide the student with seating near the teacher’s desk so the student
can be quickly (and subtly) redirected.
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Minimize distractions in the classroom.
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Provide student with a workstation in a quiet area if possible.
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Create a comfortable, daily routine in your classroom.
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Incorporate visual aides, written instructions, and demonstrations into
class lessons.
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Set
reasonable time limits for assignments. If possible, avoid “timed”
tests.
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Allow
students to test in a quiet area away from others.
Rationale: a significant number of children with TS have learning problems
and experience difficulty completing their work. They also may have
attention and organization problems. Written work may be of poor quality,
and verbal instructions alone may be insufficient for ensuring
understanding.
1. After
obtaining consent from the child with TS (and parents), educate
peers and staff. The child’s physician, the school nurse, and school
psychologist can assist in this process.
2. Use
a non-judgmental and accepting attitude toward the child.
3. Focus
on the student’s strengths and interests when grouping or pairing students
for assignments.
4. Notify
the student with TS about unexpected events (assemblies, guest speakers,
fire drills, etc.) as soon as possible.
5. Praise
positive behaviors.
6. Consider
incorporating empathy-promoting activities, coping skills, and social skills
training in the school curriculum.
7. Set
reasonable expectations for the child’s behavior. Remember – punishment for
a child’s tics is not appropriate. Punishing a child for symptoms of a
medical disorder violates that child’s civil rights!
Rationale: Because stress typically exacerbates tics, tactics that help to
alleviate stress can reduce the incidence of
tics.
For
more strategies, visit the website of the Tourette Syndrome Association,
Inc. at:
http://tsa-usa.org
1.
Frequent tics can cause fatigue. A child’s attempts to
suppress tics also may be tiring. Thus, the child with TS may need a rest
period or between-meal snacks during the regular school day.
2. Provide
the child with TS opportunities for physical movement.
3. Provide
the child with a safe place to express tics.
4. Monitor
for behaviors that threaten the safety of the child, other students, and the
school staff. Work with the parents, the physician, the school nurse, and
the school psychologist in developing appropriate intervention techniques
for those behaviors that are potentially injurious to the student or others.
5. Request
information about the child’s medication and potential side effects. Be
aware that some medications can impact on the child’s physiological AND
cognitive processes.
6. Report
changes in behavior, changes in the frequency and intensity of tics, and
side effects of medication to the child’s parents and the school nurse.
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