|EDUCATION QUESTION OF THE MONTH
Q. I am a Special education teacher. Recently a new student moved into the area who has TS. I am interested in serving him in the best possible way. My main concern is that I hold him accountable for his actions, so he understands that he is responsible for them. I understand that we are not able to control our disabilities, but I also know that teenagers will use their disabilities to get away with inappropriate actions. I have seen this student use his tics after a girl laughed and started talking to him; so I know that the potential is there. Any information that you have would be greatly appreciated.
A. Thank you for contacting us in an effort to assist this student with TS.
It is often difficult to determine typical “kid stuff” from true neurological symptoms. Tourette is particularly complex because symptoms change periodically; wax & wane; can sometimes be suppressed; are inconsistent and often hidden; can appear to be purposeful and are sometimes suggestible. It’s helpful if we remember that symptoms of TS are urges which, due to TS, are difficult or impossible to suppress depending on the moment. It might be helpful for you to a view a brief clip from “I Have Tourette's but Tourette's Doesn’t Have Me” http://tourette.org/ZHBO/VideoPlayer.html. An excellent resource for teachers is, “TS in the Classroom, School, and Community” – video of an Educator’s In-Service with a 24 minute introduction to TS in the classroom as well as brief clips regarding specific related difficulties: http://www.tsa-usa.org/ZEdDVD/MainMenu.html.
In our experience, instead of focusing on ‘accountability’, helping the student learn life-long strategies to manage (not control or stop) symptoms in order to respond in socially appropriate manners works best in the long run. Over the past 25 years in which I have assisted parents and educators attempt to understand and provide appropriate supports, I have rarely experienced a student who uses their symptoms as an excuse for bad behavior. I have, however, known young adults to pretend that their symptoms are purposeful because it’s almost always better for a teenager to be seen as ‘bad’ instead of ‘weird’.
In response to your example, it would not surprise me that a young boy’s tics would increase while speaking to a young girl. Stress will typically make symptoms worse. Social interactions are often stressful for all students. Additionally, it is not unusual for a student who has tics to act like they do them on purpose if they receive what they perceive to be a positive reaction from classmates. Generally speaking, tics are embarrassing and something that students would like to stop having to do.
You may want to check out articles on the education page of our website at http://tourette.org/Education/education_main.htm such as “Tics in the Classroom- An Educator’s Guide”.
Ask the Tourette Association Education Advisory Board a question about Education - all questions
will be answered.
RESOURCES FOR EDUCATORS
- 10 Things Teachers Can Do For Students with Tourette Syndrome - article
Very often, teachers and school personnel misinterpret the symptoms that are associated with Tourette Syndrome. Every student with TS is unique; therefore, it is important for education professionals to remain curious about how to utilize teaching strategies and offer the appropriate supports to help students achieve academic and social success... [More>>]
Key take-away points include:
• Learning how to recognize TS and its common co-occurring conditions.
• Being observant of the student’s strengths and weaknesses.
• Providing creative interventions to teach life-long strategies.
- Identifying Common Education Difficulties with TS - article
Due to the misunderstanding of the underlying symptoms of Tourette Syndrome, there is a common misperception that these symptoms are done purposefully. Students are often so focused on masking their symptoms that their true intellectual abilities may be disguised. It is important for educators to recognize the common education difficulties students with TS face in order to better address their needs...[More>>]
Some of the common signs to look for include:
• Problems with managing assignments and insisting on having things “just right.”
• Difficulty in transitioning between tasks, following directions, and paying attention.
• Avoidance and refusal to participate in social functions and displaying disruptive behavior
- TS is More than Tics: Understanding Behavioral Challenges & Related Symptoms- article
Tourette Syndrome and its common co-occurring conditions are often misinterpreted as disruptive behavioral problems. When the educator is not sufficiently knowledgeable about TS, there is more of an opportunity for the student to face punishment because he or she is seen as a problem. If the educational team recognizes that the student is struggling due to co-occurring problem, they will be more likely to develop and implement proactive strategies and work with the student to instill a positive outlook on academics and the school environment...[More>>]
To gain a better understanding of some of the behavioral challenges students with TS face, the article suggest many ways for educators to be more positive, proactive, and effective.
Common behavioral challenges include:
• Disinhibition and immaturity.
• Oppositional behaviors and rage.
• Extreme reactions to the environment and difficulty with transitions.
• Obsessive compulsive behaviors and attention deficits.
Suggested strategies for educators include:
• Acknowledging the student separate from his or her symptoms.
• Working with the student to develop and practice modification strategies.
• Being mindful of the student’s possible triggers.
- Classroom Strategies and Techniques for Students with Tourette Syndrome- article
Key elements for creating a supportive educational environment include awareness, acceptance, and creativity. When school personnel are educated about Tourette Syndrome, able to recognize it, and can offer the appropriate supports, the students will have greater opportunities for success......[More>>]
This article provides a list of strategies that can assist in developing effective supports in the areas in which the student struggles.
- Tics in the Classroom: an Educator's Guide - article
In the classroom, tics may seem disruptive or intentional, but educators need to understand that tics are not the student’s fault and that they are not simple habits that can easily be replaced or stopped...[More>>]
Key points to remember for providing a supportive academic environment include:
• Understanding that tics change and can affect academic performance.
• Using accommodations as necessary and ignoring the tics when possible.
• Effectively managing extreme tics in the classroom by conducting behavioral assessments and providing supports to prevent disruptive behavior, and ensuring the student still participates in the lesson plans.
- Vocal Tics in the Classroom - an Educator's Guide- Webinar - slides, audio, downloads
- Anxiety Management in the Classroom - Children with Tourette often have accompanying worry and anxiety - this article gives accommmodations and strategies for teachers and school-based professionals to help students manage their anxiety. Written by Helene Walisever, PhD, Clinical Psychologist and member of theTourette Association Education Advisory Board.
- Handwriting Issues - article
Dysgraphia, or written language deficits, is a common issue for students with TS. The reasons for these deficits are varied and complex, but they can prevent students from being able to transfer thoughts into writing...[More>>]
This article offers suggestions for addressing issues related to dysgraphia and handwriting. These may include the use of assistive technology and providing accommodations for assignments and assessments, such as extended time or oral reports. It also offers suggestions for advocating for writing support.
- A Guide for Paraprofessionals - article
Paraprofessionals and classroom aides can play an important role in ensuring a safe and successful school experience for students with TS by providing positive supports...[More>>]
This article provides suggestions for developing a trusted relationship between a student and a paraprofessional, and for utilizing positive supports to help students with TS succeed in the classroom.
Key recommendations include:
• Fostering regular communication between the paraprofessional and another teacher or counselor.
• Educating the paraprofessional about the complexities of TS, related disorders, and the unique and sometimes challenging symptoms that children with TS often experience
Using positive and proactive interventions and strategies.
Utilizing the insight and understanding that paraprofessionals can offer due to their close working relationships with students with TS.
• Periodically assessing the fit and type of support of the paraprofessional for the student with TS.
- Tourette Syndrome In-service
Offers essential information on Tourette Syndrome and related conditions for school-based staff. This resource will discuss the following:...[More>>]
- Overview of TS: What is it, what does it look like, and how common is it?
- TS and co-occurring conditions in the classroom: the impact on learning and possible management strategies.
- How to promote communication between educators and parents.
- Tourette Syndrome in the Classroom, School and Community - Seminar for educators - filmed at an all-day live presentation by members of the Tourette Association Education Advisory Board - addresses the following topics:...[More>>]
- Educator's Guide for Developing Plans for Students with Tourette Syndrome - article
- Online Video "Stand Up for Tourette Syndrome"
Short video (3 min., 39 sec.) in which school kids STAND UP for TOURETTE SYNDROME by helping Luke, a young boy with TS explain his TS to a group of kids who have been acting really mean to him - video is downloadable as is a Teachers' Guide - click here.
- DVD with Teacher's Resources:
HBO Documentary, I Have Tourette's But Tourette's Doesn't Have Me.
The DVD features content shown on the HBO broadcast plus a variety of resources for educators, families, and children interested in learning more about Tourette Syndrome, and supplementary information from experts John Walkup, M.D., Susan Conners, M.Ed., and Evan Trost, M.D. DVD available here.
Free Teacher's Guide - Click here to View or Download
- Book with Teacher's Resources:
In this novel, Carrie, a seventh-grade girl has just been diagnosed with TS. Targeted to early teens, Quit It explores Carrie's struggles to cope with TS while trying to fit in with her peers. Available here.
Free School Reading Program and Sample Lesson Plan Using Quit It. Click here.
- Programs for Educators and School-Based Staff
The Tourette Association offers programs to special education directors, IEP team chairpersons, regular and special education teachers, school psychologists and social workers, school nurses, paraprofessionals, speech therapists, occupational therapists in professional association, conference, and university settings. Presentations are given on Tourette Syndrome and associated disorders; attendees receive course materials (click here for program details and contact information).
- A Workbook for Conducting a Functional Behavioral Assessment and Writing
a Positive Behavior Intervention Plan for a Student with Tourette Syndrome - Publication #E-126 - Practical guide and valuable resource to address complex behavioral issues. Includes Overview of Functional Behavioral Assessments, FBA Worksheets, Positive Behavior Interventions.
- Section 504 - provision of the Rehabilitation Act of 1973 (Federal Law) which prohibits recipients of federal funds from discrimination against persons with disabilities
Section 504 Plan - A legal document outlining accommodations and modifications provided by the school so that a child is not discriminated against.
- Individuals with Disabilities Education Act (IDEA) - Federal Law - stated purpose (in Section 1400 (d)(1)) is “…to ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment and independent living” and “to ensure that the rights of children with disabilities and parents of such children are protected….”
IDEA specifically includes Tourette Syndrome under the definition of Other Health Impairment (OHI)§300.8(c)(9)); the Department of Education explains why Tourette Syndrome is included under OHI:
"Discussion: ... we do believe that Tourette syndrome is commonly misunderstood to be a behavioral or emotional condition, rather than a neurological condition. Therefore, including Tourette syndrome in the definition of other health impairment may help correct the misperception of Tourette syndrome as a behavioral or conduct disorder and prevent the misdiagnosis of their needs.
Changes: We have added Tourette syndrome as an example of an acute or chronic health problem in §300.8(c)(9)(i)."
§300.8(c) "Definition of disability terms. The terms used in this definition of a child with a disability are defined as follows:
...(9) Other health impairment means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that:
(i) is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, and sickle cell anemia, and Tourette Syndrome; and
(ii) adversely affects a child's educational performance"
IDEA regulates Independent Education Programs (IEPs).
- IDEA Basics- audio and slides
- IEP (Individualized Education Program) - Each public school child who receives special education and related services must have an Individualized Education Program (IEP), designed for that student, and must be a truly individualized document. The IEP is developed by teachers, parents, school administrators, related services personnel, and students (when appropriate) documenting the specific supports school personnel will be provided to enable the child to meet individualized academic and functional goals.
- IEP Essentials for Parents - Publication #E128 - Explains the basics of the IEP including what it is, the steps
to obtain one, the formal meeting process, eligibility, and developing an IEP.
Understanding Assessments & Evaluations - audio and slides
- IEE (Independent Educational Evaluations) - audio and slides
- LRE (Least Restrictive Environment) - audio and slides - students with disabilities must be educated
with non-disabled peers, to the greatest extent appropriate
- F.A.P.E. - Section 504 and the IDEA require that a Free and Appropriate Public Education be provided to all eligible students who attend school which receives funds from the US Dept. of Education.
- FERPA - Family Education Rights and Privacy Act. A Federal statute with the purposes of ensuring that parents have access to their children's education records, and to protect the rights of children and parents by limiting access to these records without parental consent, and to manage misleading or incorrect information.
- New Federal Education Law - the Every Student Succeeds Act (ESSA) - replaces No Child Left Behind, rejecting the overuse of standardized tests and one-size-fits-all mandates in our schools.
SELECTED ADDITIONAL RESOURCES