While every student is unique, the following are general suggestions that may help a student who has TS or tics to be successful in your class. For more information about Tourette Syndrome, please refer to Five Things College Professors Need to Know about Tourette Syndrome.
- Educate yourself about Tourette Syndrome. Having a basic understanding of TS and related disorders will help with identifying symptoms as possibly being a component of this complex neurological disorder and can prepare you for the presentation of both motor and vocal tics during class.
- Recognize that tics are involuntary movements and sounds that wax and wane and can change unpredictably. In many cases, students with TS will attempt to suppress their tics to avoid negative attention from others. While the tics may appear to be within the person’s control and are being done purposefully, they are not. Some people attempt to suppress their tics, which can lead to increased intensity at a later time. Tic suppression is not always possible and not all people are able to do so. A student should not be expected to suppress tics.
- Ignore the symptoms that can be ignored. This demonstrates acceptance and normalizes Tourette Syndrome and other related symptoms. Modeling acceptance can reduce both bullying and stress and may help the student with TS to focus his/her energy on academics rather than tic suppression.
- Understand that stress typically increases symptoms. Setting clear expectations and providing a detailed syllabus can minimize anxiety. Tests and presentations generally increase stress and therefore, symptoms.
- Check with the designee at your institution to determine which accommodations and academic adjustments have been approved for the student. Requirements under ADA require postsecondary institutions to make reasonable accommodations and modifications for students with disabilities in order to provide equal opportunity to participate in courses, programs, and activities. Accommodations for students with TS can help reduce anxiety, address handwriting challenges, and compensate for time spent either experiencing tics or focusing on the suppression of them.
- Extended time for course work and testing
- Substitution for specific courses to meet degree requirements
- Reduced full-time course load (number of credits taken at one time)
- Alternatives for note-taking: computer, tablet, note-taker, audio recordings, and/or providing lecture notes
- Testing in an alternate location, like a testing center
- Remote access to class (Skype, for example)
- Written copies of oral directions
- Assist students with the university’s policies and refer them to the disability services office if they disclose their disability and ask for accommodations. Eligibility for services under the ADA is not the responsibility of faculty members; it is determined by the personnel in the disability services department.
- Allow the student to leave the classroom when necessary. For some students, tics can be preceded by a feeling or sensation called an urge. A student may prefer to step out of the classroom for relief, rather than tic in front of their peers or focus solely on tic suppression instead of instruction. People with TS describe the feeling of trying not to tic to attempting to hold back a sneeze or refrain from scratching an itch. Sitting near a door can be important.
- Be aware of co-occurring conditions, such as Obsessive Compulsive Disorder (OCD), Attention Deficit/Hyperactivity Disorder (ADHD), handwriting issues, and anxiety disorders including depression. With regard to ADHD, students with TS present predominantly with the inattentive type and can be overlooked because they are not typically behavior problems. The characteristics of these conditions are often more problematic and harder to manage than the tics themselves.
- Respect the privacy of students with TS. They are not required to disclose their disability to their peers. Although they must disclose information about TS to their designated official at the institution to receive access to accommodations, they do not have to disclose to everyone. Treat information given to you as confidential. Do not engage in philosophical debates about “fairness” with other students. If you have a concern, contact the office of student disabilities services to ask what, if any, accommodations a student may have. If you are unsure if a student has TS, do not ask them. Ultimately, it is the student’s responsibility to provide you with the information. However, professors should strive to cultivate an atmosphere of tolerance for all disabilities, which may make students more comfortable and willing to seek accommodations.
- To assist educators, The Tourette Association offers a variety of programs and materials designed to help with recognition and management of TS symptoms in the classroom and school environment. The most helpful thing an instructor can do is to be knowledgeable about TS and empathetic to the student. Understand that, although the symptoms may sometimes cause a distraction in class, there is no one more distressed than the student themselves. Use the Association’s resources for assistance in developing supports and strategies.