Red Flags: Identifying Common Education Difficulties with TS

Common Challenges that Impact School Performance

The following is a list of common education-related difficulties that children with TS may exhibit. It is important that family members and educators are aware of these as too often the symptoms/difficulties are not recognized as being related to Tourette Syndrome.

Educators and families should be aware of common challenges or “red flags” that impact school performance among children with TS. Sometimes these challenges are misperceived as being ‘purposeful behaviors’ not related to TS, or any disability.

Often a student’s intellectual abilities can disguise symptoms in elementary school, while in higher grades, symptoms begin to interfere as academics and social needs become more challenging. Additionally, older students often put more energy into suppressing and/or masking symptoms due to a desire to ‘fit in’ and be accepted by peers.

  • Handwriting Issues/Dysgraphia: Sloppiness; frequent erasing; obsessed with neatness; excessive need for accuracy; reduced output; slowness of handwriting; difficulty with punctuation, spelling, and capitalization; refusal to write.
  • Executive Function Disorder: A brain disfunction that impairs a person’s ability to analyze, plan, organize thoughts and materials, schedule, begin, edit and complete tasks.
  • Difficulty completing homework: Failure to understand the assignment; inconsistency in copying down assignments; not completing assignments on time; refusal to begin assignments; inconsistent ability to hand in assignments.
  • Disorganization: Problems managing time, tasks, and belongings; difficulty beginning and/or following through on tasks; failure to produce a ‘product’.
  • Perfectionism: Erasing; must have things ‘just right’; hyper-vigilant regarding rules; insistence on performing rituals.
  • Difficulty attending: Complex and simple tics or obsessions interfering with concentration even though the student appears to be focused. Some students are able to attend to activities/instruction while experiencing tics even though it may appear otherwise.
  • Challenges with transitioning: Problems when transitioning between tasks and classes; resistance to changes in schedule and/or routine.
  • Difficulty following directions: Slow to respond; inability to complete tasks that have complex or multiple directions; repeated requests for directions.
  • Discrepancy between assessment scores and class performance: Score high on specific subtest but underperform in class
  • Sensory Issues: Sensitivity to light, sound, touch, smells, or tastes. 2. Sensory seeking needs such inappropriate touching; harming oneself physically; excessive inappropriate behaviors in order to relieve a sensory urge need.
  • Stress and Anxiety: School or academic avoidance: shutting down when overwhelmed; excessive trips to nurse, bathroom or counselor; emotional outbursts.
  • Impulsivity: Shouting out answers; exhibiting inappropriate reactions without thinking first
  • Disinhibition: Behaviors that is not impulsive and student recognizes as inappropriate or prohibited but has difficulty consistently inhibiting. Such as touching certain objects, making inappropriate yet contextual statements.
  • Oppositional Behaviors: Inconsistent refusal to engage in an activity or task for reasons which are not obvious; may be due to task deficit. Need to assess why, where, and when the oppositional behavior occurs, in order to determine how to support student so that challenges are less likely to reoccur.
  • Explosive Behaviors in School or at Home: Significant and disruptive behaviors which appear to be overly reactive to a situation. May be due to exhaustion from suppressing symptoms, experiencing anxiety, feelings of failure, or being overwhelmed while at school or with homework.
  • Social Skills Deficits: Immature behaviors, rigid responses, socially inappropriate behaviors, inability to consistently get along with peers.

For a more detailed resource: Understanding Behavioral Symptoms/ Tourette is More than Tics

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