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- What is Tourette’s Syndrome?
- Diagnosing Tourette’s Syndrome
- What Causes Tourette’s Syndrome?
- Help for Tourette’s Syndrome
- More Information on Tourette’s Syndrome
What is Tourette’s Syndrome?
With Tourette’s Syndrome, which usually starts in childhood, individuals feel an irresistible urge to make sounds and body movements that are beyond their control. These uncontrollable movements and sounds are called tics.
For people with Tourette’s Syndrome, tics can be extremely distressing, only bringing relief once they have been expressed. In some cases, they might blurt out obscenities - an element of Tourette’s Syndrome that is rare, and one that has been unfairly exaggerated in movies and television shows.
Tics often increase with tension, and decrease with relaxation or when focusing on an absorbing task. Although it is a newly recognized condition, Dr. Georges Gilles de la Tourette (after whom the condition is named) described nine cases in 1885.
While Tourette’s Syndrome is often thought of as a type of mental illness, Tourette’s Syndrome is actually classified as a neurological (brain) disorder.
Diagnosing Tourettes Syndrome
If you notice your child displaying unusual movements or behavior, pay a visit to your health care professional, as the first sign of Tourette’s Syndrome is often a facial tic.
When diagnosing Tourettes Syndrome, it is important to remember that almost all people with Tourette’s Syndrome experience tics, but just because a person has a tic, it doesn’t mean they have Tourette’s Syndrome. Many children develop tics that last for a few weeks or months and then go away on their own.
The best treatment plan begins with an accurate and thorough diagnosis. Unfortunately there is no specific test used in diagnosing Tourettes Syndrome that can be used. Instead, doctors must rely on the history of the person's symptoms.
Although there is no such thing as a "typical" case of Tourette’s Syndrome, the condition follows a fairly reliable course in terms of the age of onset and the history and severity of symptoms. Symptoms of Tourette's Syndrome are incorrectly attributed to behavioral problems.
In preparing to visit the specialist, it is useful to record a diary of the tics, including situations which make them worse and how often they happen. Your doctor will want to know whether tics are causing school or social problems for your child.
Your child may also need psychological testing and screenings for learning problems. Your doctor may ask whether you have noticed signs of other problems for which your child is at increased risk, such as depression or anxiety disorders.
Some emotional or mental conditions may accompany Tourette’s-type symptoms, which can lead to incorrect diagnosis. This makes it very important to have a comprehensive and professional assessment so that an accurate diagnosis can be determined – as this will affect the type of treatment chosen.
Types of Motor & Vocal Tics
Examples of Simple Motor Tics:
- Eye blinking or darting
- Head jerking
- Finger flexing
- Sticking tongue out
Examples of Complex Motor Tics:
- Touching the nose or other people
- Smelling objects
- Obscene gestures or flapping arms
- Jumping or twirling about
- In rare cases, self-injurious actions, including hitting or biting oneself
Examples of Simple Vocal Tics:
- Throat clearing, tongue clicking, yelping, or sniffing
Examples of Complex Vocal Tics:
- Uttering words or phrases randomly and blurting out offensive words
What Causes Tourette’s Syndrome?
The exact cause of Tourette’s Syndrome is unknown, and there is no known way to prevent it. Theories about the causes of Tourette’s include:
- Brain structure abnormalities
- Brain chemical abnormalities
Help for Tourette’s Syndrome
There is no known cure for Tourette’s Syndrome, so treatment focuses on managing tics and helping the individual to adjust to live with the disorder. Individuals that show symptoms of Tourette’s should have a full and thorough evaluation.
There are a wide range of treatment options available for symptoms of Tourette’s Syndrome, which may involve counseling, learning coping techniques, medication, and natural remedies.
All of these are aimed at assisting the person with Tourette’s (and their family) in learning to cope with the disorder. The best results are usually obtained by combining a selection of treatment options, depending on the individual needs of the sufferer.
It is important for parents of newly diagnosed children to spend some time investigating the different avenues of treatment. Be sure to discuss possibilities with your health care provider.
Treatment Options for Tourette’s Syndrome
Prescription medication is the most commonly used conventional approach for treating symptoms of Tourette's Syndrome, but in most cases, it can be avoided. Although drugs may sometimes be effective, they should be used as part of a broader treatment plan. Due to the frequent side effects of these drugs, people on prescription medication should be closely monitored.
As an incorrect choice of drugs may cause symptoms to become worse, it is strongly advised that you research these drugs thoroughly and make an informed decision.
Counseling and psychotherapy
Counseling can assist a person with Tourette’s Syndrome, and help his or her family cope. It is important to make family members understand and help the person with Tourette’s, as well as manage the patient’s own stress over the condition if necessary. This can be effective in helping patients deal with low self-esteem or other feelings that have arisen as a result of the disorder.
Cognitive behavioral therapy (CBT)
Widely accepted as an evidence-based, cost-effective psychotherapy for many disorders, cognitive behavioral therapy has been used with children and adolescents to treat a variety of conditions with good success.
Coping techniques: habit reversal training (HRT)
Intended to increase tic awareness, develop a response strategy to the tic, and motivate the individual to keep a consistent and positive attitude to treatment. Controlled trials have demonstrated that HRT is an acceptable, tolerable, effective, and durable treatment for tics.
Coping techniques: relaxation
Exercise, yoga, or meditation, may be useful drug-free approaches to relieving the stress that may aggravate tics. Frequently, the tics subside with explanation, reassurance, and understanding of the condition in a supportive environment.
Special educational needs for children
It is important to inform the school when a child has Tourette’s syndrome and to ensure that teachers understand the condition. Although most children with Tourette’s disorder have average IQ, some may have special education needs as a result of associated disorders.
Other treatments include deep brain stimulation (DBS) and brain surgery, both of which are serious procedures and should be carefully considered, as they may pose a high risk to the patient.
More Information on Tourette’s Syndrome
Tips for Coping with Tourette’s Syndrome
- Stay positive. Remember that tics usually lessen in severity with age, usually reaching their peak in the early teens to mid teens. This concept may be hard for a young child to think about, but it may offer hope that life won't always be this way.
- Stay physically active. Get involved in physical activities or hobbies. Research indicates that being engrossed in activities can help reduce the frequency and severity of tics.
- Stay mentally active. If you must be in a public place for a while, such as on an airplane or bus, take something to occupy your mind, such as a crossword puzzles, story book, or sketchbooks.
- Reach out. Connect with others dealing with Tourette’s Syndrome for support and information
Tips for Concerned Parents
There are many ways you as a parent can help your child with symptoms of Tourettes Syndrome. Here are a few examples:
- Educate yourself and others about the condition.
- Understand how the tics affect your child, and make changes at home and school to best accommodate them.
- Keep a record of your child’s tics-- when they get worse, and the events that surround them. This may help identify triggers. Be careful not to cause your child more stress - approach this in a way that makes your child feel secure.
- Realize tics are not on purpose. Although tics may frustrate you, do not punish your child for having tics, and try not to show any frustration you may feel. Doing so may increase your child's anxiety and cause more tics.
- Alternate household tasks with free time to allow relaxation and prevent stress.
- Encourage your child to increase responsibilities at his or her own pace.
Tips for Educators
- Provide more time for the pupil to take written tests.
- Provide alternatives if tics affect writing. Allow the child to use a computer, word processor, or typewriter to create assignments rather than handwriting them.
- Provide a quiet place – position a seat where there is privacy and little distraction.
- Allow for frequent rest periods when needed.
- Allow the child to leave the room if he or she needs to let the tics occur in private.
- Set a good example for accepting the pupil. It is important for teachers to discourage teasing by responding quickly and firmly whenever it occurs.
- Provide extra tutoring, learning laboratories, or special classes if needed
Living with Tourette's Syndrome
The overall prognosis is positive. Although there is no cure, many people don't need treatment when symptoms aren't troublesome. People with Tourette’s Syndrome can live a normal life span and intelligence is not affected in any way. Only a rare minority of severe cases can inhibit or prevent individuals from holding a job or having a fulfilling social life.
Often discussions delve into the question, "Are there any advantages of having Tourette’s Syndrome?" And, you may be surprised to hear that the answer to that question may be a resounding - Yes!
Discussions with adults who have Tourette’s Syndrome reveal that not everyone wants treatment, especially if that means they may "lose" something else in the process. Some believe that there may even be advantages associated with the disorder.
Some advantages associated with Tourette’s Syndrome include enhanced cognitive control in young people, as they may learn to ‘camouflage’ tics, mastering great mental control.
Children with Tourette’s Syndrome in some cases had higher IQ scores than predicted by statistical models, and some may be unusually gifted!