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March 12, 2021

Tourette’s Syndrome: What Is It and What It Means for Kids

I have Tourette's syndrome !

What Is Tourette's Syndrome?

Tourette's syndrome (Tourette's) is a neurological disorder characterized by the occurrence of uncontrollable movements and sounds, called tics. The tics can be body movements such as simultaneous movement of the arms and legs, jerking of the head, sounds such as tickling, shouting, grunting and others.

Tourette's syndrome is usually a precursor to cervical dystonia, another neurological disorder. Although Tourette syndrome is associated with the occurrence of tics, it can also be accompanied by other symptoms, such as hyperactivity disorder, aggression, difficulty concentrating, and others.

There is no cure for Tourette syndrome, but treatments can help manage symptoms. These treatments may include medication to relieve symptoms, psychotherapy to help manage countertransference and emotions, and speech therapy to address communication difficulties. Also, proper environmental management can help reduce symptoms of Tourette's syndrome (Tourette's).

It is important to treat Tourette's syndrome (Tourette's) with respect and understanding, and to promote full and healthy participation in society for people with Tourette's syndrome. An approach that combines public education about the disorder and symptom management can help create a more understanding and open community for people living with the disorder.

Tourette's Syndrome (Tourette's) or Gilles de la Tourette's Syndrome is a neurodevelopmental disorder characterized by the presence of multiple motor and vocal tics.

Tourette's syndrome is a condition that affects the nervous system. Consequently, myospasms - known as tics - are its most common and characteristic symptom. In other words, in this syndrome, the nervous system undergoes specific contractions.

One could liken tics to non-stop hiccups. Although a person may not want to be caught hiccupping, it is nevertheless something that happens involuntarily. The same is true for those who suffer from Tourette's syndrome (gilles de la tourette). Tics are not caused by anxiety, stress or behavioural problems.

One cannot want to stop them. They occur involuntarily, and although some people may, after a great deal of effort, manage to delay their occurrence for a while, they do occur eventually.

Tourette's symptoms usually appear in childhood, between the ages of 5 and 9.

It is not common and boys are more likely to be affected than girls. The tics associated with Tourette syndrome tend to become milder or disappear completely as children get older. Until this happens, parents can help their child cope with the condition.

It's worth noting that Tourette's syndrome (Tourette's) is not the only type of myospasm disorder. It is, however, the most serious. According to the U.S. Centers for Disease Control and Prevention (CDC), about 1 in 50 children aged 5-14 years has some type of persistent myosing disorder. 

Symptoms of Tourette's syndrome (Tourette's)

Myospasms (tics) are the main symptom of Tourette's syndrome (motor and at least one vocal tic). They consist of the production of sudden, short and repetitive movements or sounds. These myospasms usually occur for the first time in young children aged 5-7 years and peak just before puberty.

They are also much more noticeable when the person is very stressed or happy and usually fade when the person is calm or concentrating on an activity. Myospasm is possible to evolve, disappear or reappear over time.

Myospores are classified into four groups. There are simple, complex, motor and verbal. The definition of simple and complex myospasms and some examples are given below.

Simple myospores
Simple myospasms involve only one muscle group (e.g. the muscles in the shoulder or around the nose, mouth and eyes).

Complex myospasms
Unlike simple myospasms, complex myospasms involve several muscle groups. An example of this category is the simultaneous movement of the shoulders and a part of the face (shrugging the shoulders and, at the same time, contracting the muscles of the nose and mouth).

Motor myospasm
Motor myospasms may be simple and complex (multiple motor). In addition, it is possible for a person to have more than one myospasm of varying degrees of severity and frequency.

Examples of simple motor myospasms:

  • Uncontrolled blinking
  • Involuntary oscillation of the eyes
  • The contraction of the nose muscles
  • The shrugging of the shoulders
  • Shaking of the head
  • Movements of the mouth
  • The shaking of the arm
  • Clearing the throat
  • Sucking the nose
  • Screams
  • Flapping of the tongue

Examples of complex motor myospasms:

  • Combined movements, such as moving the mouth in parallel with the shrugging of the shoulders
  • Touching objects or trying to perceive their smell
  • Bending or twisting
  • jumping or squeezing
  • The different ways of walking
  • Repetitive movements
  • Verbal sniffing

Verbal myospores are also referred to as vocalizations. They too are divided into simple and complex, varying in frequency and severity.

Simple verbal myospasms:

  • The clearing of the throat
  • The production of short dry sounds
  • The sniffling
  • The grunting
  • The production of loud and sharp sounds

Complex verbal myospores:
Repetition of words or phrases by the affected person
Echolalia, the repetition of other people's words and phrases
Coprolalia, the use of vulgar or abusive language

What are tics

Two types of tics are associated with Tourette's syndrome:

  • Motor tics - sudden, seemingly uncontrollable movements such as intense eye blinking, grimacing, jerky head movements or shrugging
  • Vocal tics - such as repeated throat clearing or coughing, snorting or mumbling.
  • Complex kinetics: Jumping, touching other people or things, spinning around and sometimes self-injurious acts such as flailing or biting hands.
  • Complex vocalizations: Irrelevant words or phrases, coprolalia (socially unacceptable words), echolalia (repeating a sound, word or phrase that has just been heard) and palalalia (repeating the last word the child has said).

Tics are classified as simple or complex:

  • Simple motor tics usually involve only one muscle group, such as blinking or grimacing.
  • Complex motor tics usually involve more muscle groups and may look like a series of movements. For example, someone may repeatedly touch a body part or another person. In rare cases, people with Tourette's syndrome may harm themselves, such as hitting themselves in the head.
  • Simple vocal tics may be throat clearing, snorting or grunting.
  • Complex vocal tics may include shouting, repeating the words of others (echolalia) or involuntary swearing (coprolalia).

When the person is under stress, involuntary twitches may become more intense, more frequent or last longer. Sometimes the type of contractions can change. If a person focuses on controlling the contractions, it may be difficult to focus on anything else. This can make it difficult for children to converse or concentrate in class. So it is important to find ways to reduce stress in children.

    Causes of Tourette’s Syndrome

    tourette's-syndrome

    While the condition does run in families, the exact cause for Tourette’s syndrome is unknown. Many healthcare professionals also believe that neurotransmitter problems may contribute to Tourette's syndrome, but more research is needed to confirm anything.

    Risk Factors

    Even though there is no known cause for Tourette's syndrome, some risk factors may increase someone's chance of having the disorder.

    These are:

    • Family history — as mentioned above, parents may pass down certain genes that can cause Tourette's syndrome.
    • Gender — males are more likely to develop Tourette's syndrome than females. Males are three to four times more likely to exhibit tics than females.
    • Prenatal health — mothers who had health complications or smoked during pregnancy may increase their children's risk of Tourette's syndrome.

    As you may notice, none of these risk factors are controllable for the child. In fact, the only one that is controllable in any way is a child's prenatal health. But, even this one is not necessarily controllable as health complications can come up without warning.

    What Tourette's Syndrome Looks Like in Kids

    Tics are often worst in children as they have either just begun or not yet settled. This means that your child may exhibit a lot of different tics throughout the day or exhibit the same types of tics frequently throughout the day. It is important to note that tics can evolve over time, and some can be harmful.

    Remember, tics are not a choice. They are involuntary movements that your child cannot control.

    How to Interact with Someone with Tourette's Syndrome

    To better interact with and build connections with children who have Tourette's Syndrome, follow these simple guidelines:

    • Do not scold them for having tics. They do not want to tic on purpose, and they cannot stop it voluntarily.
    • Do not ask them to stop having tics. They cannot stop, which will only make them feel more self-conscious or stressed, making them tic more frequently.
    • Ignore the tics and just interact with them like you would other children.
    • Explain to them what Tourette's syndrome is and how it affects them. Help them understand what their body is doing. This can help them to feel less confused and anxious about their tics.
    • Help them avoid feeling ashamed of their tics. You can explain it to them like hiccups; this is something that many children will understand and identify with.
    • Teach them relaxation techniques. When people with Tourette's syndrome are calm or focused, their tics can become less severe or frequent. This can be especially helpful for individuals who may have tics that can be harmful to themselves or others as it can help to lower the frequency or intensity of their tics.

    Diagnosis of tourette syndrome

    The diagnosis of Tourette's syndrome depends on the type, characteristics and duration of symptoms (at least one year). A child with Tourette's symptoms may need to see a neurologist. The neurologist may ask the child's parents to keep track of the types of tics involved and how often they occur.

    There is no specific diagnostic test for Tourette syndrome - instead, the healthcare provider diagnoses it after taking family and medical history, examining symptoms, and performing a clinical exam. Sometimes, tests such as magnetic resonance imaging (MRIs), computerized tomography (CT), electroencephalogram (EEG) or blood tests can rule out other conditions that may cause symptoms similar to the syndrome.

    Just as the disorder is different for each person, treatment may also vary. Although there is no cure, most tics do not interfere with daily life. Tourette's syndrome is not a mental condition, but doctors sometimes refer children and adolescents to a psychologist or psychiatrist (stress management, relaxation techniques).

    Most people show great improvement in their late teens to early adulthood, although some will continue to experience symptoms as adults.

    Tourette's syndrome (Tourette's) and inappropriate social behaviour

    Tourette syndrome can cause inappropriate social behavior because people living with this disorder may have tics or other uncontrollable movements and sounds that are out of their control and can cause anxiety and confusion in others.

    People with Tourette's syndrome may try to soothe their tics, but this can lead to tension and other symptoms, and can increase the anxiety and stress they feel. Also, people with Tourette's syndrome may react to situations that are unstable, such as stress, fatigue and tension, by increasing tics.

    To address inappropriate social behavior in people with Tourette syndrome, public education is important. People need to understand that this behaviour is not flamboyant or unprovoked, but is the result of a neurological disorder. It is also important that people with Tourette's syndrome are given the appropriate environment and support they need to develop their confidence and self-esteem.

    Psychotherapy can help people with Tourette's syndrome (Tourette's) to cope with the anxiety and tension they feel and develop their self-awareness. Speech and language therapy can also help manage communication difficulties, and education for parents, teachers and other people associated with people with Tourette syndrome can help create an understanding and supportive     environment. 

    Tourette's syndrome and other disorders 

    Only about 12% of children with ST who are seen by specialists have only tics.

    Most children and adolescents with ST are likely to develop additional tics:

    Obsessive-compulsive disorder, in which the child develops obsessions (compulsions) and feels the need to do something repeatedly (compulsions), such as washing their hands multiple times or checking multiple times if the door is locked.

    Attention Deficit Hyperactivity Disorder (ADHD), in which there is difficulty concentrating, increased mobility and impulsivity.

    Learning Disorders, such as Dyslexia, Dysgraphia or Dyscalculia.

    Impulse control difficulties, in the form of aggressive behaviour or antisocial acts.

    Sleep disorders, such as delayed onset of sleep, intermittent sleep, sleepwalking and nightmares.

    Self-destructive behaviour, which is seen in only a small proportion of young people with ST. It includes but is not limited to hitting or slapping oneself, scratching wounds and biting lips.

    Obsessive-compulsive disorder

    Obsessive-compulsive disorder (OCD) is a mental health disorder characterised by unwanted, disturbing thoughts (obsessions) and repetitive behaviours (compulsions) that are difficult to control. These obsessions and compulsions can interfere with daily activities, relationships and social functioning.

    Obsessions are unwanted, repetitive and persistent thoughts, impulses or mental images that cause significant distress or anxiety. Common themes of obsessions include fears of contamination, fear of harm or danger, and a need for symmetry or order.

    Obsessions are repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession. Common compulsions include excessive hand cleaning or washing, repetitive checking, counting, and arranging or organizing objects.

    Although some people with OCD may recognize that their obsessions and compulsions are irrational or excessive, they may feel unable to control them. OCD can be treated with therapy, medication or a combination of both. Cognitive-behavioral therapy (CBT) is a type of talk therapy that can be effective in treating OCD by helping people learn to manage their thoughts and behaviors. Antidepressant medications, particularly selective serotonin reuptake inhibitors (SSRIs), are often used to treat OCD.

    Coping- How to help children with Tourette syndrome

    Many people don't understand what Tourette's syndrome (Tourette's) is or what causes it, so they may not know how to behave with someone who has a tic. If people stare or comment, children and teens may feel embarrassed and frustrated. These tips can help children cope with uncomfortable and awkward situations:

    • Engage. Some experts say that when children and teens are excited about an activity, their tics are milder and less frequent. Sports, exercise or hobbies are great ways for kids to focus their mental and physical energy.
    • Give a helping hand. Dealing with the syndrome often makes children and teens more understanding of other people's feelings, especially other troubled youth. They may use this special sensitivity in volunteering. Knowing that they have helped other people can help build trust and reduce any self-consciousness about feeling different.
    • Embrace creativity. Creative activities such as writing, painting or playing music help focus the mind on different things.
    • Find support. Talk to an expert who can help and guide you.
    • Take control. Push children or adolescents to investigate what is happening to them, ask questions and take an active role in their treatment, taking control of their lives.
    • Each person with Tourette's syndrome will cope differently with their physical, emotional and social challenges. Daily life does not need to be disrupted, and children who have it can enjoy the same things as other children.
    • Don't scold children for their myospasm. They are not deliberately causing them and there is nothing they can do themselves to stop them.
    • Don't ask children to stop expressing them, as this is unachievable. All you will achieve if you do is to increase the frequency of the disorder, as children will become more anxious and very uncomfortable.
    • Don't pay attention to these muscle twitches and make sure you communicate with the children who manifest them just like you do with other children.
    • Explain to children what Tourette's syndrome is and how it affects them. Help them to understand what is happening to their body. This way, they won't feel so embarrassed and stressed about what is happening to them.
    • Make sure to rid them of any feelings of shame about their tics. You can explain to them that tics are like hiccups. Most children know what a hiccup is and can identify with it.
    • Teach children relaxation techniques. When children with Tourette's syndrome are calm or focused, their tics are milder and less frequent. Relaxation techniques are especially helpful for those who have tics that can harm either themselves or others. This is because these techniques help to reduce the frequency and intensity of tics.
    • Drug treatment depends on the child psychiatrist or paediatric neurologist, as each case is different. 

    What a teacher can do to help a student with Tourette's (Tourette's)

     tourette-syndrome

    The teacher can apply techniques that will facilitate the child and create a pedagogical and pleasant climate adapted to his/her needs.

    Remind himself that tics happen suddenly and without intention from the child. Therefore, annoyance on his part is the last thing the child needs in his attempt to manage these movements or sounds. Understanding and patience are the key characteristics that the teacher must have. That is, he needs to learn to ignore the tics. In this way he will also set an example to the other students in the class.

    He has to inform all the students and sensitize them so that mocking and aggressive attitudes towards the child can be avoided.

    It is advisable that the child can write your exams - if he/she wishes to do so - in a classroom alone, so that he/she can express him/herself freely and concentrate without being embarrassed.

    "The secret to living without rejection and without shame in a world where I was different from anyone else was to be completely indifferent to that difference. Al Capp

    Conclusion
    If your child has just begun to exhibit myospasm or you are a teacher who has children with such disorders in your classroom, by utilizing the above information, you will be sure that you are not creating more anxiety in children than they already have about their tics. Thus, children will be able to focus on other aspects of their lives, and, ultimately, manage their problem more effectively, since they will be relaxed and calm

    Original content from the Upbility writing team. Reproduction of this article, in whole or in part, without credit to the publisher is prohibited.

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      Filed in: Causes of Tourette’s Syndrome, Symptoms of Tourette’s Syndrome, tics, tourette syndrome in kids, Tourette's syndrome, What Is Tourette's Syndrome
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