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Understanding Tourette Syndrome-TS In Schools PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Understanding Tourette Syndrome (TS) In Schools".
This medical PowerPoint presentation talks about the Tourettes syndrome, a neurological disorder that affects both children and adults.
Tourettes syndrome is characterized by involuntary movements and vocalizations, also known as tics, that occur repeatedly and unpredictably. The exact cause of Tourettes syndrome is unknown, but it is thought to be related to abnormalities in certain brain chemicals or neurotransmitters.
Tourettes syndrome can manifest in a variety of ways, including simple or complex motor tics, such as eye blinking, head nodding, or shoulder shrugging, and vocal tics, such as throat clearing, grunting, or shouting out words. These tics may be worsened by stress, excitement, or fatigue, and may be temporarily suppressed by concentration or distraction.

Tags : Tourettes syndrome, neurological disorder, tics, complex motor tics, Child Neurology PowerPoint presentation, Neurology PowerPoint presentation

Published on : Mar 21, 2023 | Views : 1150 | Downloads : 0

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Slide 1-

UnderstandingTourette Syndrome (TS)In Schools Teacher workshop
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What do you know about Tourette Syndrome (TS)?Have you ever known/worked with anyone with TS or Tics?What symptoms did they show?What is your perception of TS from the media? 2
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Destroying the myths about TSTS is often misunderstood as a condition which makes people swear, or say socially inappropriate things. Although it is true that ‘coprolalia’ (the clinical term for involuntary swearing) is a symptom of TS, it only affects a minority of people, between 15 – 20%. 3
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4 https://www.youtube.com/watch?v=_AqLU2JZvVk Click on the link above to view a video that Tourettes Action made to help dispel the myths around Tourettes Syndrome.
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What is TS? Tourette Syndrome (TS) is a genetically determined neurological condition. Tics usually start around the age of 6/7 years and tend to peak around early adolescence. TS affects one school child in every hundred (as common as autism) and is more common amongst boys (75% are boys). TS is a spectrum condition ranging from mild to severe symptoms. Individuals may move across the spectrum over time or in response to environmental factors. 5
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TS can be initially triggered by emotional events Tics (involuntary sounds and movements) present for at least 12 months Changeable/wax and wane Not just vocal and motor tics – visual, intrusive thoughts, conversational tics Increased by stress, anxiety, excitement, hunger, tiredness, sensory changes Decreased by exercise, distraction, deep concentration In approximately 50% of cases tics can lessen by adult hood 6
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Having Tics doesn’t always mean Tourette Syndrome!!!Tourette Syndrome is on the spectrum of conditions known as Tic Disorders. Other conditions on this spectrum include:Provisional/Transient tic disorder – vocal OR motor tics that tend to be transitory. Tics only last a few weeks or months.Persistent/Chronic tic disorder – vocal OR motor tics that tend to persist rather than be transitory. Tics occur for more than 1 year.A tic disorder not specified - tics are present, but do not meet the criteria for any specific tic disorder. 7
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Here are some examples of common motor and vocal tics: 8
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Hidden Tics Visual tics e.g. looking at shadows/counting objects. Intrusive thoughts e.g. harming someone or themselves. Suggestive tics e.g. overwhelming urges to follow through inappropriate suggestions. Thought tics e.g. something we all think but kids with TS cant regulate. (It can be a bit like having a window into their soul). Conversational/contextual e.g. these can sound and appear to be in the correct context but they just find it very hard to switch off their regulator button. 9
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Approximately 85% of people with TS will also experience co-occurring conditions such as: Attention Deficit Hyperactivity Disorder (ADHD) Obsessive Compulsive Disorder (OCD) Autism Spectrum Disorder (ASD) Anxiety Sensory Processing Disorder (SPD) For many, the co-occurring conditions can be more challenging than the tics. Co-occurring Conditions 10
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11 There is much more to TS than you see on the surface. There is often lots more going on than you realise.
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Why might getting a diagnosis be important? Correct labels School support ( i.e. better understanding, reasonable adjustments, EHCP) Treatment options Permission to parent differently! 12
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After Diagnosis Access to CDC / CAMHS services Local support groups Befrienders Grants / Possible statutory support, i.e. DLA Leisure discount cards Parent’s grieving process Psychoeducation for the children, family and school Therapies – HRT, ERP, CBITS 13
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Tourette Syndrome is not a mental health condition but it can certainly effect a child’s mental health. Anxiety, rages, depression and suicidal thoughts. Such symptoms can be made worse by factors like hormones, bullying and change. A huge amount of stigma surrounds TS, often limiting the confidence and self-esteem of those diagnosed, especially young people. Encourage a child to talk about their TS. It’s important that they understand what’s going on for themselves and if possible encourage them to share with their friends. Mental Health 14
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Negative cycle 15
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There is always a reason for bad behaviour! Tics can sometimes appear to be in context. You may need to ask the child. Bad behaviour alongside TS can be a sign of the child trying to regain some control and distracting from their tics. Whole school approach. If you’re unsure then assume it’s a tic. Talk after/ask child …What happened? Why do you think that happened? How can we help you next time? Get to know the child rather than challenging and questioning them and listen to your instincts. Tics vs Neuro-typical Bad Behaviour – The magical question! 16
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Can tics be controlled? Although tics are involuntary, many people are able to suppress their tics for a short time. This is why you may see less at school than parents do at home as home is a safe place where no judgment will be made. A helpful way of understanding this is to compare it to a blink, cough, yawn, sneeze or scratch. For a short period of time it is possible to keep your eyes wide open and avoid blinking but eventually you will have to blink as the urge is too strong to control. Premonitory urge – the feeling some people get before a tic is released. Lets try it! 17
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It can take a great measure of concentration to resist the urge to tic, but with practice and therapeutic intervention a certain level of control can be applied by most people if they are mature enough to take this on. Some people will be able to suppress their tics more easily than others and some just may not want to as find it to uncomfortable. Takes a lot of energy to supress. It is quite common for children with TS to suppress their tics at school, yet families will notice a marked increase in their child’s tics at home. (Suppression v’s environmental changes) School is very structured with reinforcers that may make a child want to control their tics. In comparison, home life is more relaxed and therefore helps children to feel at ease with expressing their tics. 18
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MedicationNeurolepticsRegarded as the most effective medication for reducing tics and work by blocking dopamine receptors in the brain. Dopamine has been strongly linked with TS. Neuroleptics are primarily marketed for treating psychotic conditions like schizophrenia, but there is no clinical link between psychosis and TS - dopamine appears to be important for both conditions.Examples of medications in this group include Sulpiride, Risperidone, Pimozide, Quetiapine and Haloperidol.Side effects can include sudden stiffness and prolonged muscle contraction, shaking, restlessness and more commonly drowsiness. 19
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Atypical AntipsychoticsThe newer neuroleptics are now more likely to be prescribed. These types of drug are more selective dopamine signaling blockers, however, they are also known to affect serotonin - an important signaling chemical in the brain. Examples of drugs in this category include Aripiprazole, Risperidone, Olanzapine and Quetiapine.Side effects from this drug are usually mild to moderate and temporary including insomnia or drowsiness, fatigue, nausea and headaches.ADHD medication Ritalin – stimulantSleep medication Melatonin – sedative 20
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What therapies are available?Habit Reversal Therapy – finding a competing response.Exposure response Prevention – learning to supress for periods of time.Psychoeducation – learning and teaching as much as we can about TS.Social supportRelaxation TherapiesDiet 21
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How can TS create a barrier to learning? 22
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TS does not in itself affect IQ, but it can have an effect on a child’s ability to learn. For example: writing can be made difficult by movement tics. impulsive traits can manifest as calling out in class. concentrating on a lesson can be hard if a child is trying to suppress tics. Co-occurring conditions may get in the way e.g. ADHD (concentration), OCD (perfection). Visual tics Disruption for others Homework – reduce the amount but not necessarily difficulty. 23
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Sleep – generally relaxing the body or bedtime rituals and routine. Medication – may make children tired which can effect their work. Feeling socially isolated from peers can also impact on learning. Motor tics of the eyes, head or neck may interfere with reading and motor tics may also affect handwriting or the ability to write for prolonged periods of time. Motor and vocal tics may make a child reluctant to read aloud, ask or answer questions and even sometimes to ask for help. Physical and vocal tics can be exhausting and sometimes painful for the child experiencing them, leading to tiredness and lack of enthusiasm. 24
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Simple Exercise This simple yet effective exercise powerfully demonstrates how tics can impact on a child's concentration and their ability to complete a task under time constraints. 25
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How can you help?Suggested strategies 26
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Approach the child and family to find out how their TS affects them and keep communication as open as possible. Try not to respond to tics, unless they really require a response e.g. danger/safeguarding of other pupils. Consider alternative therapies to help reduce anxieties such as art, music or Lego therapy to aid self expression. Nurture programmes and Emotional intelligence training such as: ELSA - (Emotional Literacy Support Assistance) Educational led psychology intervention for promoting the emotional wellbeing of children in primary. MISP - (Mindfulness in schools project 7 – 11) JIGSAW - secondary Careful seating plan 27
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Personal passport/one page profile 5 minute earlier start time (executive functioning skills). Time out card/leave room Safe place/tic release Special job/sensory break Visual timetables Feelings chart Brain Gym - (JSJ) 28
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Scale down work amount not difficulty. Check understanding after class input. Never single a child out in class because of their tics. Never punish a child for their tics. A whole school approach to understanding Tourette Syndrome can really help a person to feel accepted and understood. Awareness assemblies are an effective way to educate other pupils (celebrating differences). Scribe? 29
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TS often worsens during the transition to secondary school or even just a new classroom, teacher or year group. Environmental factors can play a huge part in TS. This time can be especially difficult and may well require extra planning and support. Extra visits Talk lots about what’s going to happen. Photos of new school and staff – 6 weeks can be a long time out of school/routine to get anxious. TA leaflets to give staff at new school/class. Suggest TA training to feeder school. Transition 30
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If the TS child is on the SEN register they may be entitled to: 25% extra time for assessments/SATS/GCSE’s/A Levels Different/quiet room Stop the clock/extra breaks Scribe/amamuensis Consider the child’s ‘usual way of working’. EHCP? Communication & Interaction, Cognition & Learning, SEMH, Sensory/Physical. Explore possible adjustments and technical adaptions that might help ease any anxiety and support the person with the challenges they face. SEN Support 31
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Questions to ask yourself Are we as a school meeting the needs of this child? Are we as a school doing everything we can to remove any barriers to learning for this child? Are we as a school providing reasonable adjustments to cater for this child? Can we be sure we are not setting this child up to fail? Has this child got full access to the curriculum? Is this child reaching their full potential? Is this child happy to be in school? If not, why? 32
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Key take-away points Tics are not intentional attempts at gaining attention or to be disruptive. Tics are not the student’s fault (or the fault of parents). Tics should not be taken personally. Children should not be punished for their tics. Tics are not simple habits that can easily be replaced or stopped. There is no one-size-fits-all “cure” for tics. 33
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34 https://www.youtube.com/watch?v=LZQlch6v3W4 Click on the link above to watch a video Tourettes Action made in collaboration with a famous YouTuber, Caspar Lee. Caspar has Tourettes Syndrome and very kindly helped us make this video to spread awareness to his many followers.
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Thank you!