The Diagnostic and Statistical Manual, Fourth Edition, Text Revised (DSM-IV-TR), which is the diagnostic guide book published by the American Psychiatric Association, indicates that Tourettes Syndrome is characterized by multiple motor tics and one, or more, vocal tic. (APA XX). Tics are sudden, repetitive motor movements or phonic productions (Leckman & Cohen, 1988). These tics are considered to be either simple or complex. Simple motor tics include eye blinking, eye movements, grimacing, and nose twitching and simple vocal tics include throat clearing, coughing, sniffling, spitting, barking, grunting, growling, hissing, and sucking. Complex motor tics include facial gestures, biting, touching objects, thrusting arms, gestures with hands and complex vocal tics include phrases, speech atypicalities (unusual rhythms, tone, accents), and echoing words (Evans et. al., 1996).
Tics typically begin to occur when the child is between two to fourteen years old. Initially, research has indicated that the first tics are simple motor tics. The course of the expression of tics is difficult to predict but usually progresses from simple to complex tics (Leckman et. al., 1988). Typically, vocal tics have a later age of onset and usually appear in children when they are approximately nine years old (Evans et. al., 1996).
Tourette’s Syndrome often coexists with other neurodevelopmental disorders and conditions, including Attention Deficit Hyperactivity Disorder, Obsessive Compulsive Disorder, and Learning Disorders. As a result, it is always important to attain a comprehensive evaluation of a child’s cognitive, academic, attentional, and social/emotional functioning in order to ensure that all possible areas of concern are addressed through academic and social interventions.
The Centers for Disease Control and Prevention reported that current prevalence rates of Tourette’s Syndrome are approximately 3 out of every 1,000 children between the ages of six and seventeen living in the United States (CDC, 2010).
Treatment of Tourette’s Syndrome needs to focus on four factors: working with the child to develop coping strategies, parent and family education, school accommodations, and peer education. It is vital that the child receive specific intervention and strategies to help develop strategies to deal with anxiety associated with a tic disorder. Parents and family members need to be educated about the disorder, as well as the course and treatment of the condition. Teachers and faculty need to be educated about the condition in order to ensure that any academic staff member is aware that possible negative behaviors are tics as opposed to volitional oppositional and defiant behaviors. In addition, peers need to be educated about tics in order to ensure social acceptance. If a child with Tourette’s Syndrome continues to exhibit debilitating tics after the above four interventions have been addressed, it would be warranted that he or she have a consultation with a pediatric neurologist in order to determine if he or she would benefit from pharmacological intervention.
If you suspect that your child may be suffering from Tourette’s Syndrome, it would be warranted that a comprehensive evaluation take place in order to help ascertain the current level of functioning as well as any possible co-existing conditions such as learning disorders, attention deficit hyperactivity disorder, and social/emotional concerns.