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Tourette Syndrome (TS) is a neurological disorder characterized by several different kinds of tics (largely involuntary, rapid, sudden movements and/or sounds occurring repeatedly in the same way). Such tics are irresistible urges which eventually must be expressed, much like the urge to sneeze. The symptoms of Tourette Syndrome range from very mild to extremely severe, with most cases being in the "mild" range. Individuals with Tourette Syndrome are likely to experience other problems as well, such as obsessive compulsive tendencies, learning disabilities, sleep disorders, Attention Deficit Hyperactivity Disorder or impulse control problems.
- Early signs, which are seen in children, are often first expressed as a facial tic (blinking; twitching of the eyes, mouth or nose; grimacing), involuntary sounds (such as clearing the throat) or tics of the limbs.
- Both multiple motor tics and one or more vocal tics are involved—not necessarily at the same time.
- For an extended period of time (more than one year) tics may occur nearly every day many times a day (typically in bouts) or intermittently.
- There may be changes in number, frequency, type, severity and location of the tics—with possible symptom-free periods up to three months or so.
- Onset usually occurs prior to age 18, with the average onset between ages 7 and 10 years.
- Significant impairment may occur in social, school or workplace settings caused by the occurrence of the tics.
- Tics associated with Tourette Syndrome are not due to the chemical effects of a stimulant or other substance or to a medical problem such as encephalitis or Huntington's disease.
- Simple motor tics: arm flapping, shoulder shrugging, clapping, facial grimacing, foot tapping, head jerking, lip smacking, stomping or sticking out the tongue.
- Complex motor tics: body slamming, chewing clothes, making obscene gesture (copropraxia), mimicking movements made by someone else (echopraxia), hitting, kicking, kissing, pinching, ripping apart/throwing things or twirling around.
- Simple vocal tics: belching, tongue clicking, grunting, hissing, throat clearing, puffing, screaming, shouting, snorting, sucking or yelping.
- Complex vocal tics: animal sounds (such as barking or crowing), muttering, uttering socially inappropriate, obscene or otherwise unacceptable words or phrases (coprolalia), repeating words someone else just said (echolalia), spitting, repeating his/her own words or phrases over and over (palilalia) or yelling.
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Research continues into the causes of Tourette Syndrome. Indications are that this disorder involves the abnormal metabolism of dopamine and serotonin (neurotransmitters).
In approximately 70% of the cases Tourette Syndrome is inherited. There is a 50% chance of a parent passing the involved gene on to each child. However, that abnormal gene function results in different symptoms in different family members. It may be expressed as Tourette Syndrome, as a mild tic disorder or obsessive compulsive behavior with no tics at all. Overall, only about 10% of the children who inherit the involved gene show symptoms severe enough to warrant medical attention. Boys who have this abnormal gene are three to four times more likely to show symptoms than girls with the gene.
In some cases this disorder may not be inherited. The cause in these cases, called "sporadic Tourette Syndrome," is as yet unknown.
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Most individuals with Tourette Syndrome are not significantly disabled by their tics or behaviors and do not require medication. However, if symptoms significantly interfere with an individual's functioning in daily life, there are medications available, such as haloperidol (Haldol), clonidine (Catapres) or pimozide (Orap), to help control these symptoms. The optimal dosage differs for each individual and must be carefully monitored by a doctor.
Counseling and psychotherapy may help an individual and his/her family cope with Tourette Syndrome. Behavior therapy may successfully teach an individual to substitute a more socially acceptable tic to replace one which is highly offensive. Frequency of tics may decrease when the individual is concentrating on a task, particularly a favorite task. Since stress may cause a significant increase in tics, relaxation and biofeedback techniques may be beneficial.
Many children with Tourette Syndrome have special educational requirements. Approaches that may be helpful include the use of tape recorders or computers for reading and writing problems, tests given privately without the use of time restrictions and permission to simply leave the classroom when tics (or the urges to express the tics) become too overwhelming. If the child cannot receive the most appropriate educational services in a public school, enrollment in a special school or home schooling may be an option.
At IDTC, we follow the generally accepted methods of treatment, as outlined above. Our treatment team considers the strengths and needs of each child in order to develop an individual treatment plan. We establish consistent routines which become familiar (and soothing) to the child. Our structured environment is designed to avoid over-excitement of the child. Our education staff offer a curriculum and classroom support to bring out the child's strengths. Counseling/therapy and utilization of relaxation techniques are incorporated into the Individual Treatment Plan.
The staff at IDTC recognize that each child is unique with individual strengths and needs. Our priority is always the well being of each child. If we find that IDTC cannot offer the very best care and services for your child, we are happy to help facilitate placement in another facility.
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Feel free to contact us if you have any specific questions or would simply like more information or resources.
E-Mail (please click on the link): Catharine Crockett, Admissions
Phone: 1-317-815-0505
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Tourette Syndrome Association, Inc.
National Institute of Neurological Disorders and Stroke (NINDS)
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This information is provided as a general overview only and is not intended as medical advice. This information should not be used to diagnose or treat any health problem, disease or medical condition. It is not provided as a substitute for professional care. If you have any health concerns, please consult the health care provider of your choice.
© Copyright 2005 Indiana Developmental Training Center LLC
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