behaviors may be tics (vocal or motor).
Tapping, touching, or repeating a behavior may be related to obsessions and compulsions in the context of OCD, but in the absence of OCD, these behaviors may be more tic-like in nature. Hitting or touching another child, doing something immediately after being asked to stop a behavior or refrain from a behavior, making a sighing noise, rolling one’s eyes, or obscene gestures all have the potential to be interpreted as intentionally oppositional in nature. Or, they may be tics.
Behavioral intervention planning might look very different in these scenarios, based upon the perception of the behavior. So the ability to be effective in behavioral intervention rests on the accurate understanding of the behavior and its function. This is often of particular significance in school or social settings, as not only may the symptoms impact the student, they may also be disruptive or have an otherwise significant impact on others.
Thus, it is vital for educators and school-based service providers to understand TS in order to provide a supportive learning environment in which these students may thrive.
It is important that educators understand:
● Tics can be exhausting, uncomfortable, or even painful.
● The suppression of tics can require a great deal of mental effort and can significantly detract from a student’s availability to attend to learning.
● Tic suppression is not always possible, as tension can build and become unbearable.
● In some cases, students may not be aware of the occurrence of a tic.
● Tics are not intentional and are not “nervous habits.”
● The occurrence of tics can be modulated by emotions or physiological states (e.g., excitement, anxiety, fatigue, hunger, illness).
● Difficulty inhibiting thoughts and behaviors (applying the “mental breaks”)is very common, resulting in what may appear to be impulsive or intentionally defiant behaviors.
● Commonly co-occurring difficulties, such as handwriting and learning difficulties may result in anger, frustration, rage, or oppositional behaviors in the classroom.
● Immature behaviors and social deficits are not uncommon; those with TS are vulnerable to being taunted or bullied by peers.
● Cognitive rigidity, psychological inflexibility, perfectionism, difficulty initiating and/or completing schoolwork, and with transitions are not uncommon in students with TS.
Education is critical to creating a supportive learning environment for students with TS. Teaching the educational team to accurately identify, understand, and appropriately respond to tics and related symptoms is vital to a student’s success in the classroom. For example, if a student has an eye-rolling tic, sighing tic, or echolalia, an educator may misperceive these behaviors as rude or disrespectful and may, in turn, respond by reprimanding, disciplining, or sending the student out of the classroom. This may negatively impact the student psychologically and socially. Moreover, drawing attention to the tics and the tension this may create, has the potential to increase the tics and other related behaviors. If the educator perceives the student as problematic, rather than as having a neurobiological disorder with which he or she struggles, the educator is more likely to unintentionally perpetuate the difficulties in the classroom. Essentially, it is important to understand that the student is not giving the educator a hard time, the student is having a hard time. When the student is not misperceived as intentionally causing a problem, educators are more likely to consider what they can do for a student, rather than to a student, paving the way for supportive, empathic, proactive, and creative strategies which more effectively address the behaviors in the classroom.
Strategies to successfully create a supportive learning environment should be individualized and flexible. Strategies can be varied and many. In addition to accommodations or strategies which may be used to support a student with the commonly co-occurring struggles, a few of the most common and useful strategies spe