Tourette syndrome

Diagnosis

One of the most commonly accepted criteria for a diagnosis of TS is the one by Harvey Singer, M.D. and John Walkup, M.D. from Johns Hopkins. Normally, the age of onset is before 21. There must be a presence of multiple, involuntary motor tics (at least two), and one or more vocal tics. Tics occur many times a day, almost every day, or intermittently for a period of more than one year. The symptoms wax and wane, that means the tics can change in severity from one moment to the next. The location, number, frequency, complexity, type, and severity of the tic presentation fluctuates and changes over time. There must be an absence of another medical condition producing tics, e.g. a traumatic brain injury.

Prevalence

The tic spectrum is a common neurological disorder of childhood and is vastly under diagnosed. It knows no cultural or racial boundaries. The prevalence of TS is 1-3% of the population, and 10% for all tic disorders. Other prevalence figures are:

• Tourette syndrome affects up to 3% of general population (James F. Leckman, M.D. & Donald J. Cohen, M.D., 2000)
• Tourette syndrome affects 3 to 7% of the adolescent population (Mason, Robertson, 1998)

Inheritability

TS is passed from one generation to the next but in different forms due to the “polygenetic” nature of the disorder. That means there is more than one gene that produces TS. So in one family there may be a grandfather with Attention Deficit Hyperactivity Disorder (ADHD), a grandmother with Obsessive-Compulsive Disorder (OCD), a son with Chronic Motor Tic Disorder, his wife might have phobias and generalized anxiety disorder, and their daughter might have OCD, ADHD and depression and the son might have TS, ADHD, OCD and Visual-Motor Integration Dysfunction.

On top of this kind of new genetic presentation, there can be environmental impacts, e.g. fetal stress, illness, excitement, trauma. TS can affect both sexes but often looks different, e.g. boys with more tics and hyperactivity and girls with more obsessions and compulsions, fears, and phobias. There is no cure, but treatment is available. Students with TS reflect the normal spectrum of intelligence.

Treatment Team

TS is a chronic medical disorder that, like other chronic disorders, requires an interdisciplinary approach and a treatment team. The treatment team can be comprised of the child, the parents, teachers, doctors, and other health care professionals. One of the most important roles a teacher can play is to help other students in the class understand how to treat the TS student by modeling accurate knowledge, kindness, acceptance, and patience. Behavior Response Therapy and Exposure Prevention Therapy are behavioral therapies that can be important treatments for TS. Medication, while sometimes prescribed by a Physician, is seldom sufficient without behavior therapies to assist the person with TS to reduce the associated behaviors.

Behavior Response Therapy and Exposure Prevention Therapy are behavioral therapies that are important treatments for Obsessive-Compulsive Disorder. Medication alone is seldom sufficient for treating TS. Behavioral therapies can assist the person with TS to reduce its impact on their life.