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Supporting Students with TS+, Part 2: School Strategies for TS, ADHD, Aggression & Sensory Processing Challenges

Teacher and Student at BlackboardPeople with Tourette Syndrome usually have at least one other condition (co-morbid or co-occurring conditions). Some students have multiple co-occurring conditions. A student’s education team can address the impact of these conditions using a strategy particular to that condition. Below are some examples for tics as well as strategies and approaches for “common co-morbids.” These strategies are not exhaustive, nor do the categories cover all possible conditions that will need to be addressed. For more information on education supports, please consider purchasing the TSFC’s Understanding Tourette Syndrome: A Handbook for Educators.

Accommodations for Tic Disorders

  • Ignore tics whenever it’s possible to do so.
  • Instead of a time-out space, provide the student with a safe spot—a place they can go to calm down and release tics. Do not use the Principal or VP’s office for the safe spot as this can be misinterpreted as punishment.
  • Facilitate a graceful exit to the safe spot. For example, giving the student an envelope that has nothing in it to hand into the office is a graceful way to leave the room.
  • When assigning preferential seating, put the student near the door so that they can exit more easily when they need to do so. This will help to reduce their anxiety, which in turn reduces the need to leave.
  • Avoid seating the student at the front of the class in the centre because this makes their tics more noticeable and potentially embarrassing.
  • Provide frequent breaks/opportunities to leave the classroom to allow the student to release their tics.
  • For socially inappropriate tics, brainstorm possible solutions with the student. For example, encourage the use of a tissue or cup for spitting tics or saying Ferrari instead of a curse word beginning with the letter “F.”

Assistance with Accommodations for Students with Attention Challenges like ADHD

  • Seat the student near the side of the class at the front so that a member of their education team can help them stay on task.
  • Give the student a quiet place to do their work.
  • Allow the student to use noise cancelling headphones or a headset with instrumental music.
  • Permit the student to move around while at their desk, in the classroom and outside the classroom. This includes providing movement breaks like trips to the bathroom or fountain or a special task in the classroom.
  • Structured yet flexible classrooms are optimal environments for children with ADHD. Changing tasks frequently can help provide flexibility.
  • Use an established hand gesture to assist the student in refocusing/getting back on task.
  • Allow the student to engage in a motor activity, or involve the student in a motor activity, when they are concentrating intensely (e.g., pencil tapping on a soft item, doodling, squeezing a soft ball).
  • Permit physical activity during the day. Do not punish a student with ADHD by taking away their physical education class, recess or any other physical activity or outlet.
  • Highlight items that the student should focus on in their reading (page, passage or chapter).
  • Use brightly coloured note cards for holding under sentences to assist the student in following along when reading.

Strategies for Aggression

  • Give the student opportunity for frequent breaks.
  • Provide the student with support in developing the skills they need to become aware of feeling increased tension. Next, involve the student in developing specific alternatives to expressing the increased tension as aggression. Use these alternatives to make a plan.
  • Consider why this is happening, keeping in mind that aggressive behaviours are often the result of unmet needs, frustrations due to not being able to meet demands placed upon them, inflexibility (student, teacher or both), touching a hypersensitive student, restraining the student, feelings of failure or anxiety, bullying/teasing, hypersensitivity to criticism. Also consider possible related disorders that may have been otherwise overlooked like executive functioning deficits, peer issues, difficulty with transitions, OCD, ADHD and sensory processing dysfunction.
  • In extreme cases, you may wish to consider modified day or tutoring in the home.
  • Allow choices that will empower the student and be creative when developing a plan (try to have a plan that gives the student a sense of accomplishment).
  • Try to avoid situations that will be difficult if possible/anticipated.

Supports for Students with Sensory Processing Challenges

  • Provide the student with the opportunity to leave the class early or later to avoid high traffic or crowded halls.
  • Allow the student to eat lunch with a few friends in a quieter environment than the cafeteria.
  • Permit gum chewing or eating of hard candy.
  • If a young student has tactile hyper- or hyposensitivity, place them near a quiet child who is unlike to touch them and to the side or back of the group near a wall.
  • Put students with tactile sensitivities towards the back of the line.
  • If a student has tactile defensiveness, do not surprise them with an unexpected touch. Approach from the front so that they have a visual cue that there is a touch coming.
  • For students with auditory sensitivities, adjust the proximity to noise (e.g., seat the student so that noise that could surprise is in front of them, seat them away from fluorescent lights, cover PA system).
  • If the student has visual sensory challenges, seat them near windows for natural light, avoid fluorescent lighting, reduce unnecessary teacher/student movement during lessons, and use highlighters and other colours to cue student about the location of materials.
  • Avoid perfume or scented lotions, smelly liquids, scented markers to assist students with olfactory sensitivities (be aware of the potential impact of cleaning product and science experiment smells).
  • Be nearby when students are exposed to a lot of sensory information.
  • Seat students with vestibular hypersensitivity at the front of the bus to assist with avoiding motion sickness.
  • Allow for movement at the desk via a seat cushion, ball chair or partially inflated camping pillow.
  • Provide additional support during transitions.

Have you or your son or daughter’s education team tried any of the strategies before? What worked? What didn’t? Leave a comment below.

Stay tuned for Part 3 of this blog series, which will be published soon. Part 1 is available to read here.

Supporting Students with TS+, Part 1: Key Terms

Teacher and Student at BlackboardFor parents of children with exceptionalities like TS, OCD, ADHD and mood disorders, classroom strategies are a very popular topic. Parents are eager to understand how their child’s education team can help remove roadblocks to learning, but it is easy to get overwhelmed by all the information, terms, resources, and texts out there.

This blog series will help breakdown this information into easily digestible chunks. It is by no means exhaustive, but it will assist you in your effort to build a strong knowledge base. Part 1 is an overview of key terms. Part 2 consists of classroom strategies and specific supports for students. Lastly, part 3 will share answers to frequently asked questions.

Understanding key terms is always a good starting place when you’re trying to build a strong knowledge base. The word “modification” is important, though it often gets confused with the term “accommodation.” In fact, you may be surprised to learn that accommodations and modifications mean two very different things: Modifications change what a teacher teaches, tests and grades, whereas accommodations change how the teacher teaches, tests and grades.

For example, a modification might be having a student submit an outline rather than a whole essay. An accommodation would be allowing the student to have extra time to complete the essay. Modifications change the expectations. In this example, the student was expected to complete an outline rather than an essay. With accommodations, the student has the same expectations as everyone else in the class but is given additional supports to help them meet that expectation.

Another important term is Education/Program Plan. This is called different things in different provinces like IEP (Individual or Individualized Education Plan) or SEP (Special Education Plan). The idea of your son or daughter’s teacher having a “plan” or “program” specifically for them may sound complicated. After all, don’t all teachers “plan” out their lessons? Can’t they adjust things on the fly?

Well, maybe they can. But other reasons exist for having a written plan about how a school will assist a student with exceptional needs. For example, this gives everyone (parents, teachers, administration) a shared understanding of how the student will be assisted. The process of developing the plan or program will often help to unlock the funding that is needed to carry out the plan as well.

The contents of the Education Plan/Program are written by school staff and experts like psychologists in consultation with parents. It may include both modifications and accommodations or one or the other. To help the school create content tailored to the student’s specific needs, the student may undergo a psycho-educational assessment, or psycho-ed assessment as it is sometimes called.

A psycho-ed assessment consists of a series of tests conducted by psychologist. The tests usually focus on: learning style, ability to use language, reasoning skills, ability to do written work, ability to interpret and analyze visual material, and reading comprehensive, spelling, and math. In short, the assessment measures a student’s learning potential. Typically, a psychologist will gather information about the student through interviews, reviews of school records, observations and reports from parents and teachers as well. Keep in mind that because this assessment is so detailed, it can take several visits. If done through a school board or hospital it is free of charge, however, there are usually waiting lists. A number of private organizations will perform these assessments for a fee. Some extended health benefits or private insurance packages will cover a private assessment if the student has a referral from a physician.

A final important term is assistive technology. This term includes a number of services, devices, strategies and practices that help individuals with exceptional needs access school curriculum. It might include use of special computer software that types out the spoken word or reads the written word out loud. Other examples include digital recorders, alternative keyboards, spell checkers, pencil grips, raised-line paper, and paper stabilizers. Using assistive technology may be one type of accommodation that a student needs to do his or her best in school.

Do you or a family member use assistive technology at school or work? Is it helpful? Do you think that there any downsides to using the technology?

Stay tuned for parts 2 and 3 of this blog series, which will be published next week.

New Canadian Rock Band Features Members with TS


Say hello to Pariah.

They’re a young, ambitious Canadian rock band, and two of their members happen to have TS.

A five-piece ensemble, Pariah hails from Mississauga and Oakville, and they all love to write music, record and perform.

The band already has their own Facebook page, Twitter account and YouTube channel. On the latter you can hear a demo and watch a video of them performing live, and if you live in the Greater Toronto Area you’ll have a chance to see them play live on Sunday, April 27 at the Rockpile West in Etobicoke, ON.

Pariah is:

Chanel Martins – Lead Vocals
Jiverny Marshall – Rhythm Guitar/Vocals
Dylan Murray – Lead Guitar
Justin Speers – Bass
Ian Coll – Drums

Here’s a video of them performing a song called “Adrift”:

We wish them all the best in their musical careers!

TS Plus-Friendly Summer Camps in Canada

Often staff at a typical summer camp are unable to accommodate children or youth with TS Plus, whose challenges may include OCD, ADHD, mood disorders, neurological storms/rage episodes and so on. We are publishing this list of TS Plus-friendly camps now, since many camps require early registration, and some even have waiting lists, such as Camp Winston in Ontario. So if you’ve thought of planning a summer camp experience for your young one(s) this summer, it’s best to start acting soon.

If you know of a summer camp that specializes in neurological or cognitive disorders that is not on this list, please let us know by emailing and we will update it.

Camps in Alberta

TSFC Edmonton Chapter Day Camp for kids ages 8-10
TSFC Edmonton Chapter Day Camp for kids ages 11-13
Overnight TS Adventure Camp (TSFC Edmonton Chapter partnership with Centre for Outdoor Education)
Camp Amicus
Camp Bonaventure
Camp Health, Hope & Happiness
Camp Tamarack

Camps in BC

Eureka Outdoor Camp
Venture Academy
Zajac Ranch

Camps in New Brunswick

Camp Rotary

Camps in Nova Scotia

Camp Reachability

Camps in Ontario

Camp Concord
Camp Kennebec
Camp Kirk
Camp Kodiak
Camp Prospect
Camp Tamarack
Camp Winston
Camp Zodiac
Kinark Outdoor Centre
New Stride Day Camp
Ontario Pioneer Camp (Christian)
Rainbow Day Camp

Camps in Saskatchewan

Camp Tamarack


Guest Blogger Roddie MacDougall: The Great Canadian Grid

GridHello everyone. I’m a long time TSFC member from way back. My name is Roddie MacDougall. Some just call me Rod. I am 46 and have been living with TS well… forever!  I would like to share with you what I’ve accomplished.  Because a lot of us with TS, including me, find ourselves isolated, afraid to meet others because of twitching, I decided to learn more about how to meet others without feeling isolated. At first it started as social media, but it’s become much more than that.


I am the developer and creator of a virtual world grid called The Great Canadian Grid for Canadians where people can come and be themselves, either as an avatar or a person or whoever they want to be—without feeling embarrassed—and meet others from Canada and around the world. Currently I host the only Canadian virtual world open simulator grid, and I’d like others to see it. In the last five years of developing the grid I’ve discovered that it’s a great way to meet others without feeling isolated. I run the entire process myself with help from my global team and as of now I’m getting a license to allow streaming music and hosting for DJing inside the game.

Take care and hope to see you ‘in the world’ sometime!

Learn more at

Guest Blogger: Steve Colle

Steve_CSomething that I don’t often read about or hear people talking about regarding Tourette is the fun you can have with it with the right attitude. Believe me, I have my “down” days where I just want it to stop because it either hurts, exhausts me, or just makes me stand out like a sore thumb, but more often than not, I try to joke around about it or make light of it, which in turn creates a level of comfort with those around you, whether family, friends, co-workers, or even total strangers. Here are just a couple of instances where I’ve looked at the bright side:

  • Shortly after being diagnosed 5 years ago, I was picking my wife up at work and heading home when I tried to say the words “I’m hungry.” That, however, is not what came out. One of my symptoms is getting stuck on a word, syllable, or sound (palilalia, not echolalia) and repeating it over and over again until I basically lose my breathe and have to stop, which will sometimes end it but not always. Anyways, I got stuck on part of a word and what came out was “I’m hung-hung-hung-hung-hung…” She couldn’t stop laughing and I had to follow up with a corny remark which wouldn’t be appropriate to repeat.
  • My kids were all together at the dinner table with my wife and I one evening just talking and I got stuck on the word “or” and couldn’t stop, so I started to act like a seal with my hands clapping in front of me. They got a kick out of it.
  • One of the tics I get is the urge to bend forward at the waist, which is an extension of tics that I get in my neck which forces my head forward in a “yes” motion over and over again. The same thing happens at my waist, over and over, and I’ve joked that I look like I’m bowing and follow up with “Pleased to meet you, pleased to meet you…” which is deliberate, not a vocal tic.
  • I literally spent more than two full days non-stop repeating “Okay, okay, okay…” Needless to say, my wife took full advantage of that!
  • I’m at work in the lunchroom with two of my bosses and a co-worker when my right arm starts shooting backwards like I’m trying to elbow someone behind me, as usual, over and over again. I shout out, “Anybody got a lawnmower I can start?” Laughter all around.
  • I was walking for more than two months like I had MS, where my lower back and upper leg would cause both of my legs to shoot forwards (alternating) into giant steps like in the Mother May I game. However, this one day, I found that even though I wasn’t able to walk normally, I could (God knows why) jog! I’m at work in a large retail furniture store as a manager and had to show the store manager something in one of the departments, so I explained that I could run and I took off like a bolt. Next thing I know, he’s running right alongside me! Now that’s support.
  • And finally, a story of the innocence of childhood: I was growling pretty loud with only my 2-year-old son and myself in the house. He turns to me and asks “Daddy, are you a lion?”

I too often get, because my Tourette is sometimes debilitating, a “poor you” or “I don’t know what I’d do…” or “I could never live with Tourette” or some such remark, even from people who I’d thought had adjusted (not accepted) to my syndrome a long time ago. Those are the people I want to convince that, no matter how bad it gets or may seem, I’m fine, I’m healthy, and I know it will pass, even for a short reprieve before it starts back up. The more I can accept it as part of me, the more other people will learn to accept it as well.

Do any of you have similar stories or instances where you’ve been able to laugh about your Tourette?

Steve Colle is a volunteer with the TSFC Calgary Resource Unit, and is the coordinator of the 2014 Calgary Trek. The above originally appeared on an online forum about TS. You can join the official TSFC Forum by clicking here.

Guest Bloggers Julie Spratt & Ken Shyminsky: Coprolalia Myths Demystified

This post originally appeared on Neurologically Gifted, an amazing blog managed by TSFC board member Ken Shyminsky and TSFC volunteer Julie Spratt.

Watching a MovieMyth: Children with coprolalia come from homes where they are exposed to obscene language and/or inappropriate material.

Children who have neurological differences with the symptom of coprolalia have brains that work atypically. Despite often being diagnosed with Attention Deficit Disorder, children with ADD or ADHD are not lacking in attention ability but their attention works differently than a typical child. A typical child’s attention manages their environment by attending to what is important, or what they are directed to, in the particular immediate situation. A child with ADD/ADHD has attention but it most often easily drawn outside the immediate situation and the child is said to be highly distractible. It is not an attention deficit at all but rather the inability to focus that attention where it should be. Often attention is drawn to and captured by what is brightest, what is loudest and what is most inappropriate. Their attention flickers through all the available stimuli and if it settles it will do so on language, actions and social situations that are most different, most exciting and socially taboo or inappropriate.

Actually, the diagnosis Attention Deficit Disorder is misleading. Just ask any parent whose ADHD child can play video games or watch TV for hours but can’t attend long enough to brush their teeth properly. This phenomena is called hyper focusing and it’s very common in ADHD children. To further add to this, it’s easy to focus on things that are interesting, exciting or unusual to us. It takes mental maturity, skill and focussed attention to attend to things that we find boring.

So, the stage is set. Their brilliant minds are primed to pick up the most unusual and inappropriate data their roaming focus can find.

By walking through stores, to and from school, around the mall, and every where else, a child with ADHD or TS has their attention pulled to any inappropriate language, visual material and actions of others they find different or interesting. They notice the teens huddled in the corner smoking, using bad language, or spitting on the ground. They notice how they dress, how they look at each other and how others look at them dissatisfied with their behaviour. They notice reference to sexual behaviour and materials and how society tries to shield them from it. They often get adult sarcasm, hints and inferences. They quickly learn what is inappropriate from all these cues and because of the hyper focus and attention to the behaviours, they stick in the child’s mind like glue. My son from a very young age was particularly drawn to teen behaviour. Walking through a mall with him was a struggle. It took a great deal of effort to keep him on task and with me and I could tell instantly when there was some alternate social teen behaviour happening around us. Suddenly he would be suddenly be still and silent, watching and listening and soaking it all in. He would then recount aloud what he had heard or saw repeatedly and he never forgot his observations. And he was never reluctant to share them with others.

These cases are not bad parenting, or abuse or access to adult material that could be prevented. It is simply a hyper attentive mind doing what it does most easily and effectively: finding and perpetuating that which is most exciting and most instigating.

Unhappy Child Sitting On Floor In Corner At HomeMyth: Children with coprolalia need firmer and more consistent discipline.

Children with coprolalia know what they are saying (or doing in the case of copropraxia) is socially unacceptable. That is how they were drawn to learn it. As a matter of fact, the more they understand the behaviour is unacceptable and the more unacceptable it is, the more they will be driven to do it. Simply stated, the worst possible thing to say or do becomes the hardest thing not to say or do. Ask any child if they know what they are saying is wrong or inappropriate and they will tell you, yes. Often they are embarrassed and ashamed by their own uncomfortable symptoms.

Correcting the child or punishing the child is counterproductive and can dramatically increase the chance of its occurrence. It creates a dialogue in the child’s head that tells them not to say “@!,” because they will be punished. Don’t say “@!.” My dad really hates when I say “@!.” It’s wrong to say “@!.” I will be sent to my room if I say “@!.” The child ends up consumed with thinking “@!,” reinforcing the tic’s neurobiological pathway and making it that much more difficult to prevent its expression. This process of negatively reinforcing the coprolalia adds to the child’s stress level which ultimately makes tics, including coprolalia, worse.

The child already knows it is wrong and is usually already punishing themselves internally, creating a negative impact on their self-esteem and self-worth. Imagine the feeling of being obsessed with doing something you know causes a negative reaction from everyone you care about. The time spent obsessing and worrying about coprolalia leaves the individual less able to manage everything else. Ideally, understanding and knowledge about coprolalia, for the child and adult, helps create a caring environment where the child can grow.

Ask Dr. Ticcy: What About Relaxation Techniques?

imagesDear Dr. Ticcy,

Where can I find more information on relaxation techniques?



Dear F.,

Great question.

Relaxation is important for everyone, and can be especially helpful to someone with Tourette Syndrome. Since stress, excitement, and anxiety may intensify or fuel tics, relaxation can assist with symptom mitigation. That is why non-pharmaceutical treatments like Comprehensive Behavioural Intervention for Tics (CBIT) and Habit Reversal Therapy (HRT) are often combined with relaxation therapy/techniques.

To learn more about relaxation techniques try:


1. CPRI Brake Shop Clinic



2. Dr. Leslie E. Packer’s website “Tourette Syndrome Plus”


3.The TSFC Forum
Try threads like these:


4. Asking an Occupational Therapist or Another Trained Professional


Ask_Dr_Ticcy_LogoKeep the questions coming Canada!

Dr. Ticcy

Dr. Ticcy is a pseudonym for the TSFC National Office, which draws on information from experts across Canada and beyond to answer questions from the TS community. Please send your questions to with the salutation “Dear Dr. Ticcy.”

TS Research Breakthrough: Scientists Undercover Mechanism Controlling Tics

300px-Transcranial_magnetic_stimulationScientists have discovered a mechanism that controls Tourette Syndrome tics. This groundbreaking study may allow for the creation of new, non-drug therapies to help TS individuals with their symptoms.

The University of Nottingham-based team used Transcranial Magnetic Stimulation or TMS (pictured) to stimulate patients’ motor function and induce a tic response. They monitored the patients’ brains during the tic stimulation and were able to measure the alterations in brain excitability. Understanding the relationship between the cortical excitability and tics means that scientists may be able to help children better control their tics, says Professor Jackson.

Next, the team used Transcranial Direct Current Stimulation or TDCS to stimulate the brains of children with TS. Early results suggested that this type of brain stimulation may help to reduce the excitability which leads to tics, thus helping individuals to have long tic-free periods.  They also found that a different form of TDCS that increases excitability may help with memory function and learning in the context of behavioural therapies.

The hope is that the technology used in the study can be made into a cheap and portable device that can be applied to children while they are at home. The device would then help the children to control their tics and make their control more effective.

The research was conducted by PhD student Amelia Draper and was funded by the James Tudor Foundation.

For more information, click here.

The next issue of The Green Leaflet, our national newsmagazine, is The Clinical Issue. To receive more amazing content like this, please become a member of the TSFC.

Top 13 TS Moments of 2013

2013 was a big year for the TS community both in Canada and internationally. Here’s the TSFC’s list of the biggest TS moments of 2013. Do they match yours?






  • 7. “Building Your Toolbox” at the National Conference on Tourette Syndrome Plus in Mississauga, Ontario




TS Heroes Poster_boy_200px





What do you think the biggest TS moment was this year? Leave a comment below.