People 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.