Today, 20 April 2008

Yesterday, 19 April 2008

Question
I have a second grade student who exhibits behaviour similar to those of someone with Tourette's Syndrome.

He also displays attention deficit behaviour. For instance: he blurts out sounds (I don't think he even knows any curse words) or repeats a word from something I say in class.

He constantly fiddles with things in his desk. He has taken bits of crayon and rubbed repeatedly back and forth inside his desk. When sitting on the floor with me, he will twirl his finger around the top of his sock.

When tested for the "gifted" programme last year, the school psychologist noted that his distractability prevented him from scoring much higher on the evaluation.

The boy's mother reported that he makes the same sound outbursts at home and that she asks him to go the garage to do it as much as he wants.

The student and I spoke about his outburts in class and together devised a strategy to help himself control the behaviour. However, the better he performs in class, the worse he appears to get after leaving.

Does this sound like Tourette's to you? What should I do?

Answer
> It could well be, but one needs a proper assessment, to rule out developmental disorders such as Asperger's (a form of autism) and a severe Attention Deficit Disorder which may involve elements such as echolalia (repeating sounds) as well as verbal/physical fidgeting and making random noises.

On the other hand, the fact that he can control the blurting temporarily and then has to "catch up" afterwards, sounds much like Tourette's.

It's relevant, because the medication that is recommended may be different for these different diagnoses, as well as the kind of support and advice that might be made available to the parents.

While the school can comment on behaviour observed in class, ultimately it is the parents' responsibility to ensure that the child's problems are addressed and to decide what is acceptable in terms of treatment.

It's good to hear that this child is already open to helping others and himself, in handling and limiting the effects of his problems, and that doing this is opening up more educational opportunities for him.

If it is Tourette's he may be facing a lifetime struggle with it, so the more he can be affirmed for managing "despite" the problems, the better.

The outcome of the "gifted programme" assessment is a good indication of just how this disorder, whatever we eventually call it, is frustrating him and concealing his true abilities.