Understanding Students with Tourette Syndrome

(Originally titled “Tourette Syndrome in the Classroom”)

In this helpful Educational Leadership article, Pittsburgh educator Amanda Coffman (mother of two children with Tourette Syndrome) says the challenge for teachers is seeing children with the syndrome as having a problem rather than being a problem. This condition, which is believed to be genetic and occurs in at least 3 of 1,000 school-age children (most often boys), manifests itself in tics – involuntary sniffing, throat clearing, blinking, words or phrases, hopping, or body contortions. The tics can occur frequently for a while, fade, then reappear, often changing from one to another. 

Tourette Syndrome usually develops when children are 5-9 years old and becomes more prominent from 10-15. For two-thirds of children, symptoms resolve by early adulthood and don’t interfere with daily living. About one-third continue to have significant issues as adults. Tourette Syndrome carries a stigma, which is why some parents don’t inform the school about a diagnosis.

The most important thing for educators to understand, says Coffman, is that the tics are involuntary. “If we view the child as the class clown, someone lacking in social skills, or a poor reader, then our responses are going to be inconsistent with the truth of the situation and are not going to be helpful,” she says. Tics do not respond to standard behavior modification plans, and children suppress them with great difficulty, which interferes with concentration in school. The most dreaded word for kids with Tourette Syndrome is “Stop” since that increases anxiety and makes the tics worse. Teachers or peers who are overly solicitous or overprotective don’t help either. Coffman believes that elimination of tics is not an appropriate goal for an IEP and is not something school personnel can accomplish. So what can schools do? Coffman suggests the following:

• Purposefully ignore tics. This is easier said than done, but knowing that tics are involuntary really helps. Teachers set an example to other students by controlling their facial expressions and body language.

• Place students strategically. The best spot for children with Tourette Syndrome is with no students behind them.

• Make accommodations you and the student can live with. Some teachers allow students with the syndrome to get up and move around in specific areas of the class, or even leave the room when they feel the need.

• Increase wait time, use prompts. Students with Tourette Syndrome often need a few more seconds to process a question. Some teachers leave sticky notes on a student’s desk providing prompts.

• Be open with families. Some tics are socially inappropriate or disrupt learning and require a frank discussion with parents. Isolation should not be the default setting, but during tests it may be necessary. 

• Use resources. Coffman recommends http://www.tsa-usa.org, the website of the Tourette Syndrome Association. Teachers who have children with the syndrome in their classes can help enlighten their colleagues – and other students. “Children cannot be accountable for what they don’t understand,” she says, “and education can be a valuable way to prevent teasing or to encourage students to tune out distracting behaviors. It’s amazing how much children can learn to ignore when they understand the tic is not deliberate.” 

“Tourette Syndrome in the Classroom” by Amanda Coffman in Educational Leadership, October 2012 (Vol. 70, #2, p. 46-49), www.ascd.org; Coffman can be reached at

amandakcoffman@gmail.com. 

 From the Marshall Memo #456