The onset of Tourette Syndrome is very distressing to the patient. While it is true that it is usually diagnosed at about the same age that a child starts school, remember that it is not always diagnosed then. Professional basketball player Mahmoud Abdul-Rauf was not diagnosed until he was a junior in High School.(1) If your child is diagnosed later in his childhood, this, too, is normal for TS and your child still needs lots of support.
The social stressors at these times in a child's life may be part of the reason that episodes manifest themselves. For the young child, the need to break away from home and learn new rules creates high anxiety. For the teenager whose hormones have run amok and for whom social acceptance is probably the most important aspect of his/her life, stress is at an all-time high. Of 15 environmental factors studied, stress was the one factor that contributed significantly to an increase in the number and severity of TS episodes for over 78% of the patients involved in the study irrespective of their age.(2) Because TS tics can be misinterpreted as non-verbal communication, socialization becomes an even greater challenge as the child copes with trying to appear normal. It is a widening spiral, trapping the child in a cycle of increasing stress and, hence, worsening episodes.
TS patients exhibit anomilies in their perception of "just right." This can result in academic failure because the child does not learn in a prescribed way, but in his/her own way. For the TS patient, many aspects of learning must conform to their own perception of what is "just right." Independent reading may be delayed for two or more years as the child struggles to become comfortabe with the skills necessary. Although TS patients tend to be above average intelligence, they share an inability to build on prior learning with those children labeled LD - "learning disabled." Each day, the child must first work out the "just right" perception of the reading before him before he can proceed. This problem is multiplied in the area of Math and many TS patients are labeled "Math Deficient". After home schooling my own daughter, I have learned that she is not deficient, but that she learns more slowly because much of her time and energy are involved in making herself comfortable with the rightness of the material every day before she can embark on new material. Many schools are not equipped to support a child above third grade with the necessary remedial tactics when that child appears to be intelligent. At that point he/she is labeled "disabled" in the applicable field and the teacher can end his/her struggle. Once the label is applied, the school is no longer held responsible for academic accountability.
Because TS can present such a wide range of problems socially and academically, it is often mis-diagnosed and medication prescribed for the specific symptom rather than for TS. Many of the medications prescribed for these types of difficulties lead to serious side effects which can further dibilitate the child (sedation, depression, loss of motivation, irritability, phobias, cognitive impairment, dullness, akinesia, weight gain and others). Abdul Raul was medicated from the first diagnosis. Although his medication was changed, the side effects were too severe and he later chose to discontinue taking drugs for TS. Today he remains drug-free and has gained control of TS and his life.(1)
