Tourettes Syndrome

Tourette syndrome (also known as Gilles de la Tourette syndrome) is a chronic condition affecting the nervous system which causes affected persons to have sudden repetitive twitches, movements or sounds.

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Definition of Tourettes Syndrome

Tourette syndrome (also known as Gilles de la Tourette syndrome) is a chronic condition affecting the nervous system which causes affected persons to have sudden repetitive twitches, movements or sounds (also known as “tics”). Tics can be likened to hiccups that someone gets and that they cannot control when they start or stop.

People who are affected by Tourette syndrome usually do not have control of their body to stop the sudden “tics” for example, they may suddenly start uncontrollably blinking over and over or making grunting sounds unwillingly (APA, 2013; CDC, 2020, Sharp & Corp, 2020; & NINDS, 2019). 

 

Causes of Tourettes Syndrome

Tourette syndrome is a neurological disorder stemming from the developing nervous system called tic disorders. The main cause of Tourette syndrome is not yet fully known, however, there is ongoing research being done. It is hence important to note that from recent research, it has been noted that most cases of Tourette syndrome involve the interaction of multiple gene variations and environmental factors.

Most recent research on this syndrome points to possible causes to deviations or anomalies in certain areas of the brain (including the basal ganglia, frontal lobes, and cortex), the circuits that link these areas, as well as the neurotransmitters (dopamine, serotonin, and norepinephrine) in charge of communication between neurons (specific nerve cells).

Some evidence suggests that this syndrome in many cases may be an inherited disorder. As research progresses, it has also been noted that a proportion of people with Tourette syndrome have mutations involving the SLITRK1 gene, which affects how neurons grow and connect with one another.

Abnormalities in the NRXN1 and CNTN6 genes (genes that also regulate the normal formation of these nerve connections), also may play a role in Tourette syndrome (APA, 2013; CDC, 2020, Sharp & Corp, 2020; & NINDS, 2019). 

 

Types of Tourettes Syndrome

Tourette syndrome usually exhibits itself through two main types which also depend on the part of the body where the tics occur, the frequency or complexity: 

Motor or vocal tics  

  • motor tics such as blinking, head or arm jerking, or shoulder shrugging repetitively and involuntarily.
  • vocal tics such as humming, yelling out a phrase or word, or throat clearing, sniffing, barking or grunting repetitively and involuntarily.

Simple or complex tics 

  • Simple tics are known to exhibit themselves as very brief movements or vocalizations, typically without social meaning. They happen suddenly, briefly, repetitively and involve a limited number of body muscles. 
  • Complex tics exhibit themselves as longer lasting and may comprise of a combination of simple tics and may sometimes seem to have social meaning (that is they could be recognizable gestures or words) and hence may be misinterpreted as being intentional. However, it is critical to note that those affected are not doing these actions voluntarily and certainly hence they are not a sign of mischief, misconduct or misbehaviour.

(APA, 2013; CDC, 2020, Sharp & Corp, 2020; & NINDS, 2019)

 

Symptoms

Those affected by Tourette syndrome may sometimes exhibit similar tics at a given period of time, but these tics may be different from one another, have varying intensity or even not occur at the same frequency. In some instances, an affected person may experience tics several times within the same hour and then they remit or disappear for a few months. The main symptoms of Tourette syndrome are tics, these include:  

  • Uncontrollable and repetitive blinking
  • Uncontrollable and repetitive frowning
  • Uncontrollable and repetitive head or arm jerking
  • Uncontrollable and repetitive shoulder shrugging
  • Uncontrollable and repetitive grunting or barking
  • Uncontrollable and repetitive sniffing or snorting
  • Uncontrollable and repetitive throat clearing

(APA, 2013; CDC, 2020, Sharp & Corp, 2020; & NINDS, 2019)

 

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

Arlington, VA: American Psychiatric Association.

Centers for Disease Control and Prevention (2020, May 13). Risk Factors and Causes for Tourette Syndrome. CDC.

Sharp, M. & Corp, D. (2020). Tourette Syndrome and Other Tic Disorders. MSD Manual.

National Institute of Neurological Disorders and Stroke (2019, March 3). Tourette Syndrome Fact Sheet. NIH.

 

Behaviour Help

If you are supporting an individual with this diagnosis, please refer to our services and resources. They aim to help children, adolescents and adults achieve better communication, social, emotional, behavioural and learning outcomes. So whether you are wanting guidance on parenting, teaching, supporting or providing therapy, Behaviour Help is at hand.

Note: This is not an exhaustive list of all the possible causes, symptoms and types but some general information that can be further explored. Based on what you have read if you have any concerns about an individual, please raise them with the individual/s. The caregiver can then raise these concerns with their local doctor who can provide a referral to the relevant professional (e.g. paediatrician, psychologist, psychiatrist, allied health professional and learning specialists) for diagnosis and treatment if appropriate.

Which resources are right for you?

Apps

Based on the Taking CHARGE of Rainbow of Emotions Workbook this app helps children of all ages develop emotional regulation skills. The app guides the child to firstly, identify and express their emotion in appropriate ways. Then the child is guided to use emotional management tool/s from the CHARGE tool kit to manage their emotions in a healthy way.

The acronym CHARGE stands for the different categories of emotional management tools – Chat tools, Helpful thinking tools, Amusement tools, Relaxation tools, Good routine tools and Exercise tools.

Behaviour Help App - Using the evidence-based approach of Positive Behaviour Support (PBS), the Behaviour Help web-based app allows people supporting individuals with emotional and behavioural difficulties to complete a Functional Behaviour Analysis and put together a comprehensive Behaviour Support Plan (BSP). The BSP can then be used by everyone interacting with the individual to manage and prevent challenging behaviours and ultimately improve their lives, and the lives of those who support them.

Books

If you want to learn more about emotional and behavioural difficulties then we have a great range of books you can read on your Kindle or order from Amazon.

Coaching

Personalised and practical one to one help tailored specifically to your family.

Online Courses

Access these online courses anytime online to learn about a range of diagnoses, practical skills and strategies to help develop the individual’s emotional regulation skills. Also learn to utilise the positive behaviour support framework to address anxiety, aggression, ADHD, ASD and ODD.

SEL Educational Videos

Minimise or eliminate the occurrence of challenging behaviours by teaching children of all ages appropriate ways of communicating, interacting, managing their emotions and behaviours.

The SEL curriculum uses video modelling to provide direct, explicit and systematic teaching of the various skills by discussing the importance of the skill, modelling the skill so the child learns what the skill looks like? sounds like? feels like? and learn the skill in staged situations that simulate real life scenarios.

Therapy

Personalised and practical behaviour therapy tailored specifically to your family.

Webinars

Webinars discuss a range of practical strategies to guide your child learn positive ways of behaving and managing their emotions.

Workshops

Attend our practical and interactive workshops to learn about a range of diagnoses, practical skills and strategies to help develop the individual’s emotions, behaviours, social and communication skills in your learning environment.

Ask Dolly

Since you’re here, you probably have questions and concerns. I am Dolly Bhargava, am here to help. I am a NDIS registered behaviour support practitioner and speech pathologist.

I have worked in a number of settings for over 21 years so, how can I help?

Please tell me what is worrying you right now and I will do my best to recommend resources and/or services that will be most useful to you in your situation.

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