Episode 8 - Supporting Students with Tourette Syndrome and Tick Disorders

🎙️ Think Different, Teach Better

Episode 8: Supporting Students with Tourette Syndrome and Related Tic Disorders

Introduction

Welcome back to Think Different, Teach Better. I’m Charlotte, and in our last episode, we explored OCD and OCPD in the classroom. Today, we’re diving into a condition that’s often misunderstood—Tourette Syndrome, along with other tic disorders and trichotillomania, or hair-pulling disorder.

These conditions are often hidden or mistaken for behavioural issues, but in reality, they’re neurological in nature and deserve understanding and support. In this episode, we’ll explore how tics show up, why students can’t just “stop,” and what teachers can do to create safe and responsive environments.

Understanding Tourette Syndrome and Tics

Tourette Syndrome (TS) is a neurological disorder that involves both motor and vocal tics that have lasted for more than a year. Tics are involuntary movements or sounds, and while they might seem random, they’re often preceded by an uncomfortable urge—like a mental itch that doesn’t go away until the tic is released.

There’s a common misconception that children with Tourette’s can control their tics. In reality, suppression may work for short periods, but it often causes significant distress, exhaustion, or a rebound in tic intensity later.

There are several tic-related conditions to be aware of:

• Provisional Tic Disorder – Tics present for less than 12 months
• Persistent (Chronic) Motor or Vocal Tic Disorder – Only motor or vocal tics present, lasting over a year
• Tourette Syndrome – Multiple motor and at least one vocal tic for more than a year

Tics may wax and wane, change over time, or become more pronounced under stress, excitement, or fatigue.

Co-occurring Conditions and Related Disorders

Tourette Syndrome often co-occurs with:

• ADHD – attention challenges, impulsivity
• OCD – compulsions and intrusive thoughts
• Anxiety – particularly social anxiety
• Autism Spectrum Disorder
• Sensory Processing Sensitivities

Another related condition we want to highlight is trichotillomania, or compulsive hair pulling. This is a body-focused repetitive behaviour (BFRB), similar to skin picking or nail biting. It's not about seeking attention—it’s often a way to manage anxiety or overwhelm.

In fact, many children don’t even realise they’re doing it. Others are deeply ashamed. These behaviours require gentle, supportive intervention, not punishment or exposure.

Common Challenges in the Classroom

Students with tics, Tourette’s, or trichotillomania might:

• Seem like they’re not paying attention, when in fact they’re managing internal urges
• Struggle with participation, especially speaking in front of the class
• Be exhausted or withdrawn after a day of suppressing tics
• Get labelled as disruptive or “silly,” especially if their tics involve noises or movements
• Use frequent toilet breaks or leave the room to mask distress

It’s important we see the behaviour for what it is—a signal, not a problem.

What Teachers Should NOT Do

Let’s be clear on what not to do:

• ❌ Don’t ask students to “just stop” ticcing
• ❌ Don’t reward suppression of tics—it reinforces shame and can worsen symptoms
• ❌ Don’t call it out in front of the class
• ❌ Don’t assume it's attention-seeking or oppositional

Instead, we focus on normalising, supporting, and making the classroom a place where students feel safe enough to be themselves.

Strategies That Work

✅ Environmental Adjustments

• Create a calm, structured space: predictable routines, low sensory input
• Allow for movement breaks or quiet zones
• Use noise-cancelling headphones or calming tools as needed

✅ Support During Learning

• Let students record responses or use assistive tech if handwriting or speaking aloud is difficult
• Allow flexible seating or test conditions
• Introduce oral tasks gradually, especially if vocal tics are present

✅ Social-Emotional Support

• Teach the class about neurodiversity using respectful, inclusive language
• Establish a calm corner with sensory tools
• Build a growth mindset about difference and challenges
• Use mindfulness, breathing, and grounding techniques regularly for the whole class

CBIT and Professional Collaboration

One therapy showing strong results is CBIT—Comprehensive Behavioural Intervention for Tics. It teaches:

• Tic awareness
• Competing responses (e.g. clenching a fist instead of jerking an arm)
• Environmental strategies to reduce tic frequency

It’s best done by a trained professional, but teachers can support it by reinforcing strategies in class and staying in contact with psychologists or OTs.

Supporting Trichotillomania

Here’s how to support students who pull hair:

• Gently offer fidget alternatives or tactile tools like putty or smooth stones
• Let the student access a calm, private space if needed
• NEVER shame or punish—it increases anxiety and worsens the cycle
• Work with families on subtle uniform adjustments or head coverings if bald spots are causing distress
• If possible, refer to a psychologist trained in BFRBs or habit reversal training

Case Study

One Year 5 student I worked with had shoulder shrugging tics and occasional vocal tics. Other students were starting to notice, and he became increasingly withdrawn.

We made a few changes: gave him a calm space, allowed for sensory breaks, and spoke to the class (with parent permission) about neurodiversity. We also used quiet check-ins with a support teacher. Over time, his anxiety around school lessened, and he began joining group work again.

Understanding—not correction—made all the difference.

Resources

Here are some resources we’ve found useful:

🎧 Podcasts:

• Helping Children Defeat Tics and Tourette’s
• Psychiatry Unplugged – Tourette Syndrome
•  

📚 Books:

• Front of the Class by Brad Cohen
• The Anxious Generation by Jonathan Haidt

🌐 Websites:

• Tourette Syndrome Association of Australia
• Child Mind Institute
• TLC Foundation for BFRBs

📱 Apps:

• Calm
• Headspace
• Keen (by HabitAware – helpful for trichotillomania)

📺 YouTube:

• Progressive Muscle Relaxation for Kids
• CBIT training and awareness videos

Wrap-Up and Engagement

If you’ve supported a student with Tourette Syndrome, tics, or trichotillomania, we’d love to hear what worked for you—or what you’re still wondering about.

📧 Email us at: thinkdifferentteachbetter@gmail.com
📲 DM us on Instagram: @thinkdifferentteachbetter

Don't forget to follow or subscribe, and share this episode with a colleague. Our next episode will explore Pathological Demand Avoidance (PDA) and how we can reframe oppositional behaviour through a lens of neurodivergence and autonomy.

Until then—keep thinking different and teaching better.