Tourette’s Syndrome
Tourette’s Syndrome is a neurological disorder characterised by repetitive, involuntary movements and vocalisations commonly referred to as tics. The syndrome was first recognised by Dr Georges Gilles de la Tourette in 1885 and has been the subject of intense study ever since. Tourette’s Syndrome is an inherited neuropsychiatric disorder with onset in childhood, characterised by the presence of multiple physical (motor) tics and at least one vocal (phonic) tic.
The early signs of Tourettes are often noticed in childhood, with the average onset of the syndrome occurring between the ages of seven and ten years. As with many neurological disorders, there are varying degrees of Tourettes, with some cases being barely noticeable while others will develop more pronounced symptoms. Tourettes can be a chronic condition, with symptoms lasting throughout the sufferer’s life. Most people with the condition experience their worst symptoms during their early teens, with improvement occurring in the late teens and into adulthood.
What are the symptoms of Tourette’s Syndrome?
Tics are classified as either simple or complex. Simple motor tics are sudden, brief and repetitive movements that involve a limited number of muscle groups. Some of the more common tics include rapid eye blinking, facial grimacing, shoulder shrugging and head or shoulder jerking. Simple vocal tics may include repeated throat clearing, sniffing or grunting sounds. As these tics become more complex, the affect on the sufferer can be more marked. Complex vocal tics include repeated words or phrases that may sometimes be deemed to be inappropriate within a social context.
These tics can be triggered by stress or excitement and can be reduced during periods of calm or if the sufferer is focused on a particular activity. Although the urge to perform tics is never fully eradicated, many sufferers do learn techniques to help them control verbal and physical tics as they move into adulthood.
Although these tics are involuntary, some people can learn to suppress, camouflage or manage them in an effort to minimise their impact within a social context. If children with Tourette’s Syndrome are taught at an early stage the techniques for this masking, the impact on their social interaction within family and peer groups such as school environments can be minimised, reducing the amount of disruption they can cause.
What causes Tourettes?
Although the actual cause of Tourettes is as yet unknown, modern research suggests that it stems from abnormalities in certain brain regions including the basal ganglia, frontal lobes and cortex. The circuits that interconnect these regions and the neurotransmitters (including dopamine, serotonin and norepinephrine) are responsible for communication among the nerve cells.
How can Tourette’s Syndrome be treated?
The most common treatments that are often prescribed for controlling motorised (physical) tics are in the form of medication, although this has little or no effect on vocalised tics. What has been shown to help, however, is the use of Cognitive Behavioural therapy in the form of awareness training and competing response training. This involves training the sufferer to replace the urge to tic with a more socially acceptable outlet for the tic. Verbal Behaviour can also help sufferers to recognise situations that may increase stress levels to a trigger point that initiates a series of tics and to learn to control this response and suppress the tic successfully. This method is particularly successful in young children, and can help both the learner and their family to understand the condition more fully and recognise the trigger points that may initiate a tic response. In addition to recognising trigger points, Verbal Behaviour can be used to teach appropriate replacement behaviours which is an exciting progression in our field.
At VBC, we have an extensive knowledge and experience in working with Tourette’s Syndrome and have developed ground-breaking processes within the fields of Cognitive Behavioural therapy and Verbal Behaviour to help reduce the impact of this condition. If you would like further details on this or any of our treatment programmes,
contact us in confidence for more information.