As a parent of a now-grown child with ‘Tourette Syndrome +’ (Tourette Syndrome plus related disorders such as OCD and/or Autism), a past Coordinator of a local Tourette Syndrome support group, and current peer-supporter for the Parent-to-Parent network, I am contacted for advice and support for families with a family member diagnosed with Tourette Syndrome. A therapist contacted me yesterday looking for help for such a family. Besides a doctor recommendation, I gave him eleven items I always tell a parent who contacts me.

It occurred to me that someone reading this might know of someone who would also benefit from the information. Please copy & paste and send on, and tell them to contact me if they need more help.

1. I know that your child getting a diagnosis of Tourette Syndrome is daunting, frightening, and sometimes soul-crushing. But it is not a fatal disease, there are other diseases much worse that your child could have instead, and it should not stop your child from doing whatever they want to do in life.

2. Expect that the reactions from extended family members may be hurtful to you (i.e. “They are twitching because they are stressed from you being too hard on them”), so be prepared for it. You MUST be knowledgeable not only about Tourette Syndrome (as it is a commonly misunderstood and misdiagnosed disorder), but the disorders that many times accompany it (such as Obsessive-Compulsive Disorder). Read, go online, and soak up everything you can about TS. Extended family members are well-meaning and think they are offering you good advice, but you must trust your own knowledge, and the knowledge of the team of professionals you surround yourself with.

3. In your own family everyone may react differently to the diagnosis. In my experience Moms are usually the ones to see the symptoms first, and the ones who work to get the diagnosis. Dads are harder to come along with everything. Some choose to deny the diagnosis in an angry way, some don’t want to deal with the diagnosis and leave all of the work involved to their wives, some are just lost and confused… or any combination thereof. Keeping a good marriage going while dealing with the diagnosis and all that comes with it is difficult. Take it easy on yourselves and each other. Obviously siblings must not get lost in the chaos either.

4. I am always up front about the lack of knowledge of TS in medical professionals of all kinds (doctors, dentists, MH professionals, etc) We travel the length of our state to get care for our son (besides the Tourette, my son has Asperger’s and Panic Attacks, among other disorders, and I could not find adequate care for him in our area). As parents we must learn everything we can, network with other parents, and many times educate the mental health/school professionals about TS. We must think to do things many other families don’t have to (i.e. calling ahead to our chosen dentist, to apprise him or her about our child’s condition, and among other things the possibility they might not be able to sit still for a jaw x-ray)

5. Parents must become knowledgeable of school policies, and the laws and regulations about special ed students. One of the best resources I had during Josh’s school years was a Child Advocate. They know the special ed laws in & out, they have working relationships with the schools in their county, and are able to bring respect to a parent during daunting school meetings. Whether or not your TS child is doing well in school, you should still have a relationship going with a Child Advocate, so when things get rough, they are familiar with you and your child and can get you help swiftly. They can be found in each county’s Mental Health Assn., or the county’s base service unit; or they can direct you where to find one in your county. Important decisions must be made concerning school placement, whether aides need to be available, whether homework needs to come home (in Josh’s case, he did all of his homework at school so he could completely unwind at home), or whether an option such as Cyber School needs considered.

6. Avoid getting caught with the invariable questions from teachers and others, when discussing inappropriate behaviors, about where the TS tic ends and just a plain bad behavior begins. There is no way to adequately answer this, so it is just frustrating futility to go down that road. If a behavior plan is created right, it will clearly define for everyone the expectations and responsibilities of the TS child. To argue in a school meeting about whether or not Johnny failed to complete a task in class that he was expected to was because of his ticcing, his reaction to his new medication, or just because he was bad is such a waste of time. The same can be said for the home setting. Again, keep the Big Picture in mind… just drive through the potholes and just keep moving.

7. In whatever public setting your TS child is part of (church, Boy Scouts, family parties, school, bus rides to & from school, etc) the participants need to receive information about TS either from an in-service type of thing, or you yourself explaining the situation. To wait to do so is a mistake. The things people make up in their mind when first confronted by the tics are so much worse than the reality. If they are told ahead of time what they are seeing, and why it is happening, they can skip over the shock-like reactions that breed name-calling, social avoidance, and other forms of ostracism. Don’t listen to the teachers, friends, and other well-meaning folks that advise you not to say anything ahead of time. I learned the hard way that is NOT the right way to handle it. I always carried TS pamphlets with me… as an example of their helpfulness is when Joshua had to go for weekly allergy injections. While waiting in the exam room following the shot, the room would be filled with people. He would try not to tic, but then, of course, he would, and after getting attention for it, would get nervous and then tic like crazy. I asked the doctor if I could leave a small stack of pamphlets about TS in the office, and it helped a lot. When Josh was particularly ticcy, I would straighten up the stack deliberately, so as to bring attention to it. That, and the big button on my purse reading, ‘Ask Me About Tourette Syndrome’, proved very helpful.

8. As TS kids have many monkeys on their backs during a school day (i.e. trying to suppress tics; trying to keep their OCD rituals and thoughts at bay; etc) their mood can be extremely negative or even violent once at home. Sometimes Moms are frazzled by this. I explain that the child is only comfortable with a few select people, one usually being their Mom, so that is who the frustrations get vented on. Extreme patience must be employed, and the ‘Big Picture’ always needs to be in view. These Moms need respite whenever it is possibly provided by other family members, friends, or others knowledgeable about TS behaviors. A Mom can’t relax if her TS child is being watched by a ‘normal’ babysitter. Trust me.

9. Become members of the National TS Assn (http://www.tsa-usa.org). Go to the conferences whenever you possibly can. The more you realize you are amongst many many other people dealing with TS the better you will feel. The national conference is an awesome experience. I highly recommend it to anyone with an interest in TS.

10. Decisions must be made about what type of therapy, medications, etc. are appropriate for your child. Perhaps Family-based or WrapAround Services would benefit your child. They are intrusive, but sometimes make all the difference in the world. Perhaps a TSS needs to not only be with your child at home, but accompany them to school. These are decisions not made easily, and, again, this is when you rely on your own knowledge of your child, your understanding of TS, and the advice of your trusted team.

11. Tell your TS child how much you love them often. The world can be a cold and formidable place to a person who, other than strange movements and sounds, looks otherwise normal. The lack of an obvious disability (such as a missing limb for example) makes it even harder for the average person to understand the physical and verbal ticcing… there is a ‘sympathy factor’ lacking from being otherwise normal looking. Tell them they are terrific, because they are.