dyslexia signs and symptoms

Famous People with Dyslexia

Imagine that you are a second grader, leaving the neuropsychologist’s office. BlogGraphics-FamousPeopleDyslexiaMain-LandscapeYou’ve completed diagnostic testing to evaluate the way that you think, read and write. You had to complete odd tasks, feeling nervous and increasingly tired. To top it all off, the neuropsychologist explained to your mom that you show characteristics of something called “dyslexia.” You could tell your mom was upset and maybe even a little sad. You leave feeling even more nervous, thinking “Is something wrong with me?

At the time of a dyslexia diagnosis, your child might feel embarrassed and isolated. Imagine the feeling of hope they might experience when finding out that some of the most successful people they read about in books or see daily on the television also have dyslexia.

Historical Figures:

  • Thomas Edison
  • Henry Ford
  • Scott Fitzgerald
  • Pablo Picasso

Entrepreneurs:

  • Ingvar Kamprad, Founder of IKEA
  • Richard Branson, Founder of Virgin Enterprises
  • John T. Chambers, CEO, Cisco Systems
  • Charles Schwab, Founder of Charles Schwab Corporation

Entertainment Celebrities:

  • Billy Bob Thornton, writer, director and actor
  • Whoopi Goldberg, Academy Award winning actress
  • Keira Knightly, actress
  • Jay Leno, TV entertainer
  • Henry Winkler, actor and writer

See the website for the International Dyslexia Association for more “Success Stories” in the areas of science, research, politics, and law.

The diagnosis of dyslexia bears no reference to an individual’s intelligence. In fact, some scientists believe that people with dyslexia often are innovative thinkers due to different “hard-wiring” of the brain. As you can see from the above list of leading entertainers and business people in the United States, the diagnosis of dyslexia does not define or limit a child’s success in their career or life.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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Specific Learning Disorders in Children

Learning disorders are some of the most common neurodevelopmental LearningDisorders-Main-Landscapeconditions that children face. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the guidebook on classification of diagnoses published by the American Psychiatric Association indicated that the prevalence of specific learning disorders across academic domains of reading, mathematics, and written expression is between 5%-15% in school aged children.

There is significant discussion both in the literature, and among clinicians and researchers, regarding how to appropriately classify and subsequently diagnose a specific learning disorder. Traditionally, it was assumed that a specific learning disorder existed when there was a significant discrepancy between a child’s cognitive ability and achievement in reading, mathematics, or written expression. However, within the US, changes have occurred over the past decade regarding the criteria used for determining a specific learning disorder which is now based on a multi-tier process involving early identification and intervention and the child’s response to the intervention.

Where children might exhibit learning disorders:

According to the DSM-5, there are three specifications of learning disorders that children might exhibit: Specific Learning Disorder With Impairment in Reading, Specific Learning Disorder With Impairment in Written Expression, and Specific Learning Disorder with Impairment in Mathematics. It is quite common for children to exhibit multiple learning disorders.

Potential related deficits:

There are definite concerns with a child’s social, emotional, and behavioral regulation if they have a documented learning disorder. Prior studies have indicated that up to 75% of children with a diagnosed learning disorder demonstrate significant social skill deficits expressed by peer rejection and social isolation.

What can be done:

It is our strong recommendation that in order to most effectively address a child’s specific learning disorder, it is important that the child undergo a comprehensive evaluation in order to effectively classify and make sense of the patterns of difficulty that the child presents with as well as to rule out additional existing factors of concern, and to best determine what specific interventions are warranted. Recommended interventions are specifically based on the area of weakness a child exhibits both across the testing as well as within the child’s academic environment.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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How Parents Can Help A Child With Tourettes

When you look at someone with Tourettes, all you see or hear are the tics. You don’t see the constant struggle, the constant commotion that is going on inside the person’s body. Although it might be easy to assume that when a person is not ticcing, they are okay or calm or not experiencing anything related to Tourettes, more often than not, that assumption would be entirely incorrect. tourettesparentmain

Here are a few tips on how parents can help a child with Tourettes

  1. Learn as much as you can about Tourettes. The internet can be a scary place, so make sure you are getting your information from reliable sources.
  2. Connect with other parents for support, guidance and referrals. Many times parents of kids with disabilities become isolated from friends and family. Know that you are not alone and there is a community of people out there who share your struggles. Ask for referrals from trusted people within these connections so you can find professionals experienced with Tourettes and the co-morbid disorders.
  3. Understand that as confusing as the symptoms can be for you, it is even harder for the teachers. Do your best to work with the teachers and the school in order to help them understand symptoms of Tourettes, the co-morbid disorders, and what your child needs to succeed. Try to be patient with them, as this is a learning experience for them too.
  4. If the teachers are having a hard time getting your child to do work at school, remember it will probably be even harder for you to get him to work at home. Don’t expect to do all the day’s school work PLUS the homework in one evening. Work with the school to develop a plan that will accommodate your child’s needs but still keep him moving in the right direction. This could include such things as a motivational intervention plan, school counseling (with other kids who have Tourettes, if possible), modified work, assistive technology, and built-in teacher-student time in order to foster a positive, understanding relationship.
  5. Have your child connect with other children with Tourettes. Living with a body out of control can be embarrassing and very scary. As hard as it is for you, it’s harder for your child. Children need to know they are not alone and the connection between kids with Tourettes can be very powerful and therapeutic. Look in your area to find meetings, activities and camps for kids with Tourettes.
  6. Introduce your child to successful adults with Tourettes. This provides hope and will most likely increase their motivation to overcome their challenges. Keep reminding them (and yourself) that there IS life beyond Tourettes.

Click here for more information on what it’s like to live with Tourettes. Readers can also click here to learn how teachers can help a child with Tourettes.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

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About the Author: Shari was the 3rd person in IL to be diagnosed with Tourette Syndrome (1976). Her parents co-founded the IL TS chapter along with several others, including Joe Bliss. In 1978, while at a board meeting in her parent’s home, Mr. Bliss told Shari about his theory of premonitory urges and provided some tips and tricks on how to control the tics. It was the first time Shari felt “understood” and attributes much of her success to Mr. Bliss and his strategies. She co-founded the Illinois Tourette Resource Network in 2014 and is honored that she can continue the legacy of providing TS support to the Illinois community.

The Benefits of Bilingualism

There are definitive advantages for children who are learning two languages simultaneously. Though parents may question whether or not they should teach their child to be bilingual, research has proven that bilingual children develop language skills in the same manner as peers who are learning one language.

Parents should begin using both languages from the start and continue to give their child opportunities tobilingual hear and communicate in both languages throughout their daily routines. Bilingual children typically have a dominant language; that is, one that they know better and use more proficiently. Learning two languages simultaneously does NOT hinder speech and language development. If a child truly has a language disorder, this will be evident in both languages. Additionally, bilingualism may confuse grammatical rules or use words from both languages in the same sentence, and this should not be concerning.

According to the American Speech-Language-Hearing Association, research has demonstrated a variety of benefits to being bilingual including:

  • Being able to learn new words easily
  • Playing rhyming games with words like “cat” and “hat”
  • Breaking down words by sounds, such as C-A-T for cat
  • Being able to use information in new ways
  • Putting words into categories
  • Coming up with solutions to problems
  • Developing good listening skills
  • Connecting with others

Language learning follows patterns. Developing sounds in the first language may further support how a child learns and uses their second language. ASHA also reports that currently 1 in 5 individuals over the age of 5 speak a language other than English at home. Subsequently, simultaneously language learning is becoming more common and is expected to increase over time.

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NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Sensory Play in the Snow

It’s that time of year again! The temperature changes, the holidays pass, and the ground becomes filled with a powdery white. While you may be dreading the shoveling, defrosting, and traffic that follow, if you bundle up and brave the cold, you can help create valuable sensory experiences for your child! snowmain

The play experiences you create with your child can help their bodies learn to process sensory information more effectively and efficiently. From snowball fights to building snowmen, snow can create a chilly yet enriching environment for our brains to process, respond to, and use the sensory information it receives.

Here are 10 sensory activities for you and your child using the snow just outside your door:

  1. Snow Angels– Making snow angels is a great activity to target the tactile system, our sense of touch, as your child learns about texture and temperature while the snow moves under their arms and legs.
  1. Freeze Bubbles– When the temperature drops below 32 degrees, blow bubbles and quickly catch them on the wand. Watch the bubbles freeze, then shatter into crystals, and note the vivid colors.
  1. Build a Snowman– Pushing the snowballs across the ground as you roll them into bigger shapes provides our bodies with resistive input which targets our proprioceptive system. This input is generally organizing and calming, and can improve attention as well as arousal level and body awareness. Create even more fun by using candy for the snowman’s arms, buttons, and nose.
  1. Go Sledding and Tubing– The movement provided while in a sled or tube allows for changes in head position and our sense of where our bodies are in relation to gravity, which targets the vestibular system. The vestibular system helps coordinate eye and hand movements, use both sides of our bodies together, and affects balance and equilibrium. Have your child sled in different positions (on their back, on their belly, etc.) to provide further changes in head position.
  1. Snow Painting– Take a spray bottle filled with water tinted with food coloring out into the snow and spray it around. Allow your children to create pictures with it or make colored snowballs. You can place a few drops of food coloring directly in the snow to allow for smaller “paintings” too.
  1. Snowball Throwing Contest– Using colored water, spray a large circular target into the snow. Have your children stand back from the target and see how many snowballs they can get into the circle! This will help target their visual system as they learn to interpret distance.
  1. Snow Maze– Walk all over the yard in different directions, creating a bootprint maze for your children to follow.
  1. Scavenger Hunt– Hide a cooler full of fun items in the snow, and create a scavenger hunt with clues for your children. Have them follow the clues to various spots around the yard, eventually leading them to the cooler with surprises!
  1. Shoveling – Shoveling snow provides great resistive input to target the proprioceptive system, much like pushing the balls to make a snowman. This activity can be calming and focusing for your child, not to mention will help you tackle the daunting task! Make sure to use a child-sized shovel and provide your child with short distances (such as shoveling horizontally across a driveway rather than vertically).
  1. Hula Hoop Contest– Hula hooping can be hard as it is, not to mention with layers of winter clothing on! When you’re all bundled up, take some hula hoops out into the snow and see who can keep the hula hoop going the longest.

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NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

How Teachers Can Help a Child With Tourettes

When you look at someone with Tourettes, all you see or hear are the tics. You don’t see the constant struggle, the constant commotion that is going on inside the person’s body. Although it might be easy to assume that when a person is not ticcing, they are okay or calm or not experiencing anything related to Tourettes, more often than not, that assumption would be entirely incorrect.

Here are a few tips on how teachers can help a child with Tourettestourettesteachermain

  1. Trust that if the person did not have an urge to tic, they would not be doing the tic. Know that although there might be some level of control for some kids some of the time, it is difficult to control and takes an inordinate amount of energy. The consequence of “not-ticcing” is often delayed tic-bursts, decreased concentration, lost instructional time and/or social time, and muscle soreness.  The consequence of ticcing is often embarrassment, shame, isolation, muscle soreness, decreased concentration, loss of instructional and/or social time.
  2. Ignore the tics. Don’t worry what the other kids will think or if they will become distracted. Be the role model. Keep on and so will the kids. They will get used to the noises just like you would get used to hearing the sound of a fire truck if you lived near a station or the smell of baked goods if you worked in a bakery.  If the noises bother you, just remember they bother the child a whole lot more…and he can’t walk away from himself.
  3. Remember that, as bad as the tics can be, they are usually just the tip of the iceberg. The common Tourette Syndorome (TS) co-morbid conditions are OCD, ADHD and Learning Disabilities.  Your student is battling, not only a body out of control, but some major disabilities that even adults have difficulty living with.  Remember this is a real, neurological disorder that the child did not ask for and does not want.
  4. Learn as much as you can about the disorder(s) and the child. Just because you knew one kid with Tourettes in the past does not mean that you know anything about the current student. Listen to the parents. Contact the child’s private clinicians. Ask questions. Above all, if the adults in the child’s life feel it is appropriate, talk to the child!  Let him know you are trying to understand, that you will do your best to protect him from the bullies, and that you care.  Let him know it’s okay to tic if he needs to and come up with safe places if he needs to leave the room.
  5. Does your student have behavioral issues? It’s possible that things you think are “bad behaviors” are manifestations of Tourettes. The shouting out? Tourettes. Doing what the teacher says NOT to do?  TS is a disorder of disinhibition. If the child hears “Don’t run” he will most likely feel compelled to run. If he knows he shouldn’t be saying certain words or doing certain things, the premonitory urge will center around those words or those actions and it will be extremely difficult, if not impossible, for him to control the urge.
  6. Work with administrators to schedule a teacher in-service for all the adults working with the child, including the related arts teachers, lunch monitors and bus drivers. TS does not go away when the child leaves your room. Children with TS need to know that there are in a safe place with understanding adults who will support them.
  7. With parent permission, set up a peer in-service. Have someone who is knowledgeable about TS speak to the students. There are organizations that have teens, young adults and adults who can provide this service.  This will help all the children, including the one with TS, feel less fearful and more comfortable with each other.

Click here for more information on what it’s like to live with Tourettes.

Meet-With-A-Neuropsychologist
About the Author: Shari was the 3rd person in IL to be diagnosed with Tourette Syndrome (1976). Her parents co-founded the IL TS chapter along with several others, including Joe Bliss. In 1978, while at a board meeting in her parent’s home, Mr. Bliss told Shari about his theory of premonitory urges and provided some tips and tricks on how to control the tics. It was the first time Shari felt “understood” and attributes much of her success to Mr. Bliss and his strategies. She co-founded the Illinois Tourette Resource Network in 2014 and is honored that she can continue the legacy of providing TS support to the Illinois community.

How to Help Your Child Cope with the Suicide of a Friend

For a child losing a friend through suicide brings up a lot of questions and emotions, such as why did this happen or what could have been done? A teen or adolescent may have copingwithsuicide-mainmany mixed feelings or may feel “numb.” Whatever they are feeling, your role as the parent is to help them and be supportive. Reassure the child whatever feelings they might experience, they have permission to let them out. If they want to keep to themselves for a while, let them. Don’t tell a child how they should or should not feel. Also, don’t discourage them from expressing negative emotions like anger. Talking about suicide will not increase the risk that others will go on to take their own lives. In fact, like a death from any other serious illness, suicide is now part of the family’s health history. Knowing the truth about mental illness and suicide enables all surviving family members to be appropriately vigilant about their own health moving forward, and take preventative steps.

Although it’s understandable that adults naturally wish to protect children from pain or bad news, shielding children from the truth can undermine trust and create a legacy of secrecy and shame that can persist for generations. You can protect children best by offering comfort, reassurance, and honest answers to their questions.

A child may experience the following feelings and that’s okay:

  • Abandoned – that the person who died didn’t love them.
  • Feel the death is their fault – if they would have loved the person more or behaved differently.
  • Afraid that they will die too.
  • Worried that someone else they love will die or worry about who will take care of them.
  • Guilt – because they wished or thought of the person’s death.
  • Sad.
  • Embarrassed – to see other people or to go back to school.
  • Confused.
  • Angry – with the person who died, at everyone.
  • Lonely.
  • Denial – pretend like nothing happened.
  • Numb – can’t feel anything.
  • Wish it would all just go away.

Tips on Explaining Death to Children and Teens

  1. Use the correct language- never use euphemisms. Do not use phrases as Grandma went to sleep or went away. These explanations can lead young children to become afraid to go to sleep or worried when parents leave the house and “go away.”
  2. Be honest with them and encourage their questions and expressions of emotions. It is important that kids know they can talk about it (even if you don’t have all the answers) and be sad, angry, scared, or whatever emotions they feel.
  3. Kids often will repeatedly ask the same questions; it is how they process information. As frustrating as this can be, continue to calmly tell them that the person has died and can’t come back. Also, do not discourage their questions by telling them they are too young.

If you believe your child could benefit from speaking with a specialist, click here.

Resources

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

What to Expect in a Pediatric Speech and Language Evaluation

The purpose of a speech and language evaluation is to determine your child’s strengths and challenges related to a variety of areas and conclude if therapy would be beneficial in further developing skills and aiding his/her ability to communicate effectively with SLPmainothers. Parents may request an evaluation if they have concerns, or children may be referred by a pediatrician, teacher, or after a developmental screening. While it may vary across settings, the following is a general outline of what you can expect from a formal speech and language evaluation.

  • Background and Developmental Information: Upon beginning the process, most facilities will request information regarding your child’s early developmental history. This will include things such as birth history, age milestones were met, and significant medical history. If your child has previously participated in therapy or related developmental/educational evaluations, providing copies of these reports to your therapist will be extremely beneficial in helping develop the whole picture of your child. In some settings, the therapist will obtain information from your child’s teacher regarding challenges specifically related to classroom learning and peer relationships.
  • Caregiver Interview: An essential portion of the evaluation will be information provided by the child’s family. The therapist will guide a discussion regarding your major concerns, what you would like to achieve by participating in the evaluation, and goals you might have for your child. The therapist may ask for specific examples of times you’ve noticed these challenges, thoughts about your child’s awareness toward the issue, and other questions to develop an overall understanding of how your child is communicating. Depending on the age of the child, he/she may participate in the interview portion to share feelings and thoughts on the area of difficulty, and what he/she would like to accomplish. Based on the background information provided and the caregiver interview, the therapist will choose assessment tool(s) to evaluate the area(s) of concern.
  • Assessment and Observation of the Child: Initially the therapist will spend time talking and/or playing with your child to develop rapport and make observations based on how he/she interacts and communicates in an unstructured setting. Then, your child will participate in assessments that may include:
    • Oral motor assessment to observe the structures of the face and mouth at rest and while speaking, as well as oral musculature and motor planning of oral movements.
    • Standardized assessment of the area(s) of concern (not an exhaustive list)
      • Expressive (what he/she produces) language and/or Receptive (what he/she understands) language
      • Speech production and fluency of speech
      • Pragmatic or social language
      • Feeding and Swallowing
      • Reading/Writing skills
  • Evaluation Report: The therapist will then compile all of the information gathered from the family, observations, and assessments and summarize it in a formal report. It will include a description of each area of assessment and its findings. Based on the results, the therapist will determine if therapy is necessary and if so, develop a plan for treatment. Specific goals to target the areas of need and a time frame for doing so will be included in the report.

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NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

What It’s Like To Live With Tourettes

tourettes1mainThe diagnostic criteria for Tourette Disorder is so simple, so clear, so straightforward:

For a person to be diagnosed with TS, he or she must:

  • have two or more motor tics (for example, blinking or shrugging the shoulders) and at least one vocal tic (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time.
  • have had tics for at least a year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on.
  • have tics that begin before he or she is 18 years of age.
  • have symptoms that are not due to taking medicine or other drugs or due to having another medical condition (for example, seizures, Huntington disease, or postviral encephalitis).

So simple, so clear, so straightforward.  So why is understanding the person with Tourette so complicated, so challenging, so confusing?  In large part because although it is easy to explain what it “is” it is exceptionally difficult to explain what it feels like to live with it.  Without that understanding, though, it would be incredibly difficult, if not impossible, for teachers and parents to effectively support children with TS.  And this is why…

When you look at someone with TS, all you see or hear, are the tics.  You don’t see the constant struggle, the constant commotion that is going on inside the person’s body.  Although it might be easy to assume that when a person is not ticcing, they are okay or calm or not experiencing anything related to TS, more often than not, that assumption would be entirely incorrect.

What causes Tourette tics?

Although once thought to be an “involuntary disorder”, there is a fair amount of peer-reviewed research that indicates people with TS have “triggers”, both internal and external. However, the triggers are ever-changing and inconsistent over time and even moment to moment. The initial documentation of a TS tic “trigger” was made by Joseph Bliss in 1980 (footnote) in the first-ever layman’s article published in the Archives of General Psychiatry.  His article describes how very slowly, over the years, he came to be aware of the faint signals that preceded a movement.  He described the sudden leap from impulse to movement as ”the moments before a sneeze explodes … almost as uncontrollable as a twitching nerve,” and concluded that the movements are actually voluntary: ”the intention is to relieve a sensation, as surely as the movement to scratch an itch is to relieve the itch.” Although a controversial concept in its time, it is now believed that in fact, most people with TS have “premonitory urges” in which they feel a sensation and then respond to it with a tic, which eliminates the sensation, but only for a fleeting moment when the urge begins again.

What are examples of triggers?

What are some of these triggers?  In addition to constantly changing, they vary person to person. Externally, they can be noises (loud noises but also softer noises like breathing and chewing), crowded places, certain people, unanticipated events, feeling as if someone is staring or talking about them, very cold weather, very hot weather, being physically over-stimulated, being physically under-stimulated, sitting for long (or even short) periods of time, being touched, certain foods, clothing, and smells, and so much more.  Internally, it can be hunger, over-eating, being tired, not having a specific task on which to focus energy, illness, injury and over-sensitivity to internal sensory input, to name just a few.  Although knowing what triggers a child’s tics can be helpful, for some children it is nearly impossible to figure out what they are, and some cannot be controlled regardless.  Therefore, as a start, it is essential for parents and teachers to gain a solid understanding of what Tourette feels like to the person living with it:  Joe Bliss’ concept of the Premonitory Urge.

What are Premonitory Urges?

Before a tic occurs, most people with TS feel a build-up of tension at a specific site within their bodies. Multiple “tension sites” can occur simultaneously.  This “tension” has been described in multiple ways such as an itch, a tickle, a punch, a storm, fullness, an ache, tingling, burning, and a feeling that something is not “just right.”  Once that feeling hits, the need to tic is extremely strong, analogous to holding in a sneeze or how it would feel if someone held their eyes wide and were told not to blink.  Although some people can control tics for periods of time, most people feel that if they don’t tic when they get the urge, that they will “burst” or get that feeling like they want to jump out of their skin. Even when tics are suppressed, eventually they need to be let out, creating a “tic storm” that can be painful, embarrassing, and create missed learning and/or social opportunities.

What is an example of a child with Tourette Syndrome?

So, let’s think about this in the context of a school setting.  Young Danny, aged 10, has Tourette. He was diagnosed at 5 and currently has no other diagnoses. However, over this past year, his parents are concerned about symptoms that look like anxiety and depression. They have also noticed that he is much more irritable when he gets home, than he has been in the past. He is a bright boy, with no learning disabilities but is not doing well in school.

Danny gets on the bus and sits with his friends. As they are talking, he feels an urge to lift his shoulders. It’s all he can think about and decides that a little shoulder movement isn’t going to cause attention to him so he does that tic and for a few moments he feels relief.  Then, he feels pressure building up in his arms and knows that if he tics, there is a chance he will punch the seat in front of him so instead of succumbing to the feeling, he focuses on tightening his arms, hoping that the feeling will go away. And it does until he exits the bus, but for the rest of the bus ride, all Danny can think about is squeezing his muscles as the tension build-up is getting stronger and stronger.  So much so that he has no available resources to talk to his friends.

As he exits the bus, he can no longer control the urge in his arms and is also aware of pressure building throughout his body. He stands still so he can fling out his arms, jerk back his head, and make a loud grunting noise.  It only takes a couple of seconds and when he is re-composed, he is acutely aware of 2 girls standing near the school door, laughing and pointing.  Danny feels a sinking feeling but is used to this, he ignores it, walks into the school, and starts to feel the premonitory urges build up once again.  As he heads down the hallway he wonders if there will be a lot of kids by his locker. He knows that if there are, it could set off his tics again if they get too close or touch him. If he’s touched on his left shoulder, he needs to touch his right shoulder. The closed in feeling will increase his urge to tic. Just the thought of this, combined with not knowing what to expect, starts to make him feel nervous. As he is reaching his locker, he sees only 2 boys there and feels some relief, but then all of a sudden he is aware of building tension in his mouth and throat and before he knows it he lets out a shriek. The kids turn and he feels humiliated. But, he knows if he doesn’t hurry up he’ll be one of the last people in the classroom, and walking into a crowded classroom increases his urge to tic, so he ignores the stares and continues to his locker.

Once in the classroom, Danny is continually assessing the situation.  It’s a constant effort of managing and mediating situations, both internal and external.  “Do I tic now so I can alleviate the pressure because if I don’t it will be more embarrassing later on?”.  “Should I go to the nurse and say I’m sick because I know that having to be in a quiet library will set off my tics?”.  “Will my teacher make me work with the kids who were just making fun of me? If so, I know I’ll be nervous and my tics will increase.  That will make  the whole day bad and it’s only 9:00 a.m.”   “If I go to the library I can try to hold in the tics but that’s not a good long-term strategy because then they’ll all come tumbling out in Social Studies. But maybe it’s worth it because the worst place to tic is in a quiet library.”  All the while, Danny is trying to listen to the teacher, trying to suppress some tics, but still ticcing, and then trying to ignore the stares and murmurs.  Now it’s 9:30 a.m. and he can’t wait to go home and take a hot bath because he knows his body is going to be in so much pain from ticcing and his brain is going to be so tired from trying to hold everything together.  “And my mother wonders why I’m so crabby when I get home,” he thinks to himself.

What does the teacher see?

Let’s look for a moment at the same situation from the teacher’s perspective.  She sees Danny walk into class seeming okay because he’s not ticcing. Of course she has no idea that already twice he’s been embarrassed by his tics, been laughed at, and that his arm and shoulder muscles are hurting from trying to contain the tic.  She notices a few tics but since they are slight shoulder and hand tics and a couple of eye blinks she again assumes he’s doing okay. Then, as she is talking about the group project she notices that Danny doesn’t seem to be listening.  She wonders why such a smart boy always seems to be daydreaming. She calls out his name and tells him to pay attention, which he does immediately.   Then, as they are lining up for library she commends him and tells him she is proud of him for controlling his tics.  “If only my teacher knew how much effort it takes, how stressed I am all the time thinking about it, and how tired and bad about myself I feel by the time I go home. If only she knew that when I say I have to go to the bathroom it’s really because I want to release my tics. If only she knew how much the comments and stares bother me. If only she knew that the reason I have trouble starting my work is because the pencil on my paper needs to feel “just right” or I’ll need to erase and start over again. If only she knew that the reason I stop working so much is because my socks don’t feel right and I have to adjust them until they do.  If only she knew.

As seen above, TS causes a constant struggle between the mind and the body.  Ticcing is no different than blinking or scratching an itch.  No one WANTS to tic, yet the urge becomes so strong it is virtually impossible to block it.  If the child controls the blinking, it might come out in squeaking. What’s better, what’s worse, when to do it?  The mind of a Touretter is constantly navigating a body that is out of control.  It’s annoying, discouraging and, at times, self-defeating. And, most bodies with Tourettes usually have additional disorders with which to contend.  So, Danny’s scenario was really quite “tame” as compared to most kids with TS. The tics are just the tip of the iceberg.  Add on ADHD, OCD, Depression, and/or Learning Disabilities and the “perfect storm” is created.  Put that child into a class where the teacher, understandably, has a difficult time knowing how Danny feels, alongside kids who either make fun of him, are scared of him, get annoyed with him, or “put up” with him at the risk of losing other friends who think Danny is “weird.”  Layer on top of that parents who are worried about their child, don’t feel like anyone else understands them, becomes alienated from friends and family, is frustrated by the notes home from school wondering why Danny can’t finish his homework (well, if he can’t finish it during the day he’s probably not going to be able to do it at home, either), frustrated with the lack of medical options, and feeling so guilty and so bad for their son who comes home every day with sore muscles, an exhausted mind, and feeling very beaten down.

Resources

  • Illinois Tourette Resource Network This group provides 3 support group meetings a month, monthly family activities, adult activities, online support, and workshops. They also provide speakers, teacher in-services and peer in-services.

Bliss, J. “Sensory experiences of Gilles de la Tourette syndrome.” Archives of General Psychiatry 1980; 37: 1343-1347.

About the Author: Shari was the 3rd person in IL to be diagnosed with Tourette Syndrome (1976). Her parents co-founded the IL TS chapter along with several others, including Joe Bliss. In 1978, while at a board meeting in her parent’s home, Mr. Bliss told Shari about his theory of premonitory urges and provided some tips and tricks on how to control the tics. It was the first time Shari felt “understood” and attributes much of her success to Mr. Bliss and his strategies. She co-founded the Illinois Tourette Resource Network in 2014 and is honored that she can continue the legacy of providing TS support to the Illinois community.

handwriting

A Teacher’s Guide To Helping Students Of All Ages With Handwriting

Handwriting is a very important skill that can affect a child’s ability to learn, keep up with class, and ultimately express themselves. However, learning and honing that skill can be a stressful experience, for students and teachers alike. There are many factors that affect this (assumedly simple) skill of writing. The position of the paper, chair, and desk along with the paper and pencil used all can positively (or negatively!) affect a student’s writing. Below are suggestions to help make children of all ages beautifully legible writers!

Handwriting for Students Ages 5-6:

  1. Make it a (fun!) multi-sensory experience: Learning letters can be difficult (how to formA Teacher's Guide To Helping Children With Handwriting them, which direction they face). Help children learn with more than just their eyes by practicing letters in shaving cream, sand trays, gel-filled bags, Play-Doh, and Wikki Stix. Using songs can help as well!
  2. Teach uppercase letters: Children’s brains at this point are made for learning how to draw shapes, followed by uppercase letters. If children learn lowercase too soon, they may be forming them inefficiently, which could affect their legibility and speed later on.
  3. Check formation: Formation of letters (i.e. where to start and stop writing letters) is important for efficiency, especially when kids will be learning lowercase letters in the near future. Imitating the teacher writing a letter a certain way is also a great visual motor integration activity that is good for their sequencing of movements and attention to task.
  4. Use thick utensils (ages 5 and younger): Pencils can be difficult for these young ones to hold on to without an adaptive gripper, so give them the thick markers and crayons to help develop those hand and finger muscles needed for holding pencils when they get a little older.

Handwriting for Students Ages 6+:

  1. Use a writing checklist: This can be a list you and your students make for what to remember when writing (e.g. capital letter at the beginning of a sentence and names, punctuation, are my letters on the line? etc). This is a great tool to help students self-monitor their writing and know what is expected.
  2. 90-90-90: This refers to the ever-important 90 degree angles of the ankles, knees, and hips. Make sure your students are able to sit at their desks in this position, so they have the right amount of proximal stability to allow their arm and hand do he intricate fine motor movements required for writing at the end of their pencil.
  3. Check the position of the paper: For right-handed students, make sure the paper is tilted slightly up to the right, and the opposite goes for left-handed writers. This gives kids the optimal angle for their arm and wrist for writing smoothly. Also make sure they are stabilizing the paper with their non-writing hand.
  4. Type of paper: Some students may have difficulties with visual-motor integration or visual perception, which could make writing on standard wide-ruled or journal paper difficult. If the student’s spacing between words and/or sizing of letters are poor, try having them skip lines or give them triple-lined paper (with the dotted line in the middle) to help with overall legibility.
  5. Grasp (ages 5-7): Children ages 5 and up are expected to use a dynamic tripod grasp on their writing utensils (pads of the thumb and index finger on the pencil, pencil resting on the last knuckle of the middle finger). If your students have something other than this that seems to be affecting their writing and they are 7 or younger, it is not too late to change their grasp to help with legibility. Using a pencil gripper or a referral to an occupational therapist might be warranted.
  6. Environment: Help make the environment conducive for writing by limiting distractions. This could be anything from helping a visually distracted student move to a desk that faces a blank wall, or allowing a student block out auditory distractions use noise-canceling headphones. Give a particularly wiggly student a structured movement break during long writing assignments (e.g. at 1:10 you can go get a drink of water).

If you have students who continue to have great difficulty with writing, an occupational therapy evaluation may be appropriate.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!