Hi , again friends from The TS Chat Room! These are my notes from the Educators' symposium at the D.C. 1998 TSA National conference. Remember that they are only MY NOTES and are intended to serve as a springboard for your research and or ideas on managing and explaining our children' TS and related problems in Learning and behaviour. I hope they will be of some use.
"You can give kids roots or you can give them wings"
NEXT to parents , the teacher is the most important person in a person's life!
CRITERIA for TS
Multiple motor tics-even MILD tics may be more Bothersome
Vocal tics
Waxing &Waning-changes with stress, excitement fatigue
Uncontrolable-Supressable
Childhood onset
(Important to give the child free use of leaving the room for tic ing)
THE most common Related disorders are OCD - ADHD and Learning disabilities
FOR OCD-give options of showing what the child knows
ADHD-ex. Remember that if a child has a deficiency in his vision, he doesn't JUST STOP NEEDING Glasses because he is in the 6th grade.....and that holds true for the tools for organization
LD's-Testing ...use neuropsychologist PT
Fine motor-visual impairment visual-motor
Sensory Defensiveness-PT
Behavioural Aspect- short fuse
KEEP A SENSE OF HUMOR
FIND ROOM FOR A COMPLIMENT TO THE PARENTS
BEHAVIOUR IS A "COMMUNICATION"
Motivational Assessment Scale Duand 88
Sensory-> Environmental/relaxation
Escape-> Curriculum/self-esteem
Attention-> Ignore/redirect (may be reenforcing by negative attention....)
Tangible-> Expressive language issue
Managing TS and TS+ is like a THREE legged STOOL
Leg #1) Strategies
Leg #2) Therapies
Leg #3) Medications a good balance is the determining factor.
STORMS
Prevention strategies... use adaptations, ex...homework handed in late..
AGRESSION- TS + behavours are like an iceberg...what is not seen CAUSES ......
Above water level
Pushing, Hitting,
Spitting, Throwing
Water level~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Below water level Poor Social Judgement
Unawareness of the feelings of others
Sensory MIS - Perceptions (irratable/senitive)
Frustration Communication Limitations
Does NOT UnDERSTAND HoW TO INTERACT
OBSESSIVE COMPULSIVE DISORDER OC BEHAVIOURS
Stuck ...... anxious........... perfect........just right......
EXECUTIVE FFUNCTIONING- THAT ....CLUE - LESS - NESS...
The chile perceives "I ALWAYS DO SOMETHING WRONG"...... .(
Friends, from the TS CHAT Room..hello again. I just wanted to share another few bits of these "notes" from the conference with you...hoping they may shed some light on some of your "questions" . One of the things that I "realized" in the conference is just how much Executive Function dysfunction affects our TS kids and to a greater extent, our TS+ kids. I hope it is of some help.BB aka Bonnie/Baby
EXECUTIVE FUNCTION DYSFUNCTION
"Executive functions are control processes. They involve inhibition and delay of responding . They can be divided into the realms of initiating, sustaining, inhibiting/stopping and shifting. Another important aspect of executive function is planning and organization, which requires "attention to the future"(Dr Martha Bridge Denkla)
HALLMARKS OF EXECUTIVE DYSFUNCTION
Sheryl Pruit M.ed
Warren Walter Ph.D.
Initiating, sustaining, inhibitory/stopping and shifting
Sequencing and planning-Verbal pragmatics
Planning and organization which requires "attention to the future"
THIS IS ALL A FRONTAL LOBE DYSFUNCTION PROBLEM
Social Skills should be addressed by educators
Social disabilities are the least understood and often least often addressed through direct education.
IQ IS NOT RELATED TO THIS....
The HIDDEN CURRICULUM_ that others "GET"
Pragmatics-Language problems solving ex. Solving problems
Social Skills curriculum
Teach to ask questions....
Social Skills Autopsy
Comic Strip Conversation
Video Social Resposnes
Hidden Curriculum- Big point-things that aren't spoken (the kids don't understand)
Social stories-talk about and explain what is coming up next..........
Small social groups
Extra curricular activities- in common ....help with friendships...
Feeling words...teach and use them
EXECUTIVE FUNCTION- as pertains to Memory Functioning
Deficits Intact Systems
Strategic Memory-----------Trick Book------------Immediate Memory
Working Memory-------------------------------------Declarative Memory
Procedural Memory-----helped with lists----------Semantic Memory
See Brain-corollary discharge Theory
Mood disorders
UNIPOLAR-Depression Bipolar Disorder
Execessive laughter can be a presentation
Of mania-laughter that does not fit into
Normal context/or irritability
Theoretically depression makes TS worse/stress
Sensory Integration
Alert Program-Cognitive therapy=alert himself to the problem
Tactile /Auditory /Gustatory/ Visual/ Olfactory
Knowledge ---brushing program
Sleep disorders
Wake up at the same time---check with DR. When you can't sleep
Exposure to sunshine ---4 alarm clock system
Don't stay in bed/not sleeping --- Schedule am appointments
PSYCHODYNAMIC- Psychological
BEHAVIOURAL- Teaching
NEUROLOGICAL- Recognizing WE ARE HERE
Our theoretical basis
Proactive Behaviour Management
Adaptations- Minutes of the meeting for IEP
Strengths
Limitations
Adaptations
CLIMATE IN THE CLASSROOM
POSITIVE---HAPPY___CONTENT---ENVIRONMENT is CRICIAL
DO NOT TRY TO PROBLEM SOLVE in VIEW of SYMPTOMS of ONCOMING
STORM- Teach NON VERBALLY
Crisis
Silence Reassurance (We WILL get THROUGH this)and not ever
Staff anxiety-stay calm and gracefully exit- Judgemental)
A GRACEFUL EXIT IS A MUST.....A SAFE PLACE & A SAFE PERSON
PERMISSION TO GO DIRECTLY TO THAT PERSON
HIGH JUST RIGHT LOW
GRANDMAS' RULE
You don't have to eat your veggies, but I made cake , if you arent hungry/
NO CAKE!
You may go out after you clean up.....
More intervention rather than less-the sooner the better
"I am a wonderful teacher, I do a good job! Trust me...." After a Not appropriate behaviour- Talk and give strategies
1/3 of our TS kids are home again by age 30....we need to give them strategies
ts, ADHD Kids have 6 times more accidents....MISTAKE TO NOT MEDICATE ON
WEEKENDS!
Behaviour Modification
Time-out as positive Reenforcement
Not Punishment...Do not REMOVE too many times...IF YOU ARE HAVING TO REMOVE too many times , take a look at where it is happening......something is wrong...
Rewards---the child should chose something rewarding....
WAYS TO CON THE TEACHER...
Teach the clues of the "hidden curriculum"- Be specific with the child about what you want from the child
Use HUMOR as a Tension diffusor
DETECT Storm Warnings--ex. Lip out...etc.
Praise consistently
TRAINERS' GUIDE-with 2 Videos good too.
STRAGEGIES
2.9% of population 1998 England Dr. Mary Robertson
1% to 3% Tourettes
25% of all children in Special ed. Have TIC disorders
1 in 200
Who OWNS the problem? Wxx(the first day of school dressing drama) ...is it worth the fight?
OUR OPINIONS AND PERCEPTIONS ARE AFFECTED BY OUR FEELINGS
NO PUBLIC HANGINGS
DO NOT Shame in Public
AGRESSION towards
Others
AGRESSION towards FRAME the issues
Self PICK YOUR BATTLES
Destructive Behaviour
Disruptive Behaviour
Distractive Behaviour
"I don't have time to build a fence, I'm too busy chasing the cows"
(It is always worth investing the time)
there are 3 kinds of people- Proactive
Cognitive Picture rehearsal
Fear rating
From NO PROBLEM -to I'm a little uneasy- to NO WAY....
Visual Cues -for ex. THINGS TO DO TODAY -sign or list.
Environmental
Group Schedule
Relaxation
Direct Teaching/Repetitive Practice
Deep Breathing
Muscle Relaxation
Imagery
Alert Program
Sensory Boxes
Foot and hand Massages
Relaxation Room /Lighting and Music
READY FIRE AIM OOPS ;(
OCD - Make sure the kid can go back and repair-Have them look at the face(not necessarily
The eyes)
Regular anger relaease- beat pillow--------and BENIGN Correction Proceedure
GOOD TEACHING STRATEGIES
LIMIT SURPRISES, MAINTAIN THE MOST CONSISTENT SCHEDULE POSSIBLE
CREATE PREDICTABLE ROUTINES IN YOUR CLASSROOM
REMEMBER THE GOAL OF A LESSON WHEN CONSIDERING ADAPTATIONS
USE VISUAL CUES TOENHANCE STUDENT UNDERSTANDING
USE SEMANTIC MAPPING- FOR MAKING OUTLINES
HIGHLIGHT RELEVANT INFORMATION WHEN TEACHING NEW CONTENT
HAVE A SYSTEM FOR INTRODUCING CHANGE
USE VISUAL TASK LISTS AND TECH LIST MAKING
NEVER EMBARRASS STUDENTS
TEACH ORGANIZATIONAL SKILLS
UTILIZE PEER MENTORING SYSTEM
MODEL TOLERANCE
MODE CONTROLLED BEHAVIOUR
GIVE MORE THAN 50% TO BUILD RELATIONSHIP
MODEL-Cleaning up
2 parts Praise
What we say to the child and what he in turn, says to himself........
Children often misbehave when they have difficulty with......
ORGANIZATIONAL SUGGESTIONS
Give choices - let the kids try and chose strategies
Long range assignments- Break up into segments
Focus on today- organize..for difficult focusing in ADD
PROVIDE THE CHILD THE TOOLS THEY NEED TO BE SUCCESSFUL
Delvope secret signals with the child.
Yack Back or recorder as assignment reminder
DO NOT EXPECT MORE THAN THEY CAN ACCOMPLISH.
INPUT from the child on problem solving and organization
WORK IN A COLLABORATIVE EFFORT- AVOIDS TEACHER CONFRONTATIONS
