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cont. from
Co-Morbid Conditions: ADHD
by Susan A. Conners
ADHD can often be the precursor to Tourette Syndrome. It appears from birth and the
tics most often start nearer the age of 6. ADHD is characterized by several
behaviors. Children with ADHD are very fidgety. They have a difficult time
remaining seated for any length of time; they seem to be in constant motion.
They also exhibit a very short attention span. These children can be very
impulsive. They shout out answers before being called on. They interrupt and
get in your face. They also have a difficult time initiating or finishing
anything. They lack what we call executive function in the brain, which means
that they are some of the most disorganized children you will ever encounter.
These are the kids who always come to your class unprepared and with the wrong
materials. They lose everything, pencils, pens, homework, etc. They can be
some of the most frustrating children you will ever teach.
The 17-year-old son of a close friend of mine was recently involved in a very
serious car accident. He sustained a traumatic brain injury to the frontal lobe
of his brain. This once organized, high functioning honor student and athlete
suddenly was having difficulty with the simplest of tasks. His attention span
was very short; he could not retrieve words that he always knew; he had become
very impulsive and seemed to lack the ability to plan, organize, sequence or
understand the consequences of his actions. ADHD results from difficulties in
the frontal lobe are of the brain. How easy it is now for me to understand the
medical, neurological nature of this disorder.
Strategies for working with the TS/ADHD child are numerous. These are kids
who should always be on an assignment sheet which is verified and initialed
after each class by the teacher to assure accuracy. These are students who need
all assignments broken down for them. They need to be seated in the front of the
class, preferably on the side since tics may be more obvious to the rest of the
class when the child is in the center front. They need constant help with
organization-- a set of textbooks at home, color coordinated textbooks and
folders to mention a few. The most difficult times for them in a school setting
will be the cafeteria, the school bus, crowded hallways and the playground.
Structure is lacking in all of these situations and kids with ADHD become very
easily overstimulated in these environments.
When I entered my 20th year of teaching several years ago, I made the
conscious decision not to "sweat the small stuff." I gave up worrying about kids
who forget their pencils. I simply lend them one. I find that the majority of
kids who always forget or lose their supplies are kids with ADHD. They are not
doing it on purpose. They simply have a neurological disorder that prevents them
from remembering. So why lose sleep over such a petty thing? We don't punish
hearing impaired kids because they can't hear or visually impaired kids because
they can't see, so why would we punish ADHD kids because they forget their
pencil?
Learning Disabilities
Another
commonly associated disorder with Tourette's is Learning Disabilities. Once
a diagnosis of Tourette Syndrome has been made, I strongly urge that the child be tested by the
school psychologist. Children with TS can have disabilities in many areas, but
a very large number of children with TS are affected by nonverbal learning
disabilities. These disabilities are usually in the area of auditory
processing, fine motor and visual-motor impairment. It is therefore also
strongly suggested that the child be evaluated by an Occupational Therapist and
an outside Neuropsychologist. Fine motor impairment translates into very
laborious and very messy and illegible handwriting. Visual-motor impairment
makes it impossible for the child to copy accurately from the chalkboard,
overhead projector or from the textbook to the paper. The child may copy the
Math problem wrong and line up the columns incorrectly, which will surely result
in an incorrect answer. Standardized tests pose particular difficulty for these
students. They will know the correct answer, but transfer it incorrectly to the
computer sheet. The simple answer to all of these issues is the use of a
computer. A computer is the electric wheelchair to a child with nonverbal
learning disabilities. They need it for survival.
continue: Tourette Syndrome and OCD
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Reviewed: 03/2006
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