Tourette & tics at school, work and in public

In a study of 100 people with Tourette syndrome, most often tried to hold in their tics. Over 90% said it felt uncomfortable and took concentration or extra effort. About two-thirds could hold tics in for less than 10 minutes.

In the same study, people who felt more satisfied with how they managed their tics also reported better quality of life.

Many people believe that holding tics in leads to a burst of tics afterwards. In one study of 20 people, measurements in a clinic and at home did not show this “rebound” after practice at holding tics in.

Everyone is different. Notice what is true for you, without pressure to hold tics in.

Most children with Tourette syndrome also have another condition, like ADHD, anxiety or OCD. More than a third of people with Tourette syndrome have OCD.

In a silent test room, students often spend a lot of energy holding in tics, which can hurt how they do. Testing in a separate place, with extra time or a reduced workload, can help.

Extra time on tests and a different seat are common school supports.

Some children with Tourette syndrome have problems with writing. Using a computer is one accommodation schools can offer.

Reminding a child not to tic often increases the urge to tic.

Instead, teachers can

• Carry on teaching as normal
• Ignore tics that can be ignored
• Quietly check in later if the student seems stressed

Sending a student out to tic may feel like being punished for something they can’t control, and can bring shame. Any break should be the student’s choice and part of an agreed plan.

• “I have Tourette’s. My body makes movements and sounds I can’t control.”
• “It’s not catching, and it doesn’t hurt.”
• “The best thing you can do is just ignore it.”
• “You can ask me about it. I don’t mind.”

Children with Tourette syndrome experience more bullying than other children. Bullying, teasing and harassment should not be treated as a normal part of growing up.

Bullied children are more likely to feel depressed, lonely or anxious. Adults help by talking about bullying and creating safe schools.

• Agree on what your child wants friends’ parents to know
• Have a calm, private space they can use if tired
• Remind them they don’t owe anyone an explanation

Under U.S. law, you can usually keep a medical condition private. If you share it, your employer must keep that information confidential.

You may ask for an accommodation at any time. You don’t need to have a specific one in mind.

• A cubicle divider or more private workspace
• Disability awareness training for coworkers
• Flexible or modified breaks
• Noise-canceling headsets or white noise
• Working from home some days

Some people ask for short, scheduled “tic breaks”, like the breaks other workers take.

The Americans with Disabilities Act bans disability discrimination in hiring and promotion. Court cases involving Tourette syndrome have had mixed results, so it can help to get advice early.

The Job Accommodation Network (JAN) gives free, confidential guidance on accommodations. Website: askjan.org. Phone: 800-526-7234.

• Check whether an employer has a written commitment to disability inclusion
• Look into your state’s vocational rehabilitation services for job and interview help
• Talk with current employees, if you can

If vocal tics are hard to cover with background noise, ask the venue about a private box or other seating. Some places have rooms or areas meant for people who may make noise.

Focusing on something can reduce tics. Bring a puzzle, sketchbook, game or crossword for waiting rooms, lines and trips.

If complex tics slow you down, give yourself extra time to get in and out of places.

The Tourette Association of America offers free “I Have TS” cards that explain tics. They are especially useful in stressful places, like when traveling or in crowds. There is also a version about swearing tics, and a digital card.

People with stronger tics may want to carry one in case their movements or sounds are misunderstood.

• Carry an “I Have TS” card
• Choose an aisle seat if moving helps
• Tell staff ahead of time if you’d like to
• Pack your focus kit

• “I have Tourette’s. These are tics. I can’t control them.”
• “It’s a neurological condition. Nothing to worry about.”
• “Just ignore it. I do!”
• Or say nothing at all. You don’t owe anyone an explanation.

• Afterwards, talk about how it felt and what helped
• Stay calm and keep doing what you were doing
• Use one short sentence with strangers, then move on
• Praise your child for handling it

The Tourette Association of America has a free toolkit to help police, EMTs and other first responders understand and support children with tics.

If stopped by police

• Keep hands visible as best you can
• Say early, calmly: “I have Tourette syndrome. I may move or make sounds I can’t control.”
• Show an “I Have TS” card, telling the officer before you reach for it

The Tourette Association of America offers an “I Have TS” card made for swearing tics (coprolalia).

Where swearing tics could upset customers, some people ask to move to a role with less public contact. This can protect both the job and your peace of mind.

Word tics can bring shame, especially in quiet places or around children. Remind yourself that these are not your words or values. A therapist who knows tics can help with the feelings and with practical plans.

The Tourette Association of America has information for children, teens, adults, families and educators, online and local support groups, and a provider finder. Website: tourette.org.

• Bullying or teasing is wearing you or your child down
• Tics are painful or causing injury
• Tics or worries make school, work or going out very hard
• You feel low, anxious or alone much of the time