Some children with ADHD can also have tics as a complication of their condition. These are rapid, involuntary, recurrent non-rhythmic vocal or motor actions. They frequently fluctuate in intensity, during the day and over weeks and months. Motor tics include recurrent eye blinking, facial grimacing, shoulder shrugging, tongue protrusion, knuckle cracking. They may also be more complex, often involving jumping, lip biting and facial gestures. Vocal tics include throat clearing, coughing, spitting, grunting and whistling, among others.
Some children have severe tics and are diagnosed as having Tourette Syndrome. ADHD and Tourette Syndrome frequently occur together in the same child.
Try to get an idea of the nature of the child’s tics and in what situations they are better or worse. You may find that stressful situations, such as exams, can make tics worse. It is worth noting whether the child is able to contain the tics at school, as is often the case. Parents often report that they become worse when the pupil returns home. Ask the child’s parents for any suggestions for coping with his tics, as they will almost certainly have found strategies that help.
It is generally best to ignore a child’s vocal or motor tics in the classroom and this lead will tend to have a flow-on effect to the other children’s attitudes. Ensure that the child is not bullied or teased and that attention is not drawn to the tics by staff or other children.
The child should not be punished or chastised because of them.
If the child is having a difficult period because of the tics, let him take frequent breaks from the classroom to run errands, or find some other reason for him leaving the classroom. This will give him the chance to release his tics.
You could encourage pupils in the class to learn more about tics. Some children with severe tics have given brief presentations to their class on Tourette Syndrome and this has subsequently been very beneficial for all involved. However, be very sensitive in suggesting this
If you need more information on tics, contact the Tourette Syndrome Association (wvAv.tsa.org.uk).