One thing to be very aware of in Tourette Syndrome, and something rarely discussed, is that tics (or TS activity) are not only expressed vocally or as movements (vocal and motor tics). These are just the bits others see or notice -what can present the greatest challenge to the individual themselves is the activity that takes place in the mind, these 'thought tics' and 'busy' and often intrusive thoughts that can be exhausting and affect concentration. I recall one child with TS who wrote in a poem "my mind is like a busy bee." People with TS may have to consciously 'filter' both impulses that arise within the higher cortex of the brain and incoming sensory input (e.g. sound, sight, tactile and limb/joint/body awareness). This filtering, controlling and selectively limiting or inhibiting is a function that is largely automatic and sub-conscious in other people.
In an educational setting, this can result in an individual experiencing difficulties in following what is being said during lessons, group discussion, audio-visual presentations and, in reading, writing and computer-use, reduce the speed and efficiency with which they are able to carry out those activities.
Some individuals are better able to suppress or 'hide' tics that others might notice and so are able to reduce the amount of attention those tics might draw from others. Generally children find this more difficult than more experienced adults and are frequently not aware that they are ticcing but this is not always the case. Some adults may have only a limited ability to suppress attention-grabbing tics or in some cases experience an increase in severity with age. Some individuals may exhibit motor tics that are either concentrated in less-noticeable areas of the body such as the abdominal muscles or diaphragm or involve unseen muscle tensioning and relaxing and have vocal tics that are incorporated into normal speech or be expressed as throat-clearing, sniffing, rapid exhalation etc. However it may not, logically, follow that their TS is any less problematic in other respects.
Some individuals are better able to suppress or 'hide' tics that others might notice and so are able to reduce the amount of attention those tics might draw from others. Generally children find this more difficult than more experienced adults and are frequently not aware that they are ticcing but this is not always the case. Some adults may have only a limited ability to suppress attention-grabbing tics or in some cases experience an increase in severity with age. Some individuals may exhibit motor tics that are either concentrated in less-noticeable areas of the body such as the abdominal muscles or diaphragm or involve unseen muscle tensioning and relaxing and have vocal tics that are incorporated into normal speech or be expressed as throat-clearing, sniffing, rapid exhalation etc. However it may not, logically, follow that their TS is any less problematic in other respects.
