By Vera Joffe, Ph.D.

A couple of years ago, I was watching television and the main theme of Allie McBeal’s episode was on a woman who had Tourette’s Syndrome. The woman had killed her boyfriend by stepping on the accelerator while he was in front of the car. Initially, the woman stated that she did it purposely, but afterwards, she confessed that she touched the accelerator of the car without intention, and that was part of her condition, Tourette’s Syndrome.

The main character of the episode that had Tourette Syndrome had many symptoms, such as complex motor and vocal tics, she had echolalia (she repeated what other people said and did), and she sometimes used obscene language.

I watched the program very carefully, and again I was somewhat disappointed with the media, and the use of sensationalism to “make a story” instead of trying to portray a medical, neurological condition in a more realistic way.

I work with a lot of children and adults with Tourette’s Syndrome. When I diagnose a child with the condition, the parents become so afraid that their child is going to behave just like the character they saw on television one day… I have rarely seen Tourette’s Syndrome be described by the media (other than the Public Television) in a scientific, correct way. On the other hand, it is fair to say that in the same program, Ally McBeal, there is one character, John, that actually has Tourette's Syndrome, and his description of his condition is a positive, and more realistic one. He is also a successful attorney, and a very well like character.

Tourette’s Syndrome is a neurological and developmental condition. In order for someone to qualify for that condition, he (or she) must be showing repetitive vocal as well as motor involuntary movements (tics) for more than one year. It is easier to observe a tic than to describe it. Examples of motor tics are eye blinking, nose twitching, banging, jaw snaps, head jerks. Vocal tics may be throat clearing, coughing, spitting, as well as syllables, words, and phrases such as “stop that”.

I am sure that you have seen a program in television with a person with Tourette’s Syndrome who said obscene, inappropriate and aggressive words. This is called “coprolalia”, and it only happens in less than 15% of people with Tourette Syndrome.

Nobody knows the “cause” of Tourette’s Syndrome, but it is well known that it is a neurological condition, and that it is genetic. There are no blood tests, nor any other test (at this point) to diagnose Tourette’s Syndrome. At this point, the diagnosis is made by observation and careful description of the symptoms. Because Tourette’s Syndrome develops during childhood, the tics that first appear are facial ones, such as eye blinking, and twitches of the mouth. Also, involuntary sounds may appear also. Sometimes, children (and adults) show only motor or only vocal tics, and thus they don’t qualify for the diagnosis of Tourette Syndrome.

Usually children who develop Tourette’s Syndrome also show symptoms of other conditions, such as Attention Deficit Hyperactivity Disorder, Obsessive Compulsive Disorder, and sometimes Mood Conditions (such as depression and bipolar disorders), and learning disabilities. But not all children develop other symptoms; each child is unique in her/his own way!

It is very important to consult your pediatrician and possibly a child neurologist (or child psychiatrist) if you notice the presence of tics in your children. Children with Tourette’s Syndrome should be treated, but the “tics” are not the focus of treatment. Physicians only give medications for the tics when they create an impairing situation for the child, such as physical pain from moving the neck too much, for instance, or if the child is showing so many vocal tics at school that he/she is disrupting the work environment for everyone.

Children and their parents can receive support from therapy, from their doctors, and from the Tourette Syndrome Association. There is a very strong group in Broward County, and parents feel supported and understood when they talk to other parents, and with professionals who know the subject well. In addition, if your child is having difficulties at school due to the condition, she/he can receive accommodations to help him/her learn in a more appropriate environment.

Parents usually ask me if the symptoms improve with time. A great percentage of children decrease their symptoms when they reach adolescence and adulthood. However, tics may persist, and so do some symptoms of obsessive and compulsive behaviors.

I hope that the information I provided you is helpful. Remember: Tourette’s Syndrome is a medical condition, not a psychological condition that is created by psychological trauma, or by “bad parenting”. Thus, people with Tourette’s Syndrome should be able to lead a normal life!