Various guest lectures – such as the ones given by pediatric neurologist Dr. Abba Cargan, post-doctoral fellow Meir Flancbaum and New Jersey Center for Tourette Syndrome & Associated Disorders (NJCTS) in-service presenter Tracy Lederman on Tuesday, April 24, at GSAPP on Rutgers’ Busch Campus – often go a long way toward helping them gain that competency.
As part of NJCTS’ first annual Tourette Syndrome Awareness Week, Tuesday’s topics included the neurological and clinical aspects of Tourette, a neurological disorder that affects as many as 1 in 100 people, as well as how TS impacts families.
Cargan, who practices in Mountainside and has many pediatric patients with Tourette Syndrome, went through a comprehensive presentation highlighting both well- and little-known attributes of the disorder – such as the many different types of tics, which must be both non-rhythmic and irregular in frequency to be classified as such.
There are many common tics – blinking, eye rolling, head jerks, shoulder shrugs, etc. – but there also are more rare examples, such as echopraxia, a condition that involves a child with TS mimicking a movement he or she has seen someone else do. Cargan also talked about coprolalia, one of the most misunderstood conditions associated with Tourette.
Known as the “cursing tic,” coprolalia is seen in as few as 3 percent of children with TS, according to Cargan, who notes that the accepted societal norm for coprolalia is between 10 and 15 percent – not the “99 percent that is engrained in public perception because of what people see or hear on television,”
The main reason children with Tourette Syndrome tic, Cargan says, is because they are tired or stressed out. Sleep is extremely important for children with TS, he says, and if they don’t get it, Tourette can become a major ordeal.
Cargan then gave way to Flancbaum, a recent graduate of the Tourette Syndrome Practicum Program at Rutgers that was developed in part by NJCTS. Flancbaum, a post-doctoral fellow at Behavioral Therapy Associates in Somerset, concentrated his talk on treatments – not only for TS, but also for the many co-morbid disorders (such as OCD, ADD and anxiety) that often accompany Tourette.
“Some kids view their tics as a part of themselves and are not interested in getting rid of them in ways such as Habit Reversal Therapy (HRT),” Flancbaum said, “but treatment is a process and takes work on part of the patient and his or her family.”
One of the primary tools Flancbaum uses in treatment is psychoeducation for families, which includes discovering the nature and course of a child’s tics, how certain treatments might benefit a child, the realistic expectations of treatment and when to consider going to a psychiatrist. According to Flancbaum, “TS patients and families generally appreciate LOTS of psychoeducation.”
The GSAPP graduate students also were keenly interested in Flancbaum’s discussion of HRT, the premise of which is that tics occur to alleviate discomfort associated with the urge to tic. With HRT, an alternative but significantly less intrusive tic is introduced to help the child eventually move away from wanting to present the original tic.
Following Flancbaum’s presentation, Lederman talked about her family’s personal experience raising their 11-year-old son, Ethan, who has TS. A complete personal account of Lederman’s presentation is available by visiting NJCTS’ TSParentsOnline blog at www.njcts.org/
More information about the GSAPP program, as well as Tourette Syndrome Awareness Week, is available by visiting www.njcts.org. Tourette Syndrome Awareness Week is April 23-29 and will culminate on April 29 with Tourette Syndrome Awareness Day with the Somerset Patriots Baseball Club at TD Bank Ballpark in Bridgewater.