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Tourette Syndrome

Accommodation and Compliance: Tourette Syndrome

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About Tourette Syndrome

Tourette Syndrome (TS) is a neurological disorder that is characterized by brief, sudden, repetitive, and unusual involuntary movements or unwanted sounds called tics. Symptoms can range from mild to severe to debilitating. 

The tics associated with TS are classified as either simple or complex. Simple tics involve a limited number of muscle groups. Some of the more common simple tics include eye blinking, nose twitching, mouth movements, and head / shoulder shrugging or jerking. More complex tics involving several muscle groups and may include facial grimacing combined with a head twist and a shoulder shrug, touching objects, hopping, jumping, bending, or twisting. Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds. More complex vocal tics include repeating words or phrases, sometimes obscene or swear words. More intense symptoms may considerably impede communication, daily functioning and quality of life. 

Symptoms of TS usually begin in childhood and can be seen as early as two years of age, but are more likely to occur between the ages of six to seven. Males are three to four times more likely than females to develop TS. In most cases, the severity, frequency, and disruptiveness of the symptoms diminish during adolescence and adulthood. In other cases, the symptoms actually disappear entirely, usually by early adulthood. Rarely will the symptoms worsen in adulthood. 

Many individuals with TSexperience additional related conditions such as attention deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), learning disabilities, sleep disorders, and anxiety and mood disorders. JAN's Accommodation Solutions: Executive Functioning Deficits is a publication detailing accommodations for individuals with limitations related to executive functioning. These ideas may be helpful in determining accommodations.

Tourette Syndrome and the Americans with Disabilities Act

The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

Accommodating Employees with Tourette Syndrome

People with Tourette Syndrome may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people who are aging will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

Questions to Consider:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  6. Do supervisory personnel and employees need training?

Accommodation Ideas:

Situations and Solutions:

The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.

Events Regarding Tourette Syndrome