Autism and Imagination

Imagination is an important part of life. When reading about Autism Spectrum Disorders you might read about it as "cognitive flexibility" (ASPECT, 2002)

It is an important part of playing, learning and interacting with others. Imagination helps us understand abstract concepts, problem-solve and empathise with others.

Autism and Imagination

The National Autistic Society state:

"Social imagination allows us to understand and predict other people's behaviour, make sense of abstract ideas, and to imagine situations outside our immediate daily routine."

It is this form of imagination that children diagnosed with Autism Spectrum Disorders (ASD) find most difficult. The following are some of the key skills associated with social imagination.


Theory of mind

The technical definition of theory of mind goes something like this:

“Theory-of-Mind (ToM) is the social cognitive ability to attribute mental states to oneself and others and to use these attributions in understanding, predicting and explaining behavior of others and oneself.” (Blijd-Hoogewys, Geert, Serra & Minderaa, 2008)

In simple language, it is about the ability to empathise and evaluate how our behaviour is effecting others. As Blijd-Hoogewys et al suggest, it is a core skill in being able to interact in a socially acceptable way. Without it, children mostly act egocentrically. This means that they interact with others according to their needs and wants without identifying how their actions may effect others.

For children who are "neurotypical" (ie. don't have an ASD), the ability to empathise and evaluate how their behaviour will effect others starts to be evident in their interactions around the age of four. This is also the time when they start to develop friendship groups.

A child with ASD will be able to learn this skill, but will it not develop at the same rate or in the same way (Blijd-Hoogewys et al., 2008; Gartrell & Gartrell, 2008; Miller, 2006). This means that while they want friends, their difficulty in imagining how others are feeling, or imagining how their behaviour might effect others, means that they often do not develop friendships in the same way. Instead, they may become a little isolated as they struggle to behave in ways that are considered appropriate.


Interests

Because of their difficulty with social imagination, children with ASDs often have a narrow set of interests (ASPECT, 2010). They may find it difficult to communicate or learn about things outside this interest. They may also struggle to play games that don't fit with their interests.


Imaginative play

Many social skills are learnt through participation in imaginative play. For example, whilst playing "mummies and daddies" children are learning to communicate effectively, share and practice the different roles and activities relevant to everyday life. Children with ASDs may struggle with unstructured imaginative play because there are no set, repetitive rules for that type of play (The National Autisitic Society, 2010). It requires a lot of social imagination.

So the one type of play that could help children learn social imagination skills is often the type of play that children with ASD don't voluntarily get involved with.


Change and new experiences

Imagine this:

You have just woken up. You look around an there is nothing familiar in your environment. You aren't at home. You don't know the people you see. They are speaking a language you don't understand. They are acting in ways that don't fit with what you have come to expect from people. The weather is different to anything you have experienced before. There are noises you don't recognise. You don't know where you are.

How would you feel? Disoriented? Home-sick? Teary? Scared? Frustrated? Angry?

You feel these things because you can't predict what might happen next. You can't use any of the information you have gathered from your other life experiences to help you because everything is so foreign. You feel like things are spinning out of control. You end up with what we might call "culture shock", or an emotional and sensory overload - which can lead to anything from depression to significant anxiety.

And this is what it must be like for a child with Autism.

If you struggle to "imagine" and relate past experiences to new ones whenever a routine changes, or you go to a new place, you could experience a meltdown. Not because you are "being naughty," but because you are overwhelmed.


Danger

As the National Autistic Society (2010) mention, another skill that social imagination gives us is the ability to recognise the possible consequences for our actions. Not only in the context of how our behaviour effects others, but also how it might effect ourselves.

In short, we need social imagination in order to identify and manage risk.

As you will read in some of the parent stories that I will be sharing with you this month, one of the things that families often struggle with is getting their child with Autism to stay close. If a child does not realise that running away means getting lost, maybe getting hurt on a busy road or maybe being hurt by strangers - then they are less likely to stay close to mum or dad.

The child is not necessarily running away from mum. More likely they want something (like that favourite toy in the shop window), want to avoid something (like too much noise) or be struggling to wait while their parents get their jobs done.


This doesn't mean these skills can't be learnt

As a mummy blogger noted in her post about 10 common autism myths, just because a child has difficulty with a skill doesn't mean they can't learn it. It just takes more work. It is important that we focus on children's strengths and build on this.


Repetition and modelling

To help children with ASD get involved in imaginative play, we could use structure and repetition. For example, we can model a sequence of steps for the child to imitate to participate in pretend play. Like pretending to cook, or put a doll to bed, or drive a pretend car and so on.


Social stories

To help children predict what might happen as a consequence of certain behaviours, social stories can be used. I have discussed these in a previous post.

Just remember:
Don't judge, support and love
Use their skills and learn they will!

References

Aspect (2002). Thinking and Learning in Autism. www.aspect.org.au/publications/Thinking%20and%20Learning%20in%20Autism.pdf

Aspect (2010). What is Autism? www.autismspectrum.org.au/a2i1i1l237l113/what-is-autism.htm

Blijd-Hoogewys, E.M.A, Geert, van AEPLC, Serra, M., Minderaa, Æ R. B. (2008). Measuring Theory of Mind in Children: Psychometric Properties of the ToM Storybooks. Journal of Autism Developmental Disorders, 38, p1907–1930

Gartrell, D., and Gartrell, J.J. (2008). Guidance Matters: Understand Bullying. Young Children, 63(3), p54-57.

Miller, C.A. (2006). Developmental Relationships Between Language and Theory of Mind. American Journal of Speech – Language Pathology, 15(2), p142.

The National Autistic Society. (2010). Autism: What is it? www.nas.org.uk/autism

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Building empathy

One of the things I discuss with my trainee teachers is the importance of promoting empathy rather than sympathy when including a child with a disAbility. An issue that brings about the most debate in this context is, when a student with a disAbility first joins our class, whether we should talk to the class about that child's disability.

What children want

Chadsey and Gun (2005) interviewed a group of middle school children, asking them to explain the things that help them develop friendships with their peers who have a disability. Here are some of the key things they said:

1. Segregation is unfair
2. Teachers should come into classes to give us more information about students with disabilities
3. Don’t let students make fun of students with disabilities
4. Create programs where both students with and without disabilities can hang out with each other
5. Use volunteer peer partners (eg in buddy systems)
6. Group students with disabilities into our social networks
7. Have students with disabilities tell us about their disabilities
8. Clubs or after school activities should include kids with disabilities and should be of interest to everyone
9. Let students with disabilities take the same bus as us

Empathy

"the power of understanding and imaginatively entering into another
person's feelings" (Collins Concise Dictionary)

Understanding and relating to each other's experiences is an important part of developing relationships and respect. However, the way we help our students understand others' experiences will influence how they perceive that person.

Sympathy

synonyms: compassion, pity

A relationship built on pity or compassion is an "unbalanced" relationship, a relationship where there is not an equal balance of power or status.

For example, I want to share with you the story of a little girl with Down Syndrome - lets call her Sally. Before Sally came into the class the teacher talked about Sally's difficulties. She suggested that Sally would need help doing certain things.

The intention of the teacher was great - to promote understanding and a smooth transition. And when Sally came into class, it seemed like this is what had happened. However, on closer inspection the children were treating Sally differently. They were using baby-language to her, they were shepherding her around the school without really listening to her, they were mothering and smothering her.

What is the alternative?

Avoid talking about the child when they are not in the room. To those who ask, "Why?", think about how you might act if you have just had a "lesson" on fellow student and then the student walks into the room. First, you probably have developed an expectation of how that person will look and act based on your understanding of the teacher's words. Secondly, you will probably turn and stare - not being intentionally rude, but because you want to "see for yourself" this new person. For a child who needs a sense of belonging, to "blend" with the crowd, this can be very distressing. Even if the reactions are positive or compassionate, the child is starting off being seen as different.

If you want to share, share together. Rather than talking about one child, get everyone to talk about themselves. This way you are building a sense of similarities, and fellow-feeling, rather than setting one child up to be separate. Using "ice-breaker" or "get-to-know-you" activities at the beginning of the year (or any time during the year if there are indications that students may be at risk of bullying/being bullied) can be really effective.

Here are some ideas:

• Sit/stand in a circle. Have a bean bag/ball to be passed around. Have a theme eg. I am good at... but am not so good at .... The person who is holding the ball/bean bag has to complete the sentence, then call someone's name and pass the ball/bean bag on to them.
• Paint and/or collage a self-portrait using words, pictures, phrases, little biographical stories, photos and so on.
• Have each child write and share their "bio" - a short story about themselves.

This means that when you are sharing you are focusing less on the label, more on the person. You are also conveying a sense of similarity and belonging to all children, not focusing on what is making one child different to everyone else. Everyone is different - that is the value of diversity.

Talk about diversity, difference and individuality. Click here for a good article by the Children's Hospital.org on how to talk to children about recognising and valuing diversity. We have become very good at incorporating books that reflect diverse cultures, non-traditional gender roles and different families into early childhood, primary and secondary education. We should be increasing the range of books we use that portray people with disabilities. We should be incorporating units of work on disAbilities into our curriculum - from looking at sporting heroes, to musicians, to works of fiction aimed at promoting understanding about Aspergers, Autism, Down Syndrome, ADHD, Hearing impairments and so on. Empathy exercises can also be used - eg. we don't have to wait until we have a child with a vision impairment in our classroom before we get children to experience what it might be like by getting them to complete an obstacle course fully or partially blind-folded.

Decide what peers may need to know, and address the issue. Some children with disAbilities will be overwhelmed by emotions at times to the point that they may have a melt-down. We need to ensure that we have processes in place to ensure the safety of the child and their peers. If you are including a child who is at risk of having a melt-down in the classroom, you don't have to talk about the child, but you should talk about the behaviour. Have a discussion that is focused on helping children relate to the experience and problem-solving. For example, address:

• How would you feel if.... (lead children to talk about what makes them frustrated, angry, scared)
• What would you do if you couldn't say what you feel?
• What should we do if... (lead children to design a set of steps to follow if they are afraid someone is going to hurt themselves or others)

You could use a similar process if you need to build awareness of health issues such as epilepsy.

Let the child and parent control the information sharing process, or use rules. In some cases it will be important for the child to share specific things about themselves. For example, a classroom including a child with low vision will need to keep things in the same place and keep the floor clear of obstacles. In this case, you could have rules to this effect in your classroom. You could talk to the child prior to designing the rules to see if they want to share a little of why they need these measures in place. Some children may not want to share information with their whole class, but may want to have the opportunity to share it with a smaller supportive group of peers. For young children, it is the family (parents/caregivers) who should decide what, when and how information about the child is shared.

Be prepared. Especially with younger children, and if a child has a disability that makes them visibly different, you might get questions such as "What's wrong with Johnny?" Brushing off these questions, or treating them as inappropriate behaviour, can make children feel like there is something "bad", "wrong" or "secret" about the child with a disability. Instead, we should answer them as openly and honestly as possible. Teachers should discuss possible answers with the family and/or child before these questions come up. Families have often had much practice in answering these questions.

In the case of the question, "What's wrong with Johnny?" you might say, "There is nothing wrong with Johnny. It is just that his legs don't work the same way as yours so he has to use crutches to help him walk."

The aim should be:

Helping children relate to each others' experiences. We all have things in common, but we are also all unique.

Reference:

Chadsey, J., Gun Han, K. (2005). Friendship-Facilitation Strategies: What Do Students In Middle School Tell Us? Teaching Exceptional Children, 38(2), p52.

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How to have a peaceful Christmas... a last post for the year

On this day of only 5 sleeps to Christmas it is time to write my last post for the year. I thought I would make it a short and sweet list of things to do that may help you have a more peaceful Christmas if you are including a child who has special needs. Many of these were suggested to me by parents of children with conditions such as Autism.

Hints for having a peaceful, inclusive Christmas

• An orientation:
  

If the child is visiting your place for the first time, it is important to give them a slow and explicit tour of the building. Pictures on closed doors indicating what the rooms are and whether they can be used can help with boundary issues.

• A guest list:
  

To help children know who to expect at the gathering, you may send a guest list to parents before the day. You may even help the parent develop a photo guest list. Looking at this every day in the week before Christmas can help children be more comfortable when meeting people they may have not seen for a while.

• A Routine or schedule:
  

To help children deal with the anxiety of the day, having a picture or written schedule of events might be helpful. Again, if the child becomes familiar with this before the day it could be even more effective. Here is a sample social story and some ideas from other parents.

• A way of communicating:
  

Communication is such an important part of any social gathering. Not being able to communicate can produce difficult behaviour due to frustration or distress. Make sure you understand how the child communicates, and have some special tools available to help with communication. Here is a great example. It comes from this site, where you can find other free samples.

• A plan for anxious moments:
  

Because of the noise and busy-ness of the day, it is likely that a child with sensory sensitivities, social or behaviour difficulties may need a quiet space to calm down. Have a room set up with toys that help calm the child - they may bring a favourite sensory toy or object from home.

Tell the parent and the child, and anyone else who you think may need to know, where the room is and when it can be used. Make it clear that the space is out of bounds to anyone except those who need time out. Oh, and think of time out as a restorative process not a punishment. You could use these symbols to help the child know when it may be time to re-join the activities.

• Patience:

But, overall, your most valuable tool for creating peace at Christmas is patience. Children with special needs may struggle with many things on Christmas day. They may have melt-downs... or times when they become very upset and it is hard to calm them down. They may struggle with things like waiting, taking turns and may seem impolite at times. They may even hit or push their peers or adults at times because they are finding it hard to control their impulses or communicate what they need.

Understand that these are things that they may take longer to learn than their peers. See this behaviour as an opportunity for patience and learning. If you take the perspective that every behaviour has a reason behind it, then your response will be measured and supportive. It will focus on helping to stop the behaviour rather than punishing or criticising it.

Have a wonderful, peaceful Christmas... and a Happy New Year! I will return to blogging sometime in the middle of January. But for now, it is time for a rest.

:)

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Helping siblings and peers deal with aggressive behaviour

Please read the post on Roger’s Chain of Action first or this probably won’t make much sense….

Teaching siblings and peers about the reason for aggression

One of the things we need to do is help to promote some understanding of why one child may be more aggressive than another. This can be done in many different ways, but we need to make sure that we do it in a way that doesn’t label or stigmatise the child who is being aggressive.

For example, I just posted a u-tube video about my book, Dave is Brave. One of the things I highlight is that the book can be use to promote understanding of why children may be behaving a certain way.

In the book Golly is seen to be behaving like a “bully”, knocking children over, taking their toys and so on. As we follow the story we learn that one of the reasons he may have been doing this is that he wanted to play but was unable to articulate this. The questions to be used by teachers and parents at the back of the book highlight this and could be used to help promote empathy in children if they have a child with language and/or social/behavioural difficulties in the classroom.

General discussions about anger, fear, frustration, or playing games like charades where children are trying to get their intentions across without words can also be used to promote understanding of reasons behind aggressive behaviour.

But that is just the beginning. We also need to teach children ways they can protect themselves from aggression in their siblings or peers without increasing the chances of them being hurt. This is where Roger’s chain of reaction may come in useful.

Step one: Tactical ignoring

It is possible to teach children to ignore aggressive behaviour that is not threatening or aimed at themselves. For example, if a child with autism is having a melt-down because something is out of place or their routine is disrupted, their behaviour may be what we traditionally see as a tantrum rather than aggression aimed at other children.

In this case you could have a rule or agreement within your classroom or home that this behaviour will be ignored. You may need to discuss with peers and siblings that if someone is angry or frustrated, and they are banging things or screaming or even throwing things in a way is not threatening to them:
- That they should just keep working or playing.
- That their peer/sibling is not angry at them, just finding it difficult to cope.
- That mum/dad/carer/teacher will deal with the situation.

Step two: Simple direction, rule re-statement, or question and feedback.

If the aggression is a result of difficulties with social activities such as sharing toys and so on, you could teach siblings or peers to use prompting phrases like:
- “Use your words/picture cards/point”
- “Tell me what you want”
- “Do we need to get mum/dad/Ms X?”

These could be accompanied by a gesture such as the one used by Dave in Dave is Brave. And make sure you help the children recognise that they should speak calmly and confidently in these situations.

Step three: Repeat step two or take child aside and give them a clear choice.

If it doesn’t work the first time, teach siblings/peers to try at least three times before calling in the teacher – but only if the child is not significantly hurting them.

Step 4: Isolation, time-out, exit from the room.

As discussed in the previous post, you should have a crisis management plan for when behaviour is putting others at risk of being significantly hurt. At this point, peers/siblings could be taught one of two actions.

1. If they are not being closely supervised by an adult, to remove themselves from the vicinity of the child and seek adult help.
2. If they are being closely supervised by an adult, to calmly follow an agreed crisis procedure. This should be practiced just as a fire drill might be practiced.

Many schools have “lock down” procedures in place. For example, I heard of one school whose children promptly and calmly protected themselves with their chairs and filed out of the classroom in response to a teacher’s signal. Then they were re-located to a different room which was then locked so that the child (who was being supervised by a teachers aide) could not cause harm. The children then continued learning whilst procedures were put in place to help the child who was distressed and displaying aggressive behaviour – which may include calling in the police in extreme cases.


Reference for Roger’s chain of action:
Brady, L. & Scully, A. (2005). Engagement: Inclusive Classroom Management. Sydney: Pearson Education.

Safety in schools NSW DET document:
http://www.schools.nsw.edu.au/media/downloads/schoolsweb/adminsupport/safetysecurity/htbass.pdf

Crisis management flow-chart from the Spastic Centre
http://www.thespasticcentre.org.au/services/about_tsc/policies/s10-05.pdf

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Children with Aspergers and Empathy

Just thought I would pop up a link here about the current discussion and discoveries about children with Aspergers and empathy: http://www.thestar.com/printArticle/633688

It was forwarded to me by a friend and parent/advocate for children with Aspergers. Basically it is about the theory that children with Asperegers do not, as may have been thought previously, have an inability to empathise with others. Instead, it may be that they are so sensitive to the emotions of others that they may not be able to cope with the feeling and thus "shut down".

This could mean that the child withdraws, or avoids eye contact or physical contact, or uses other avoidance behaviour.

So this is an important thing to keep in mind when working with children who have Aspergers.

http://www.youtube.com/watch?v=IrNlqgfSq0U if you want to hear it from someone else.

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Avoiding a culture of bullying

Image from "Dave is Brave" www.learn2bebuddies.com.au Copyright Amanda Gray 2009

There are a number of things that we can do to prevent bullying. But in order to do this we need to understand what puts children at risk of bullying.

Difference or vulnerability can often increase the chance of a child being bullied. Whether they have a disability or not, a child who looks different, or doesn’t conform with the expectations or values of influential peers, or whose interests differ from those peers, is at risk of being bullied.

Carter and Spencer (2006) looked specifically at research about what increases the risk of a child with a disability being bullied. One study highlighted some key factors. It found that children with physical disabilities were more at risk of being bullied if:
- they received extra help at school
- they were alone on the playground
- they had less than two good friends

What does that tell us about preventing bullying?

One of the things it tells us is that it all begins with our attitudes. As adults – parents and teachers – we need to think about how we react to people who are somehow different. Do we respond fearfully? Do we exclude or avoid adults or children in the community whose appearance or behaviour is different to what we expect? Do we exclude people from our schools, classrooms, activities or homes based on difference? Or do we try to understand them and work with their strengths?

Because ultimately our attitudes will build the culture of our homes, schools and classrooms. If we respect and value the contributions of all people, if we look for their strengths and build relationships with them, it will flow into the culture that is created in our homes, communities and schools.

Influenctial rules to create a respectful home, school or community culture

There are many ways of influencing the culture of our homes and schools, but in this post I want to talk about rules. Rules or a code of conduct are required in schools (as mentioned in the first post this month). But there are certain things we need to do to make rules work.

Rules that work

If you say, “Don’t say nasty things!” you may yourself entabled in an argument about what is nasty. An argument that may end with the statement that "you can't tell me what to do!!!".

But let’s say you sat down with your children or students and discussed the issue. For example, you notice that there is a bit of teasing going on. Ask them if they have ever been teased, how that made them feel. Then get them to come up with some rules, or a set of rights and responsibilities. This will give them a sense of ownership of the rules, and will deflate their arguments against the rule because they came up with the rule themselves.

But avoid “Don’t” rules. As soon as a child (or an adult, for that matter) hears the word don’t, there is a great temptation to “do”.

For children who struggle with understanding abstract ideas, empathy, or have language or concentration difficulties, it is also important that your rules clarify exactly what is expected of them.
So instead of a rule that says, “Don’t be nasty” you could end up with rules such as:
- “Say kind things”
- “Treat others like you would want to be treated”

If you show children respect, they are more likely to respect others.

You should also remember that more rules you have, the less likely you will enforce them all. Keeping to a maximum of 5 rules is usually the best approach. Because rules are only useful if you consistently reinforce them. For example, you can remind children of the rule when they are breaking it to help them get back on track. Or you could praise those who are following the rule by saying something like, "That was a kind thing to say! Thank you!".

When you first introduce the rule, you should also have a system of rewards or consequences. The children should come up with these as well - though be careful because children can be harsh when coming up with consequences.

Make sure the consequences fit the action. For example, time out is not going to be an appropriate consequence for teasing or bullying on its own. Instead, the consequence should include apology and reparation of the relationship with the child who was bullied.

Do not tolerate bullying, but you should also make sure that the consequence deals with the underlying reasons behind the behaviour.

I might leave it there (it is getting late)…. Next time I will talk a bit more about how we can protect our children and students from bullying by expanding on the idea of a circle of care.

Reference

Carter, B.B, Spencer, V.G. (2006). The Fear Factor: Bullying and Students with Disabilities. International Journal of Special Education, 21(1), p11-24.

For more information about designing rules that work and a culture of respect, you might want to visit: http://www.afcec.org/tipsforteachers/tips_index.html

http://www.bullyingnoway.com.au/ideasbox/we-say/we-say-01.shtml

http://www.mindmatters.edu.au/resources_and_downloads/mindmatters/mindmatters_resource_kit_landing.html

Parenting

http://www.theparentszone.com/parenting/how-to-set-the-rules-of-parenting-discipline-to-make-your-child-respect-and-follow-them/

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Dear Teacher

A letter from a parent of a child with ADD, placed here with permission ....

Sometimes it is great to hear from parents so we as teachers can keep things in perspective. Thank you, parent, for sharing.

Dear Teacher,

By now you have had the chance to observe and interact with my son. You might find him to be goofy, high-strung, impulsive, reactive, or just plan irritating. But, no matter what your thoughts are about my beautiful boy, please remember what you have been hired to do. I put my child in your hands to guide him, teach him, inspire him, and help him grow. You cannot do this if you don't have an understanding of how he is made. On the days you feel like you can't take another minute of him, reach out to him. When he's interrupted you over and over again, be gentle. When he can't stay in his seat another moment, send him on an errand. When he's not really getting social cues from his peers and struggling relating to them, talk to all the children without singling him out. When he can't seem to focus, touch his shoulder gently without saying a word. When he says he hates school, don't take it personally, he just hates feeling so frustrated by the world around him that he can't turn off.

And lastly, please remember that this child is the apple of someone's eye. They bring us so much joy, even with the difficulties they have to endure every single day. You could be the one teacher that could change my child’s life forever, or you could be the one that could tear down his self-esteem for years. Watch your words. Our children never forget a negative comment. Remember why you want to teach, and realize you will see more and more children like mine. They want to do good. They want to succeed. They want to please everyone. You could be that one who could make a difference forever by reaching out to my child. I truly believe that the success you find in him will carry you on for many years.

Sincerely...an ADD parent.

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Ask Amanda - About Tourette syndrome awareness

What might a strategy be in order to educate a class where there is present a boy with Tourette syndrome? Ho might we address this situation with respect to the students as well as the class? The boy has blinking as well as some verbal ticks wich at times can be distracting to his learning ability as well as the rest of the class. ... Facebook Friend

When helping build awareness about a child's disability the most important rules to adhere to are:

1. Make sure the process is controlled by the parent and/or the child.
2. Promote empathy rather than sympathy

Make sure the process is controlled by the parent/child

Talk to the parent and the child. Get their ideas. What do they want to share?

If they do not want to talk about the child's disability specifically, then you need to address the issue in general terms. I will talk more about this below. This is often the most effective approach as it decreases the chances of the child being stereotyped by their "label" or disability.

Secondly, if the child does want to talk about their disability, it should be done in the context of all students talking about themselves. This sets up an environment of respect and empathy, rather than pity and isolating the student as "different" or with nothing in common with their peers.

For example, use "get-to-know-you" games. These could include sitting in a circle and throwing a ball. The person who catches a ball has to say something about themselves. It is best to have some guidelines about what they share, and also have some rules about responding respectfully. To find out more about rules go here.

And that brings me to another point - before you do anything, you need to set up a culture of respect by establishing these class rules. You also need to model the attitudes you want, such as including the child and praising the child, relating to them in the same way you would with any other student in your classroom.

Promote empathy rather than sympathy

If you want to discuss the issue with the class, make sure you do it in a way that helps them relate to the child rather than feel sorry for or fear them.

For example, don't talk about Tourettes syndrome. Talk about the things that the children see and hear (the blinking and verbal tics). But do this indirectly. An example of how you might do this is below. You will need to adapt this according to the age of the children and so on.

The way we act and what we say is effected by a lot of different things. But one of the most important things that effects how our body moves and what we say is the messages our brain sends to our body.

It is like each person is run by electricity and the brain is the power station. The "wires" that carry the electricity to "run" our body and our speech can be effected by different things. Tiredness, being sick and sometimes just the way our bodies are made. These things may mean it is hard to turn the power on or off. It may mean that one part of our body gets too much power, while another part doesn't get enough.

If we can't turn the power off when we want to we might call out when we don't mean to, or our body might move even when we don't want it to move.

Whether you personalise it or not will depend on whether the child/parent wants this. But just remember - if your students ask you "Is that what is wrong with ...", don't avoid the issue like it is taboo or a bad thing. Just calmly and briefly answer the question (or give the child with tourettes syndrome the opportunity to respond) without making a big deal of it.

This approach will help the children understand and relate to the child, rather than trying to teach them about a "label" or a syndrome - to which they won't be able to relate. Labelling can also increase the chances of bullying.

I hope that helps. If you want to know more about the syndrome and what you can do in the classroom to support students with tourettes, you might want to visit http://www.tourettesyndrome.net/education.htm

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