When my son recommended that I watch the recent Lewis Capaldi documentary on Netflix, it wasn’t only for the music; he knew I would be fascinated to hear the singer’s frank discussion of his struggle with Tourette’s syndrome.
During the coronavirus lockdowns, Capaldi began to experience exaggerated tic-like behaviours, which severely limited his confidence and capacity to perform. It was encouraging that the people around him, realising the extreme distress he was in, stopped him working to give him the time and space to recover.
About one in a hundred children are affected by Tourette’s. There’s still significant stigma associated with it, despite the fact that involuntary swearing (coprolalia) is quite rare. More common are motor tics (repetitive movements such as eye blinking or shoulder shrugging) and vocal tics (repetitive sounds or words, or throat clearing or grunting).
But Capaldi’s story reflects a new phenomenon: since the first Covid lockdown, not only has there been an overall rise in cases of Tourette’s, we have also seen an escalation of young people presenting with tics who have no previous history of them.
It’s not entirely clear why this is happening. According to Jon Stone, professor of neurology at Edinburgh University, new tics in a teenager are hardly ever caused by Tourette’s. New “functional tics” can also be symptoms of functional neurological disorder, a condition that causes limb weakness, tremors and seizures that are linked to psychological or emotional factors, such as stress, anxiety or depression.
Some have claimed that social media is responsible. Search for “tics” on TikTok and you’ll find hundreds of videos with millions of views, ranging from serious interviews with celebrities such as Billie Eilish (who has Tourette’s), medical education, self-diagnosing teens and claims of fakery.
Whatever the cause, it’s certainly the case that functional tics can present challenges for learning. They may cause young people to struggle with motor skills or sustaining attention. It can also negatively affect self-esteem and confidence.
So, what should schools do? Simply being aware of the issue is a good start. More education about Tourette’s syndrome and functional tics can help pupils feel understood and accepted, and can also reduce the stigma associated with tics.
Teachers should encourage peer support by promoting inclusive and accepting behaviour within the school community. It’s also important to keep an open and mutually supportive dialogue with families, who will be developing expertise around their child’s new functional tic-like behaviours.
Pupils need to see that they can succeed academically and socially, so reinforce strengths and accomplishments, and make accommodations where possible, with extra time on assignments and access to a quiet space to take breaks.
For those that have access to therapies in school, there is a legitimate case for cognitive behavioural therapy, with particular emphasis on understanding the before and after patterns of functional tic-like behaviours.
But, as Lewis Capaldi’s experience shows, simply having supportive people around you, who recognise when you’re struggling, can make all the difference. And by creating a positive and inclusive learning environment, we can raise the self-esteem and confidence of students who are experiencing sudden-onset tics.
Margaret Mulholland is the special educational needs and inclusion specialist at the Association of School and College Leaders
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