Intelligence can disguise disabilities and disabilities can disguise intelligence

The majority of people with Tourette Syndrome fall into the average to above average range of intelligence. A child with TS may appear bright and highly articulate. Most are early readers and develop impressive verbal skills and a substantial vocabulary. Herein lies a potential paradox. They may have non-verbal learning difficulties. Their reading (and writing) speed may be slow and assignments may take them considerably longer to do than other children/students and their performance in written assessments may poorly reflect their actual academic abilities. 


Concentration, attention span and listening ability can be impaired significantly and mean children with TS may have difficulties in following the content of lessons but may compensate in other ways as a consequence of high intelligence. Evidence suggests that children with Tourette's are often highly verbal. This is a possible unintentional compensating strategy for difficulties experienced in other communication modalities that are impaired by tics, hyperactivity, sensory processing difficulties, obsessive behaviours and thoughts and attention deficit. Conversely it often happens that individuals with overt tic behaviours (and complex ritualistic behaviours) are perceived, mistakenly, as being impaired intellectually and cognitively.


Many of the difficulties that educators have in evaluating individuals with TS and in determining appropriate educational provisions, accommodations and adjustments, arise from a misunderstanding of the disorder. It is essential that the often more profound, 'hidden' but central aspects of TS are understood. TS in most cases involves much more than the tics that are seen and heard (many tics are also not observable). In fact 'tics-only' TS is apparent in only 8 - 12% of recorded cases. In children, diagnosis tends to be more dependent on observable signs that are reported by parents or seen by a physician. Children are less able to articulate their symptoms (e.g. what they experience) as they do not know how to do so or have little basis for interpreting aspects of the disorder, with which they live daily, as anything unusual. TS is a complex disorder of 'central' neurological dysregulation/dysinhibition and overactivity, affecting cognitive, motor and somatosensory pathways and appears to involve a number of distinct areas of the brain including cortical, sub-cortical and cerebellar regions.


An excellent quotation that embraces the misconceptions that are commonly made about Tourette Syndrome is:

"Intelligence can disguise disabilities and disabilities can disguise intelligence" 


The original author of this quote is unknown but it was used recently at a conference, with good effect and insight, by specialist educator Kathy Giordano in relation to special educational provision for students with TS.