Removing the road blocks for students with coprolalia

The following blog was written by Tourette Syndrome Foundation of Canada in-service presenter/trainer Laura Locke.

What are some ways school staff can help remove the road blocks to learning for a student with coprolalia?

One of our in-service providers was recently asked to talk to a school staff dealing with this challenging though rare aspect of Tourette Syndrome.  I was contacted to see if I had any suggestions for him as he planned his presentation. From my experience as an educator and my reading on the subject, and also from talking to a few friends whom I have met at our National Conference who live with coprolalia, I suggested a few strategies that I hope will be helpful.

Coprolalia is a vocal tic that often has a sudden, explosive quality, and is usually out of context. It is vital to make sure that most if not all of the school community knows about the situation (with the student’s permission). Besides teaching staff, students and parents, this also includes caretakers, bus drivers, lunchroom volunteers, etc. who might have contact with this student. It is, of course, extremely embarrassing for the person with coprolalia. Hopefully staff and students will try their best to ignore the outbursts, armed with the knowledge that the person with coprolalia cannot help it.

Collaborative “detective work” is very helpful.

By this, I mean the student with coprolalia and his or her teachers and parents talking together and pinpointing triggers and causes of anxiety, and then trying to short-circuit or eliminate them. Allowing the student to go to a safe place (e.g. the office or resource room) or simply go for a walk when anxiety is mounting are good options that should be discussed.

Certain times and places can be potentially very challenging (e.g. the library, assemblies, recess, lunch time, on the bus home when the student is tired, loosely structured classes like music or physical education, etc.) This is when positive, supportive and honest communication between the student with coprolalia, staff and parents is so helpful. When people can get together and examine the “trouble spots” in a student’s day—and then come up with possible solutions—amazing things can happen.

A key strategy is not to make “too big a deal” out of coprolalia outbursts—and to even try to have a sense of humour about it. The teacher’s attitude will set the tone as to how others behave towards this student. Making sure the student knows that they are valued for who they are, and taking steps to ensure that they are not being judged or excluded at school because of their coprolalia, is very important.

This experience can be a valuable lesson in compassion and empathy-in-action for an entire school community. Parents, staff and students should have opportunity to have their questions and concerns addressed, and be encouraged to brainstorm about ways that they can help the student.

Assigning one special staff member (e.g. a librarian, resource teacher, secretary, aide, physical education teacher, vice-principal, etc.) who can become the student’s special friend and mentor is also a good idea. A caring adult can make a huge difference in someone’s life who is dealing with coprolalia. Part of this relationship can be to help the student develop skills and confidence to explain his or her symptoms.

Behavioral therapy with the support of a professional has been effective for many people with coprolalia. It can be helpful in learning to deal with anxiety and related symptoms, and can also train them to use strategies such as substituting a modified version or a similar word instead of the inappropriate or obscene word, to change their voice to a whisper, or to cover their mouth to muffle the words. Medication can also help, and of course, sometimes coprolalia lessens or goes away on its own with time.

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