Packer, L. E. (2005). Tic-related school problems: Impact on functioning, accommodations, and interventions . Behavior Modification , 29 (6).

Journal Article

Packer, L. E. (2005). Tic-related school problems: Impact on functioning, accommodations, and interventions. Behavior Modification, 29(6).



Attention problem; Audio recording device/software (Response); Dictated response; Dictated response (scribe); Dictated response (speech recognition system); Emotional/Behavioral disability; Extended time; International (non-U.S.); Learning disabilities; Multiple accommodations; Multiple disabilities; No age; Oral delivery; Specialized setting; Speech/Language disability; Student survey; U.S. context; Word processing (for writing)




The most common accommodations reported were giving the student permission to leave the room, allowing extended time for classwork and tests, use of preferential seating, testing in a separate location, allowing the student to use a word processor, and reducing homework.


A total of 69 parents or guardians of children with tic disorders—including Tourette Syndrome—participated, from 27 states and Puerto Rico (U.S.), as well as Australia, Canada, the United Kingdom, and Peru. Respondents completed a caregiver survey, which applied to 71 children in all; 65 children had additional identified disabilities: attention-deficit hyperactivity disorder (ADHD; n=37), obsessive-compulsive disorder (OCD; n=34), environmental allergies (n=25), learning disabilities (LD; n=23), speech/language problems (n=15), mood disorders (n=13), other behavioral disorders (n=14), and other conditions (n=9).

Dependent Variable

Respondents were asked to complete a 15-page survey that included structured and open-ended questions about tic symptoms and history, tic impact on school experiences with respect to academics and peer relationships, and any perceived changes in academic functioning or peer relationships that occurred if tics had remitted.


One half of the respondents reported moderate to significant tic-related academic impact, and 48% reported moderate to significant tic-related peer problems. Peer education and in-school counseling were generally not offered nor provided. In the minority of cases where behavioral interventions for tics were reported, contingent aversive consequences were reported to be ineffective or counterproductive, while positive reinforcement for modifying tics reportedly produced some successful results. Limitations of the study were reported, and future research possibilities were suggested.