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• Difficulties with transitions of tasks (both preferred and non-preferred tasks) • Difficulties with turn-taking and game-playing with peers • Difficulty with emotional control in social situations such as a meltdown in public places or crying easily at school • Difficulty with conflict management and inflexibility to compromise • May appear to play too rough with their peers • May use inappropriate stories, words (not related to coprolalia) or jokes when engaging in conversations (Simpson, 2015. p. 1). Recess Activity Accommodations for Students with Tourette Syndrome Accommodations should be put in place for the student with Tourette Syndrome school-wide to establish consis tency and assist with social development. In terms of the recess setting, which is unique because of less structure, some accommodations may need to be slightly changed. Potential accommodations for increasing the social ben efits for students with the disorder in recess include the following: • Set up teams and groups, do not have students choose their partners or teams • Implement activities where students can not be elimi nated or become “out” • Make sure to use proximity control to avoid having the child leave the classroom and to stop any aggressive be havior • Establish behavior rules for the student during a dis cussion with the classroom, special education teacher, and student • Make it a point to use positive reinforcement with the child when appropriate • Establish activities in which the turn-taking is clearly set-up in terms of “who goes next” • Establish the activity order if need be • Point out inappropriate words and tell students not to use them with anyone The teacher in the scenario decides to implement some of these recess modifications. The students in her class of ten play a “bowling game” at recess, even when the recess is inside. But, there is often some waiting time. She asks the physical education teacher if she can borrow some more

cones which she adds to the game and makes a few lines more to reduce waiting time. There is now a clear pattern as to “who goes next”. Also, the teacher plays for a while and gives positive reinforcement. She also stresses that no students can be eliminated as she uses proximity control, staying close to the students, in case of poor behavior such as aggressive behavior by any student. Conclusion In conclusion, the reader hopefully notes how recess can provide significant emotional, physical, and social benefits for students with Tourette Syndrome. Teachers and other school staff should know the definition, symp toms, causes, prevalence, and recess accommodations for students with Tourette Syndrome. Teachers should monitor their student’s well-being during recess and fol low some of the items noted above throughout each day. The teacher should take steps to assist the child whenever needed in this setting and others. References Center for Disease Control. (2024). Tourette diagnois . https:// www.cdc.gov/tourette-syndrome/diagnosis/index.html. Gunturu, S., Saeidi, M., Alzein, O., Jafari, K., Salehi, M., & Jaka, S. (2025). Unpacking Tourette Syndrome in Chil dren: Insights into Prevalence and Comorbidities from NSCH Data. Journal of Clinical Medicine , 14 (5), 1485. https://doi.org/10.3390/jcm14051485 Jaffee, M. (2025). Study shows underdiagnosis of Tourette syndrome in girls. McKnight Brain Institute, University of Florida . https://mbi.ufl.edu/2025/01/15/study-shows-un derdiagnosis-of-tourette-syndrome-in-girls Mayo Foundation for Medical Education and Research. (2018). Tourette syndrome . Mayo Clinic. https://www. mayoclinic.org/diseases-conditions/tourette-syndrome/ symptoms-causes Simpson, H. (2015). Social concerns related to Tourette syndrome. University of Florida Health. February 15, 2025 https://movementdisorders.ufhealth.org/2015/05/04/so cial-concerns-related-to-tourette-syndrome/ Tourette Association of America (a) (2025). What is To urette? https://tourette.org/about-tourette/overview/ what-is-tourette/ Tourette Association of America. (2020). Behavior manage ment in schools for children with Tourette. https://tourette. org/resource/behavior-management-schools/

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