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SPECIAL- Tackling Tourette's: Syndrome a challenge for student, school

published August 23, 2007


Charlie, David, and Andy Juers visit with their rat pack
PHOTO BY WILL WALKER
A quick glance at David Juers reveals a handsome, tanned 9-year-old with sky blue eyes and a sweet smile. He answers a reporter's questions seriously and thoughtfully, mentioning favorite activities like soccer, Playstation, and playing with his pet rat. But despite his normal demeanor, some of his comments are heartbreaking. 

"They hate me," David says of his schoolmates at Woodbrook Elementary School. "They think I'm crazy." 

In fact, David is not crazy; he has Tourette Syndrome, a neurological disorder that causes uncontrollable tics, movements, and sounds. In addition to Tourette's, he has also been diagnosed with Obsessive Compulsive Disorder, Attention Deficit Hyperactivity Disorder, Rage Disorder, and Oppositional Defiant Disorder-- a laundry list of diagnoses that often accompany Tourette's and that have led to an even longer list of medications. Over the years David has taken Ritalin, Adderall, Strattera, and Concerta for ADHD, the antianxiety medication Paxil, and two anti-psychotic medications developed originally to treat adult psychoses, but which are now often used to treat aggression (Risperdal) and tics (Clonidine) in children. 

David currently takes the last two.

David's parents, Michael and Pamela Juers, say it took years for them to figure out what was happening with David, one of their three sons. (Andy is nearly 11, and David has a fraternal twin, Charlie. Neither has any disorder.)

Before he was two, David exhibited symptoms of a problem.

"David would want food out of the cabinet," says Pamela Juers. If she or Michael said no for any reason-- and she says that all the boys were fed well-- David's reaction was fury. 

"At two years old," she says, "he'd break doors off the cabinet to get food."

Despite those early warning signs, it wasn't until kindergarten that David's troubles really became apparent. 

"He would act out violently," Pamela Juers says. "This is when Tourette's was full blown, and we didn't know it. We thought he was a pain in the neck, and we treated him like that."

Early on, "He was trying to compensate for a lack of making friends by doing bizarre, freaky things to make kids laugh at him," she says.

In addition to seeking laughs, David behaved in ways that his mother admits were sometimes frightening. 

"In second grade, he didn't make really good choices," she says, citing one time when he went toward another child wielding scissors. 

"We still didn't know what was going on," she says.

After trying medication for ADHD (which Juers says she's not convinced David actually has), he was finally diagnosed with Tourette Syndrome, and the behaviors began to make sense to his parents. According to the Tourette Association, as many as one in 200 people may have Tourette Syndrome, though the National Institutes of Health say it's much rarer, with only 100,000 people in the country officially diagnosed with the disorder. 

Knowing what was afflicting him didn't make it any easier for David at school, however.

Because David's IQ is high, the Juers, who both work at the ACAC health club, say he has not qualified for special education services. They say they have asked for a "504," an education plan for people with disabilities that provides a child with certain educational accommodations. For children with Tourette Syndrome, such accommodations might include having a special place to go to express tics, or being allowed to take tests separated from classmates. Thus far, they say, the request has been denied because David's academic performance is too strong.

Woodbrook's principal, Dr. William Sterrett, citing confidentiality laws, declines to comment on David, but he stresses that the school has a mission to meet every child's needs. "Each student is unique," says Sterrett, "and we will work with staff and parents."

Pamela Juers says David's high intelligence coupled with his behavioral issues creates a nearly impossible situation at school: because of his medical conditions, he's unable to control his behavior at times, but he's frequently punished anyway. Last year, Juers says, David was suspended four times and was sent to the office many others. Among the offenses: standing near another student's desk and breathing loudly.

His parents admit that David poses a significant challenge for his teachers, but they believe he has been unfairly stigmatized. The year after his diagnosis, he was suspended more times than the year before, they claim. They also say they met resistance from the school when they asked to show a video about Tourette Syndrome to David's classmates. They hoped that increasing other students' awareness would stop some of the taunting and bullying they say David often faces. They also hope that by going public in this article, they can help other local families coping with the Syndrome, since there is no local chapter of the Tourette Association.

If things are hard at school, however, the Juers say things at home can be even tougher. While David has learned to control his temper at school, his rage often flares at home. On several occasions when David's temper has become uncontrollable for hours at a time and he has destroyed property and attacked his parents, they say, they have had to call the police for assistance.

"It's hard to believe two adults couldn't control a little 8-year-old, but it's true" says Pamela, who says on one occasion Michael's hand was broken when David slammed it in a door. Other times, David has become so agitated in public that some onlookers, believing the parents are abusing him, have called the police.

"It's hard," says Pamela. "We've gone through losing our minds." In the past, she admits, both parents frequently lost their tempers in frustration over their son's behavior. Things improved, she says, after beginning family therapy at UVA's family stress clinic.

"Now we understand this is something he has," says Pamela. "You can't tell David, 'Just get over yourself.' Something happens to him. His face turns gray; his eyes won't focus."

There is recent hope for the family. Earlier this summer, they increased his medication and started David on a gluten-free diet. With that regimen, all of David's tics vanished. They say the diet is particularly difficult and expensive, and they are phasing gluten back into his meals, believing that it's the medication that has helped, although his mother says she's bothered by the side effects she notices from the Risperdal and Clonidine: he sometimes seems "flat," and he sleeps a lot.

As a new school year begins, David and his parents are apprehensive about what's in store.

"I'm anxious for him," says his mother. She hopes David will have a teacher who is "really nurturing, really hand-holding, really someone who won't isolate him and make him sit in the front of a class-- someone who doesn't bring him in the office every time he screws up."

She describes her son as "friendly, kind, loving, and family-oriented." She wishes others could see past his disorder and give him a chance.

Does David think this year will be better?

"I think so," he says, nodding his head. "I hope so."

#

                     

It is very distressing that this family should have been given inaccurate information about eligibility for 504 Plans.

Anyone in this situation with a medical diagnosis from at least one qualified professional, should insist on a 504 or evaluation for an IEP.Do not take no for an answer. Parents should go to the Piedmont Regional Education Program (PREP) located in the Ivy Creek School behind Jouett Middle School on Lambs Lane, 975-9400 for help and information. Sometimes parents have to educate local administrators/teachers about how things work!!

A good online resource is WrightsLaw.

If you make no progress, the DC Office for Civil Rights has jurisdiction in Virginia. They are the office charged with enforcing the laws regarding 504 Plans and their contact info is: tel.: 202-208-2545; address: Office for Civil Rights, US Dept of Education,PO Box 14620, Washington DC 2004; [email protected]; OCR Hotline is 800-421-3481.

To the parents in this article: Good luck and insist on your child's rights even when you encounter resistance! And remember that you will encounter people in the local schools who are misinformed.

To local media: Special Education issues in ACPS need a lot more coverage like this story!

posted by Gail at 8/24/2007 5:27:43 PM

Dear Michael and Pamela Juers:

My heart goes out to you and your sons. I applaud you for your efforts to improve your situation through changes in diet. I’m living proof that it can be done.

I have ADHD, which I just found out about last summer, at the age of 41. I am smart, but have always had trouble in school and on the job. Up until my diagnosis, I thought I was just broken. So, it's been great learning about ADHD and how to more effectively live with it. At this time, I am not medicated, but I may choose to try it next year (2008).

The reason I'm writing to you is to mention the name of a book that quite literally saved my life. Dr. Nancy Appleton has written several good books, but it was "Lick the Sugar Habit" (Avery Publishing Group, Inc. 1996) that was such a great blessing to me. I am an avid reader, and I can say that this is the best informative book I have ever read, due to her personal experience, reader-friendly authoring, extensive research, and excellent documentation Dr. Appleton so beautifully combines. A broad foundation of hard science, not just the whimsy of opinion, illuminates the importance of daily dietary choices. The Index, footnotes, and Bibliography are top notch, making it easy for the reader to search for any of the actual studies upon which the book is based.

This is my 4th year of positive dietary changes. Thanks to Dr. Appleton and other great authors, my ADHD & other symptoms, including migraines, scary thoughts, panic attacks, anger outbursts, mood swings, depression, anxiety, PMS, cramps, procrastination, rebellion, guilt & worry have all abated and my memory has improved greatly, since I began changing my diet. When I began to reduce sugars (all forms of sugar), caffeine, gluten, milk (from a gallon a day to a gallon a month), preservatives, dyes, carcinogens (MSG), and toxins (artificial sweeteners and anything else I knew was not a vitamin or mineral and I couldn’t pronounce), I experienced withdrawals. Understand that for 2 years, I had been working lots of overtime in a factory (no time to cook), drinking 6 cans of Mountain Dew per day, living on fast food and vending machine sweets, and getting 2 – 4 hours of sleep per night. Oh, yeah, serious withdrawals! The first year was the worst, because I tried to overcome several food addictions at once, without any help.

This year (2007), supplementation of vitamins & minerals with Good Days supplements (Good Living Labs, Oak Harbor, OH 43449), and the program with which they came, the Attacking Anxiety & Depression program (Midwest Center for Stress & Anxiety, Oak Harbor, OH 43449, www.stresscenter.com) have both helped immensely. Now I'm amazed at how good I feel, how much easier it is to function well every day, and to sleep well every night. I believe I'm truly off the roller-coaster! And thank God for that, it had been a rough ride.

Now, I shop at Whole Foods or Wegman's, as I can no longer find the wholesome, unprocessed, organic foods I require at the local Giant or Safeway. Please keep in mind that health is a journey, rather than a destination, and that every minute of every day, we have a choice about what we consume (including nourishing food, uplifting movies, inspiring & educational tv programs, logic-improving games, loving advice, healthy friendships & life-long education). At my age, I refuse to settle for anything less than what is best for my overall health. I may still have 50 years to go, hopefully they will be years of good health. Although I wish I’d have known all this when I was 20, I can say that I now truly appreciate the positive changes I’ve seen for my efforts.

I hope this information will assist you in making all your lives more enjoyable and productive. The transition can be difficult, but very much worthwhile. I’m living proof that diet alone has profound implications for good health or disease, based on our choices.

God bless you all. Namaste.

P.S. For a preview of "Lick The Sugar Habit" visit http://books.google.com and search for the title. There were several other titles among the results which also attracted my interest. Bon voyage!

posted by Celia at 8/28/2007 9:39:53 PM
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