Tourette’s affects 1% of the UK’s population, which doesn’t sound like a lot, until you realise that means there are approximately 690,000 people living with Tourette’s. That number only includes people who have been specifically diagnosed with Tourette’s and does not consider those who are undiagnosed or have other disorders with a similar presentation, for example Tic Disorder, autism and attention deficit hyperactivity disorder (ADHD).

In this blog, we’ll be sharing some more information about Tourette’s, tics and how legal professionals can help support the equal participation of a client who has Tourette’s or tics in the courtroom and conference room.

Tourette’s Awareness Month

15th May – 15th June are Tourette’s Awareness Month. This year, Tourette’s Action have chosen the theme #ItsWhatMakesMeTic to destigmatise the condition and to familiarise people with a range of tic presentations. The Tourette’s Action TikTok is full of videos from the organisation’s five ambassadors, who have been sharing their experiences, tics and coping strategies in real time, making the channel a fantastic educational resource for anyone who wants to learn more about Tourette’s.

What is Tourette’s syndrome and how might it affect a client during legal proceedings?

Tourette’s syndrome is a neurological condition that causes you to make involuntary movements and sounds called tics. Tics are fast, repetitive muscle movements that cause sudden body jerks or sounds.

Tics can often be made worse when the individual is going through a period of stress and anxiety, which is highly likely when going through court proceedings.

Below are some common examples of motor and vocial tics:

A common misconception is that everyone with Tourette’s shouts out obscenities! Coprolalia is the medical term described as: “The involuntary outburst of obscene words or socially inappropriate and derogatory remarks”. This is actually rather rare and only affects 1 in every 10 people with Tourette syndrome.

Since the COVID 19 pandemic, there has been a significant increase in the number of people (predominantly teenage girls) displaying ‘Tourette’ type behaviour and so the number of people presenting with similar symptoms is at a record high. With Tourette’s becoming increasingly prevalent, it is important for professionals in the legal system to know how to communicate with someone who has Tourette’s, and equally, how to assist those affected to communicate effectively with others.

Tips to assist a client with Tourette’s in legal proceedings

Below are some top tips for assisting a client who presents with Tourette’s or Tourette type behaviour during a legal conference or in a court environment:

1. Have an open conversation with your client about their Tourette’s
   
   Don’t shy away from it or ignore it.  Ask your client if they feel comfortable giving you information about their diagnosis (be mindful that they might not!). This can be an opportunity to find out if certain situations make them ‘tic’ more or if they have any strategies which they find useful in calming their symptoms.
   
   
2. Ensure your client feels comfortable asking for breaks
   
   Tell your client, from the outset, that they can take a break whenever they feel they need one. Knowing they can remove themselves from the situation, in the event their tics become overwhelming, will likely be a comfort to a client with Tourette’s/tic disorder. People with tic disorders also tend to try and suppress their tics. This can be incredibly fatiguing so be mindful your client may require breaks more frequently.
   
   
3. Request a Ground Rules Hearing
   
   This will ensure everyone is aware of the individual’s diagnosis and measures to assist (if your client feels comfortable sharing this information). During the Ground Rules Hearing that everyone within the courtroom has been made aware of the diagnosis (and discuss how the condition will be explained to the jury during a criminal trial), so that people know what to expect and that any motor or vocal tics are not intentional. Suppressing tics can be incredibly fatiguing, so it can be helpful to ensure your client knows everyone is aware, so they don’t have to stifle them. Highlight the particular stress involved in giving evidence and whether your client might have more tics at this stage. This will also be an opportunity to outline strategies that may assist your client. For example:
   
   • Asking hearing participants not to respond to any vocal or motor tics.
     
     
   • Allowing emergency breaks (your client could be given permission to hold up a break card, for example). This could be used if your client is experiencing an overwhelming amount of tics and needs to immediately remove themselves from the courtroom. It could be your client is experiencing a tic attack. If this is something your client reports to be an aspect of their condition, it should be raised at the ground rules hearing and discussions should take place regarding what to do in the event of a tic attack taking place.
     
     
   • Scheduling regular breaks in order for your client to have time to recover physically from the fatigue involved in both ticking and suppressing tics. These breaks should be in addition to those usual breaks implemented for recapping and checking your client’s retention of information (if required).
     
     
4. Recommend remote participation
   
   Anxiety is strongly linked to an increase in a person’s tics and therefore remote participation may alleviate some (not all) of this anxiety, enabling the person to participate more effectively. Participating remotely may be particularly helpful during your client’s evidence, as this is commonly the most anxiety-inducing part of the court process. Ultimately, a conversation should be had, to establish the personal preference of your client and what they believe will help them minimize stress and anxiety.
   
   
5. Be patient
   
   Tics may interrupt a person’s speech but be patient, don’t finish their sentences or predict what they are going to say. Give your client time to express their thoughts.

To learn more about Tourette’s and tic disorders, visit the Tourette’s Action website and get involved with the #ItsWhatMakesMeTic campaign on Instagram, TikTok, Twitter, LinkedIn and other channels.