**4.8 Educating the patient, family and school**

Education of parents, teachers and peers is a critical initial intervention. Patients and their parents should be informed that it is appropriate explain to others that they have tics, that they cannot control certain movements or sounds, provide patients and parents with current information about the causes of tics such as genetic factors, brain neurochemical imbalances, emphasize that they are not signs of psychological or emotional illness, a common misperception, explain how tics change in type over time and that they naturally fluctuate in severity.

A majority of GTS patients experience improvement of tics in late adolescence or early adulthood. So the prognosis of TS could be quite good.

Education is often needed for school personnel because there are many misperceptions of tics as being voluntary, attention-seeking or purposely disruptive behaviors. It is recommended that special accommodations be considered in the school setting, like excusing the child, at his or her request, to the nurse's office to release tics or providing additional time in a separate room when taking school tests. Such provisions should be mandated in the countries under laws protecting individuals with disabilities.
