KANSAS CITY, Mo. - One in 100 people has some form of Tourette Syndrome or TS, a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics.

It is estimated 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibits milder and less complex symptoms, such as chronic motor or vocal tics.

TS usually sets in during childhood, affecting mostly boys of all ethnic groups.

At Children's Mercy Hospital in Kansas City, pediatric neurologist Dr. Keith Coffman is co-director of the Tourette Association of America Center for Excellence. He says although the cause of the disorder isn't known, a lot of advances have been made.

Coffman notes there's no magic pill for TS, so each patient is treated individually for their symptoms.

"Taking more of a 'whole person' approach first and thinking about everything that can affect the child has really improved the quality of care, and therefore the effectiveness of care," says Coffman.

Children's Mercy was designated as a Center of Excellence by the Tourette Association of America, one of only eight facilities in the U.S. to receive the designation.

Dr. Bob Batterson, on the hospital's Developmental and Behavioral Sciences staff, says in the past Tourette was thought to only cause people to make involuntary movements and sounds, but now they know it can lead to other, more debilitating conditions.

"Statistics have shown that 85 percent of people with Tourette have a mental health condition, and somewhere around half of those people have at least two," Batterson explains. "A large number of people with Tourette have an obsessive compulsive disorder and ADHD as well. But depression is also common, and we have to wonder if some of that is that psychological impact."

Dr. Coffman says at Children's Mercy, they offer treatment therapy that includes teaching a patient how to control their involuntary movements. He says many patients report a feeling like they're going to sneeze prior to an attack.

"If you, when you feel that feeling, make your body do a movement that makes the tic impossible, and hold that body posture until that feeling goes away, you can actually reduce and eliminate tic without needing medication," says Coffman.

Tourette Syndrome sets in usually between 3 and 9 years of age, and often is better by the late teens or early 20s. Coffman says it's as common as autism or epilepsy, but doesn't get as much attention.


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Youth advocates continue to sound the alarm over the impact flavored tobacco products have on teenagers, and hope Minnesota lawmakers take another close look at a proposed statewide ban.

Following attempts in previous legislative sessions, a bill has surfaced to prohibit the sale of all flavored tobacco products, including menthol cigarettes, flavored cigars, smokeless tobacco and e-cigarettes.

The coalition Minnesotans for a Smoke-Free Generation said the region faces a youth tobacco epidemic.

Bethlehem Yewhalawork, program manager for NorthPoint Health and Wellness Center, said enacting proposed restrictions can prevent things from getting worse.

"Passing a comprehensive flavor policy will really prevent youth addiction and improve health for all Minnesotans," Yewhalawork contended.

According to the coalition, one in seven 11th graders in Minnesota reports using e-cigarettes, and 88% of those students use flavored products.

Proposed bans often encounter pushback from the tobacco industry and retailers. A similar ban in the city of Edina recently survived a court challenge. Currently, 25% of Minnesotans are covered by a local flavored tobacco policy.

Preethika Naveen, a senior at Eagan High School, said while overall smoking rates have declined, use of flavored tobacco is prevalent among her peers.

"Many kids use menthol chew and vape e-cigarettes. Why? Because of the flavors," Naveen observed.

Advocates also argued the tobacco industry continues to use menthol products to target Black Americans, LGBTQ communities and youth. Groups such as the Children's Defense Fund have noted early exposure to nicotine can have lasting effects on a child's brain development.

Some Indiana elementary students are getting an extra dose of emotional support in the classroom from service dogs.

Trained by the Indiana Canine Assistant Network, the dogs offer a social link to kids who may intentionally isolate themselves.

Jill Schipp, principal at West Clay Elementary School in Carmel, said kids feel an immediate bond with her dog, "Palmer," and want to pet him or read him a story. She explained service dogs are helpful for children who have trouble with fear or uncertainty, or difficulty communicating.

"I've had kids that come down that are experiencing grief or anxiety, or changes in their life, maybe kids that have made a move to a new home, and they're just upset," Schipp observed. "They're carrying big worries. Being with him, and petting him and getting dog kisses, and getting their mind off of it really, really helps."

She pointed out teachers also request visits with the service dogs during trying times, like state scholastic testing. Schipp noted she has received inquiries from other districts about the benefits of having a service dog on school grounds.

Service dogs receive special instruction and certification to address distinct needs. The dog may sense a child with a physical disability is unsteady, and let the child lean on them. Schipp added her dog is keenly aware of nonverbal communication, which is common in children on the autism spectrum.

"If they are upset, I have learned to ask the child what they need," Schipp recounted. "Some kids will say, 'I need him to sit on me.' So, I have a little mat and the child sits down, puts their legs straight out in front of them, and he sits on their lap. And they just talk to him, and he just lays there until they're calm."

Schipp thought the dogs' presence would ease students' transition back to a classroom setting after the pandemic. She began the process with questionnaires to hundreds of parents, and the majority supported the plan. She emphasized care is taken with allergic reactions or fear of dogs.


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Republican-sponsored bills and amendments in the Legislature would eliminate the Tennessee Commission on Children and Youth. More than 1.5-million children live in Tennessee. TCCY said it is a critical component of keeping children's issues front and center.

Kylie Graves, policy specialist for the Tennessee Commission on Children and Youth, said it was never consulted about the legislation, and the text in the amendment would remove any mention of the agency from the state code. She added that dismantling the commission will cause Tennessee to lose the only entity that works to address the well-being of children.

"So very short turnaround there, kind of a mix of trying to wrap our heads around what the amendment does, what it would mean for us to be completely deleted from code, it would mean that we would no longer exist, and all of our programs would have to go elsewhere if they were to continue, " she said.

Graves added the commission is reaching out to legislators who will be voting on the bills, explaining the value the panel brings as an independent consolidated state agency. Two measures are in play in the legislature. House Bill 330 will be presented before the House Children and Family Affairs Subcommittee today and Senate Bill 282 will go before the Senate Health and Welfare Committee tomorrow.

Graves said the commission has partnered with the Annie E. Casey Foundation's Kids Count for more than 30 years and they set up the infrastructure and collect data for reports. She noted the foundation will not partner with another non-independent state agency to do this work because of trust and reliability.

"To us, that's just another clear example of how we were not consulted on this legislation or where programs will move because the Kids Count work, including the State of the Child, the county profiles, our data center, all of that cannot go to another state agency. And so nonprofits will have to pick up that work," she added.

Graves said the commission is the only state agency tasked with looking at issues across the childhood spectrum and making recommendations to improve those systems, and added the 21-person board is made up of members appointed by the governor and can serve up to nine years. At least one member is appointed from each of Tennessee's nine development districts.