I had a wonderful student I worked with some years ago when I served as a consultant for an Asperger's Syndrome (AS) school. When he first arrived he started to disrupt the class frequently. I spoke with his mother and it turned out he had a duel diagnosis: Asperger's and Tourette's. I immediately thought what I often do when a student has an OCD or ADHD diagnosis along with Asperger's Syndrome (AS): The doctor is using the symptoms of AS that overlap with other conditions. A student with ADHD is easily distracted, but if they also have very poor social skills and a great deal of difficulty learning these skills they more likely have AS. Can a person have ADHD and AS at the same time? Doctors continue to debate this but if all of the symptoms of ADHD fall within AS and a student has the latter diagnosis I would say that the ADHD diagnosis is irrelevant.
This lovable student and I actually went back and forth for a time about whether he had Tourette's. I thought he was using it as an excuse to talk out all of the time. At one point I began to think I might have fallen into the classic trap: a failure to understand. I conducted some research and talked with the student. He was quite eloquent in explaining the difficulty he had controlling his need to speak and his need to do so about otherwise inappropriate topics.
I watched him exert such an effort, even tensing his lips until they looked at though they might explode and yet he could barely control himself. The other students could not help but respond to his comments and problems would erupt from there.
While I managed to convince some of the other school staff members to show him greater patience, the staff were used to helping children with Asperger's and did not accommodate the Tourette's element.
I helped him as much as I could during the time that I was there, and he made major progress. When I left that school to my next project I was heartbroken at having to leave this student behind. I understand that the staff did not treat him with the same degree of fairness and understanding after I left.
Incredibly, this student has awesome musical talent. Not only does he play the guitar but has a good ear for improvisation. He was also able to learn new songs by listening to them. I can't do that. When we put on a play at the school we organized a band with some instruments we had purchased through a grant. He was our lead guitar player and what a show he put on!!!
In the business of helping special needs children one should never presume that what a child does they do deliberately. In some cases they cannot control it.