Skip to main content Accessibility help
×
Home

Tic Disorders and Learning Disability: Clinical Characteristics, Cognitive Performance and Comorbidity

  • Valsamma Eapen (a1) (a2), Rudi Črnčec (a1) (a2), Sarah McPherson (a3) and Corina Snedden (a3)

Abstract

Tics are involuntary movements or sounds. Tourette syndrome is one of a family of tic disorders that affect around 1% of the population but which remains underrecognised in the community. In paediatric special education learning disability classes, the prevalence of individuals with tic disorders is around 20–45% — higher still in special education emotional/behavioural classes. Given the high rates of individuals with tic disorders in special education settings, as well as the unique challenges of working in an educational setting with a person with a tic disorder, it is incumbent upon professionals working in these settings to be cognisant of the possibility of tic disorders in this population. This review seeks to provide an overview of tic disorders and their association with learning and mental health difficulties. The review focuses on an exploration of factors underpinning the association between tic disorders and learning disabilities, including neurocognitive corollaries of tic disorders and the influence of common comorbidities, such as ADHD, as well as upon strategies to support individuals with tic disorders in the classroom.

Copyright

Corresponding author

Correspondence: Professor Valsamma Eapen, Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Liverpool Hospital, Mental Health Centre (Level 1: ICAMHS), Locked Bag 7103, Liverpool BC, NSW 1871, Australia. E-mail: v.eapen@unsw.edu.au

References

Hide All
Abwender, D.A., Como, P.G., Kurlan, R., Parry, K., Fett, K.A., Cui, L., . . . Deeley, C. (1996). School problems in Tourette's syndrome. Archives of Neurology, 53, 509511. doi:10.1001/archneur.1996.00550060051016
American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
American Psychiatric Association (APA). (2012). DSM-5 development: A 11 Tourette's disorder. Retrieved July 10, 2012, from http://www.dsm5.org/proposedrevision/pages/proposedrevision.aspx?rid=111#
Baron-Cohen, S., Scahill, V.L., Izaguirre, J., Hornsey, H., & Robertson, M.M. (1999). The prevalence of Gilles de la Tourette syndrome in children and adolescents with autism: A large scale study. Psychological Medicine, 29, 11511159. doi:10.1017/S003329179900896X
Bloch, M.H., & Leckman, J.F. (2009). Clinical course of Tourette syndrome. Journal of Psychosomatic Research, 67, 497501. doi:10.1016/j.jpsychores.2009.09.002
Bodfish, J.W., Symons, F.J., Parker, D.E., & Lewis, M.H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30, 237243. doi:10.1023/A:1005596502855
Bradley, E.A., Summers, J.A., Wood, H.L., & Bryson, S.E. (2004). Comparing rates of psychiatric and behavior disorders in adolescents and young adults with severe intellectual disability with and without autism. Journal of Autism and Developmental Disorders, 34, 151161. doi:10.1023/B:JADD.0000022606.97580.19
Burd, L., Freeman, R.D., Klug, M.G., & Kerbeshian, J. (2005). Tourette syndrome and learning disabilities. BMC Pediatrics, 5, 34. doi:10.1186/1471-2431-5-34
Burd, L., Kauffman, D.W., & Kerbeshian, J. (1992). Tourette syndrome and learning disabilities. Journal of Learning Disabilities, 25, 598604. doi:10.1177/002221949202500909
Canitano, R., & Vivanti, G. (2007). Tics and Tourette syndrome in autism spectrum disorders. Autism, 11, 1928. doi:10.1177/1362361307070992
Carter, A.S., O'Donnell, D.A., Schultz, R.T., Scahill, L., Leckman, J.F., & Pauls, D.L. (2000). Social and emotional adjustment in children affected with Gilles de la Tourette's syndrome: Associations with ADHD and family functioning. Journal of Child Psychology and Psychiatry and Allied Disciplines, 41, 215223. doi:10.1111/1469-7610.00602
Coffey, B.J., Biederman, J., Geller, D.A., Spencer, T.J., Kim, G.S., Bellordre, C.A., . . . Magovcevic, M. (2000). Distinguishing illness severity from tic severity in children and adolescents with Tourette's disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 556561. doi:10.1097/00004583-200005000-00008
Comings, D.E., & Comings, B.G. (1987). A controlled study of Tourette syndrome. I. Attention-deficit disorder, learning disorders, and school problems. American Journal of Human Genetics, 41, 701741.
Dornbush, M.P., & Pruitt, S.K. (1995). Teaching the tiger: A handbook for individuals involved in the education of students with attention deficit disorders, Tourette syndrome, or obsessive-compulsive disorder. Duarte, CA: Hope Press.
Eapen, V. (2011). Genetic basis of autism: Is there a way forward? Current Opinion in Psychiatry, 24, 226236. doi:10.1097/YCO.0b013e328345927e
Eapen, V., & Črnčec, R. (2009). Tourette syndrome in children and adolescents: Special considerations. Journal of Psychosomatic Research, 67, 525532. doi:10.1016/j.jpsychores.2009.08.003
Eapen, V., & Gururaj, A.K. (2005). Risperidone treatment in 12 children with developmental disorders and attention-deficit/hyperactivity disorder. The Primary Care Companion to The Journal of Clinical Psychiatry, 7, 221224. doi:10.4088/PCC.v07n0502
Eapen, V., Robertson, M.M., Zeitlin, H., & Kurlan, R. (1997). Gilles de la Tourette's syndrome in special education schools: A United Kingdom study. Journal of Neurology, 244, 378382. doi:10.1007/s004150050105
Eapen, V., & Sachdev, P. (2008). Managing tic disorders: An update on Tourette syndrome. Medicine Today, 9 (11), 1421.
Ehlers, S., & Gillberg, C. (1993). The epidemiology of Asperger syndrome: A total population study. Journal of Child Psychology and Psychiatry, 34, 13271350. doi:10.1111/j.1469-7610.1993.tb02094.x
Erenberg, G., Cruse, R.P., & Rothner, A.D. (1986). Tourette syndrome: An analysis of 200 pediatric and adolescent cases. Cleveland Clinic Quarterly, 53, 127131.
Freeman, R.D., Fast, D.K., Burd, L., Kerbeshian, J., Robertson, M.M., & Sandor, P. (2000). An international perspective on Tourette syndrome: Selected findings from 3500 individuals in 22 countries. Developmental Medicine & Child Neurology, 42, 436447. doi:10.1111/j.1469-8749.2000.tb00346.x
Hoekstra, P.J., Steenhuis, M.-P., Troost, P.W., Korf, J., Kallenberg, C.G.M., & Minderaa, R.B. (2004). Relative contribution of attention-deficit hyperactivity disorder, obsessive–compulsive disorder, and tic severity to social and behavioral problems in tic disorders. Journal of Developmental & Behavioral Pediatrics, 25, 272279. doi:10.1097/00004703-200408000-00007
Jankovic, J. (1997). Phenomenology and classification of tics. Neurologic Clinics, 15, 267275. doi:10.1016/S0733-8619(05)70311-X
Johannes, S., Wieringa, B.M., Nager, W., Müller-Vahl, K.R., Dengler, R., & Münte, T.F. (2001). Electrophysiological measures and dual-task performance in Tourette syndrome indicate deficient divided attention mechanisms. European Journal of Neurology, 8, 253260. doi:10.1046/j.1468-1331.2001.00199.x
Kadesjö, B., & Gillberg, C. (2000). Tourette's disorder: Epidemiology and comorbidity in primary school children. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 548555. doi:10.1097/00004583-200005000-00007
Khalifa, N., & von Knorring, A.-L. (2003). Prevalence of tic disorders and Tourette syndrome in a Swedish school population. Developmental Medicine & Child Neurology, 45, 315319. doi:10.1111/j.1469-8749.2003.tb00402.x
Kurlan, R., Como, P.G., Miller, B., Palumbo, D., Deeley, C., Andresen, E.M., . . . McDermott, M.P. (2002). The behavioral spectrum of tic disorders: A community-based study. Neurology, 59, 414420. doi:10.1212/WNL.59.3.414
Kurlan, R., McDermott, M.P., Deeley, C., Como, P.G., Brower, C., Eapen, S., . . . Miller, B. (2001). Prevalence of tics in schoolchildren and association with placement in special education. Neurology, 57, 13831388. doi:10.1212/WNL.57.8.1383
Kurlan, R., Whitmore, D., Irvine, C., McDermott, M.P., & Como, P.G. (1994). Tourette's syndrome in a special education population: A pilot study involving a single school district. Neurology, 44, 699702. doi:10.1212/WNL.44.4.699
Leckman, J.F., Bloch, M.H., Scahill, L., & King, R.A. (2006). Tourette syndrome: The self under siege. Journal of Child Neurology, 21, 642649. doi:10.1177/08830738060210081001
Leckman, J.F., King, R.A., & Cohen, D.J. (1999). Tics and tic disorders. In Leckman, J.F. & Cohen, D.J. (Eds.), Tourette's syndrome — Tics, obsessions, compulsions: Developmental psychopathology and clinical care (pp. 2342). New York, NY: Wiley.
Mahone, E.M., Koth, C.W., Cutting, L., Singer, H.S., & Denckla, M.B. (2001). Executive function in fluency and recall measures among children with Tourette syndrome or ADHD. Journal of the International Neuropsychological Society, 7, 102111. doi:10.1017/S1355617701711101
Marcks, B.A., Woods, D.W., Teng, E.J., & Twohig, M.P. (2004). What do those who know, know? Investigating providers’ knowledge about Tourette's syndrome and its treatment. Cognitive and Behavioral Practice, 11, 298305. doi:10.1016/S1077-7229(04)80044-0
Packer, L.E. (2005). Tic-related school problems: Impact on functioning, accommodations, and interventions. Behavior Modification, 29, 876899. doi:10.1177/0145445505279383
Packer, L.E., & Pruitt, S.K. (2010). Challenging kids, challenged teachers: Teaching students with Tourette's, bipolar disorder, executive dysfunction, OCD, ADHD, and more. Bethesda, MD: Woodbine House.
Piacentini, J., Woods, D.W., Scahill, L., Wilhelm, S., Peterson, A.L., Chang, S., . . . Walkup, J.T. (2010). Behavior therapy for children with Tourette disorder: A randomized controlled trial. The Journal of the American Medical Association, 303, 19291937. doi:10.1001/jama.2010.607
Rizzo, R., Curatolo, P., Gulisano, M., Virzì, M., Arpino, C., & Robertson, M.M. (2007). Disentangling the effects of Tourette syndrome and attention deficit hyperactivity disorder on cognitive and behavioral phenotypes. Brain & Development, 29, 413420. doi:10.1016/j.braindev.2006.12.003
Robertson, M.M. (2006). Mood disorders and Gilles de la Tourette's syndrome: An update on prevalence, etiology, comorbidity, clinical associations, and implications. Journal of Psychosomatic Research, 61, 349358. doi:10.1016/j.jpsychores.2006.07.019
Robertson, M.M., Eapen, V., & Cavanna, A.E. (2009). The international prevalence, epidemiology, and clinical phenomenology of Tourette syndrome: A cross-cultural perspective. Journal of Psychosomatic Research, 67, 475483. doi:10.1016/j.jpsychores.2009.07.010
Scahill, L., Sukhodolsky, D.G., Williams, S.K., & Leckman, J.F. (2005). Public health significance of tic disorders in children and adolescents. Advances in Neurology, 96, 240248.
Stephens, R.J., & Sandor, P. (1999). Aggressive behaviour in children with Tourette syndrome and comorbid attention-deficit hyperactivity disorder and obsessive–compulsive disorder. Canadian Journal of Psychiatry, 44, 10361042.
Sukhodolsky, D.G., Scahill, L., Zhang, H., Peterson, B.S., King, R.A., Lombroso, P.J., . . . Leckman, J.F. (2003). Disruptive behavior in children with Tourette's syndrome: Association with ADHD comorbidity, tic severity, and functional impairment. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 98105. doi:10.1097/00004583-200301000-00016
Swain, J.E., Scahill, L., Lombroso, P.J., King, R.A., & Leckman, J.F. (2007). Tourette syndrome and tic disorders: A decade of progress. Journal of the American Academy of Child & Adolescent Psychiatry, 46, 947968. doi:10.1097/chi.0b013e318068fbcc
Walkup, J.T., Ferrão, Y., Leckman, J.F., Stein, D.J., & Singer, H. (2010). Tic disorders: Some key issues for DSM-V. Depression and Anxiety, 27, 600610. doi:10.1002/da.20711
Watson, H.J., & Rees, C.S. (2008). Meta-analysis of randomized, controlled treatment trials for pediatric obsessive–compulsive disorder. Journal of Child Psychology and Psychiatry, 49, 489498. doi:10.1111/j.1469-7610.2007.01875.x

Keywords

Tic Disorders and Learning Disability: Clinical Characteristics, Cognitive Performance and Comorbidity

  • Valsamma Eapen (a1) (a2), Rudi Črnčec (a1) (a2), Sarah McPherson (a3) and Corina Snedden (a3)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed