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

Published online by Cambridge University Press:  03 April 2013

Valsamma Eapen ,
Rudi Črnčec ,
Sarah McPherson  and
Corina Snedden
Valsamma Eapen*
Affiliation:
School of Psychiatry, University of New South Wales, Australia Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Australia
Rudi Črnčec
Affiliation:
School of Psychiatry, University of New South Wales, Australia Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Australia
Sarah McPherson
Affiliation:
Faculty of Medicine, University of New South Wales, Australia
Corina Snedden
Affiliation:
Faculty of Medicine, University of New South Wales, Australia
*
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
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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.

Keywords

Tourette syndrometicsspecial educationlearning disabilities

Information

Type
Articles
Information
Australasian Journal of Special Education , Volume 37 , Issue 2 , December 2013 , pp. 162 - 172
Copyright
Copyright © The Authors 2013 

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References

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, 509–511. doi:10.1001/archneur.1996.00550060051016CrossRefGoogle ScholarPubMed
American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
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#Google Scholar
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, 1151–1159. doi:10.1017/S003329179900896XCrossRefGoogle ScholarPubMed
Bloch, M.H., & Leckman, J.F. (2009). Clinical course of Tourette syndrome. Journal of Psychosomatic Research, 67, 497–501. doi:10.1016/j.jpsychores.2009.09.002CrossRefGoogle ScholarPubMed
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, 237–243. doi:10.1023/A:1005596502855CrossRefGoogle ScholarPubMed
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, 151–161. doi:10.1023/B:JADD.0000022606.97580.19CrossRefGoogle Scholar
Burd, L., Freeman, R.D., Klug, M.G., & Kerbeshian, J. (2005). Tourette syndrome and learning disabilities. BMC Pediatrics, 5, 34. doi:10.1186/1471-2431-5-34CrossRefGoogle ScholarPubMed
Burd, L., Kauffman, D.W., & Kerbeshian, J. (1992). Tourette syndrome and learning disabilities. Journal of Learning Disabilities, 25, 598–604. doi:10.1177/002221949202500909CrossRefGoogle ScholarPubMed
Canitano, R., & Vivanti, G. (2007). Tics and Tourette syndrome in autism spectrum disorders. Autism, 11, 19–28. doi:10.1177/1362361307070992CrossRefGoogle ScholarPubMed
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, 215–223. doi:10.1111/1469-7610.00602CrossRefGoogle ScholarPubMed
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, 556–561. doi:10.1097/00004583-200005000-00008CrossRefGoogle ScholarPubMed
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, 701–741.Google ScholarPubMed
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.Google Scholar
Eapen, V. (2011). Genetic basis of autism: Is there a way forward? Current Opinion in Psychiatry, 24, 226–236. doi:10.1097/YCO.0b013e328345927eCrossRefGoogle Scholar
Eapen, V., & Črnčec, R. (2009). Tourette syndrome in children and adolescents: Special considerations. Journal of Psychosomatic Research, 67, 525–532. doi:10.1016/j.jpsychores.2009.08.003CrossRefGoogle ScholarPubMed
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, 221–224. doi:10.4088/PCC.v07n0502Google ScholarPubMed
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, 378–382. doi:10.1007/s004150050105CrossRefGoogle Scholar
Eapen, V., & Sachdev, P. (2008). Managing tic disorders: An update on Tourette syndrome. Medicine Today, 9 (11), 14–21.Google Scholar
Ehlers, S., & Gillberg, C. (1993). The epidemiology of Asperger syndrome: A total population study. Journal of Child Psychology and Psychiatry, 34, 1327–1350. doi:10.1111/j.1469-7610.1993.tb02094.xCrossRefGoogle ScholarPubMed
Erenberg, G., Cruse, R.P., & Rothner, A.D. (1986). Tourette syndrome: An analysis of 200 pediatric and adolescent cases. Cleveland Clinic Quarterly, 53, 127–131.CrossRefGoogle ScholarPubMed
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, 436–447. doi:10.1111/j.1469-8749.2000.tb00346.xCrossRefGoogle Scholar
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, 272–279. doi:10.1097/00004703-200408000-00007CrossRefGoogle ScholarPubMed
Jankovic, J. (1997). Phenomenology and classification of tics. Neurologic Clinics, 15, 267–275. doi:10.1016/S0733-8619(05)70311-XCrossRefGoogle ScholarPubMed
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, 253–260. doi:10.1046/j.1468-1331.2001.00199.xCrossRefGoogle ScholarPubMed
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, 548–555. doi:10.1097/00004583-200005000-00007CrossRefGoogle ScholarPubMed
Khalifa, N., & von Knorring, A.-L. (2003). Prevalence of tic disorders and Tourette syndrome in a Swedish school population. Developmental Medicine & Child Neurology, 45, 315–319. doi:10.1111/j.1469-8749.2003.tb00402.xCrossRefGoogle Scholar
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, 414–420. doi:10.1212/WNL.59.3.414CrossRefGoogle ScholarPubMed
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, 1383–1388. doi:10.1212/WNL.57.8.1383CrossRefGoogle ScholarPubMed
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, 699–702. doi:10.1212/WNL.44.4.699CrossRefGoogle Scholar
Leckman, J.F., Bloch, M.H., Scahill, L., & King, R.A. (2006). Tourette syndrome: The self under siege. Journal of Child Neurology, 21, 642–649. doi:10.1177/08830738060210081001CrossRefGoogle ScholarPubMed
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. 23–42). New York, NY: Wiley.Google Scholar
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, 102–111. doi:10.1017/S1355617701711101CrossRefGoogle ScholarPubMed
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, 298–305. doi:10.1016/S1077-7229(04)80044-0CrossRefGoogle Scholar
Packer, L.E. (2005). Tic-related school problems: Impact on functioning, accommodations, and interventions. Behavior Modification, 29, 876–899. doi:10.1177/0145445505279383CrossRefGoogle ScholarPubMed
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.Google Scholar
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, 1929–1937. doi:10.1001/jama.2010.607CrossRefGoogle ScholarPubMed
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, 413–420. doi:10.1016/j.braindev.2006.12.003CrossRefGoogle ScholarPubMed
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, 349–358. doi:10.1016/j.jpsychores.2006.07.019CrossRefGoogle ScholarPubMed
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, 475–483. doi:10.1016/j.jpsychores.2009.07.010CrossRefGoogle ScholarPubMed
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, 240–248.Google ScholarPubMed
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, 1036–1042.CrossRefGoogle ScholarPubMed
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, 98–105. doi:10.1097/00004583-200301000-00016CrossRefGoogle ScholarPubMed
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, 947–968. doi:10.1097/chi.0b013e318068fbccCrossRefGoogle ScholarPubMed
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, 600–610. doi:10.1002/da.20711CrossRefGoogle ScholarPubMed
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, 489–498. doi:10.1111/j.1469-7610.2007.01875.xCrossRefGoogle ScholarPubMed