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Tics Provide Clues to Learning Problems
Excerpt
By
Jenette Restivo ABCNEWS.com
Innocent tics like blinking and
eye rolling can hold clues to a child's learning disabilities,
say experts.
While most of us think of the typical Tourette's patient as the
rare eccentric who barks obscenities and jerks their arms wildly,
a recent study says much more subtle symptoms of Tourette's and
related tic disorders are far more common than once thought.
According to the study published in the journal Neurology
, mild tics such as lip puckering, eye rolling, head tossing,
and nose scrunching are important clues to diagnosing other learning
disabilities like attention deficit hyperactivity disorder, or
ADHD, and obsessive compulsive disorder, or OCD.
"[Kids with mild tics] are at a higher risk for developing future
school problems. This is a way of identifying children ahead of
time so they can be monitored — a clue to how the child's
brain is organized," says lead study author Dr. Roger Kurlan,
director of the Tourette's Syndrome Clinic and the Cognitive and
Behavioral Neurology Clinic at the University of Rochester in
New York.
Tip of the Iceberg
To determine the prevalence of tics and Tourette's Syndrome
in school-aged children, Kurlan looked at a group of 1,600 children
in both regular and special education classrooms in Rochester.
Kurlan found that just under 20 percent of children in regular
classes and up to 27 percent of children in special education
classes showed signs of tics. His study also revealed a three
percent incidence of Tourette's in the general population —
a rate three to 30 times greater than previous estimates.
"People, including parents and doctors, thought Tourette's meant
having severe symptoms, but these cases are just the tip of the
iceberg. The vast majority of cases have extremely mild cases,"
says Kurlan.
Dr. Leon Dure, a child neurologist and director of the Pediatric
Psychomotor Disorders Clinic at Children's Hospital in Alabama,
says his own clinical experience corresponds with the new statistics.
Dure says that when he started the pediatric disorders clinic
he guessed he would have very few patients. But now, he has over
700.
"A lot of children have transient tics during development, but
pediatricians usually tell parents not to worry about it, it will
go away, and it usually does."
Dure says the tic turns into a disorder if it lasts for longer
than 12 months. And for tics to indicate Tourette's Syndrome,
both vocal tics (eg, grunting, beeping, throat-clearing) and motor
tics (eg, shoulder popping, eye rolling, blinking) must co-exist
for longer than a year.
Tics Hold Clues
Experts caution that if a parent notices their child has a mild
tic, there is little need for immediate alarm unless a learning
disability is also suspected.
"You really don't need a treatment for tics, but they are a
sign you should pay attention to as they may point to other things,"
says Kurlan.
Learning disabilities such as ADHD or OCD afflict between 50
percent and 70 percent of children with Tourette's Syndrome, and
Kurlan says his study suggests that even mild tics alone, not
necessarily Tourette's, may represent an "identifiable sign of
an underlying brain developmental disorder that contributes to
academic difficulties," or a barrier to learning.
And experts stress the most important thing for parents of children
with tics to keep in mind is the impact on the child's life.
According to Dr. Glen Elliott, director of child and adolescent
psychiatry, at University of California San Francisco, "Many children,
especially boys, have transient tics, such as a cheek twitch or
eye spasm, but that hardly is a disorder. What's needed is a sense
of severity, a measure of to what extent the tics are producing
distress to the child or parent or some such."
Reference
Source 104
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