Tics Provide Clues to Learning Problems

B O S T O N, Dec. 27 -- 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.