AUTISM: TICS AND TOURETTE SYNDROME IN AUTISM SPECTRUM DISORDERS
Autism: Tics and Tourette syndrome in
Autism spectrum disorders
Tly Schildt
York College of Pennsylvania
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AUTISM: TICS AND TOURETTE SYNDROME IN AUTISM SPECTRUM DISORDERS
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Abstract
This paper will examine a study involving children and adolescents with Autism
Spectrum Disorder (ASD). The study was designed to see how many of them had
comorbid ASDs and tics. The study found a relation between the level of cognitive
functioning and the level of tic severity. The results showed the 44% of the
individuals displayed tic disorders (22%), Tourette disorders (11%), or chronic motor
tics (11%). The study concluded that there is a relation between the two and it
should not be overlooked. However, ASD and Tourette disorders (TD) have many
similarities that can cause a misdiagnosis. Both disorders present an insistence on
sameness, resistance to change, abnormal repetitive movements, speech
abnormalities such as echolalia, and palilalia and obsessive-compulsive symptoms.
Keywords: Autism Spectrum Disorder, Tourette disorders
AUTISM: TICS AND TOURETTE SYNDROME IN AUTISM SPECTRUM DISORDERS
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The Occurance of Tics and Tourette syndrome in Autism Spectrum disorders
The study in the article was aimed to see how often tourette and tic disorders
occurred within a group of patients with ASD’s. The results showed a higher rate of
tourette and tic disorders then the researchers had been expecting. This led them to
the conclusion that comorbid ASD and tics/TD should not be overlooked and should
be looked at more seriously. This is true because these disorders have many
similarities between them. If the symptoms are not looked at carefully, a
misdiagnosis can occur. Some of these similarities are the insistence on sameness,
resistance to change, abnormal repetitive movements, speech abnormalities such
as echolalia and palilalia, and obsessive-compulsive symptoms (Canitano, & Vivanti,
2007). In the United States alone, about 1 out of every 110 children being diagnosis
with ASD (Smith, 2009). With such high number of children being diagnosed, it is
important to keep a close eye on the disorder and any other disorders that may
accompany it.
The study was set up to minimize any chance of error in the testing. To
determine the participants for the study, clinicians observed them in different
settings. The different settings included free play and structured sessions, as well
as observing the patient’s in spontaneous daily activities. Researchers did a good
job not limiting their observations to one setting. This helped reduce any error in the
evaluations. However, the observations made during the patients stay at the ward
could have been affected by the fact that the ward is a new environment for the
patients (Schoenstadt, 2006). This could have caused certain symptoms to increase
and influence the results of evaluations.
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In the study, all patients were taking a pharmacological treatment at the time
of the evaluation. These treatments could have influenced the patient’s actions
when they were being observed. Certain medications can increase an individual’s
actions, such as tics, which could then cause an observer to make a mistake within
the diagnosis. Also, certain ASD medications have side effects that could be
misleading. For example, a medication can cause obsessive-compulsive behavior.
This can create a distraction for the observer and will only further complicate the
diagnosis (Medical Review Board, 2005). At the same time, the treatment could
mask such behaviors and cause a disorder to be missed (Canitano, & Vivanti,
2007). Observers must be aware of these variables in order to avoid mistakes.
The results of the study came back higher than the researchers had
expected. Out of one hundred and five patients with ASDs, twenty four of them had
been associated with tics, twelve with chronic motor tics, and twelve with TD. Also,
researchers found that the majority of twenty four individuals with tics had very low
functioning skills and the severity of the tics was consistent in all patients and had no
relation to the developmental function of the individual. This differed from the other
two groups, especially the TD group. In the TD group, the lower the developmental
function was, the more severe the TD. Also, this group scored lower on the Yale
Global Tic Severity Scale than the tics group did. However, with many similarities
between ASD’s and the other disorders, it is possible that a misdiagnosis did occur.
There are a variety of similarities between ASD’s and these disorders. One
similarity is the insistence of sameness and resistance to change that occurs in
ASD’s and TD. It is one of the distinct classic symptoms of TD and is very common
AUTISM: TICS AND TOURETTE SYNDROME IN AUTISM SPECTRUM DISORDERS
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in ASD’s (Schoenstadt, 2006). Another similarity is the speech disorders, echolalia
and palilalia. Palilalia is a speech tic that is characterized by a child's instant
repetition of words that he or she had used in conversation. Echolalia is a term that
is used to describe a child's nonfunctional repetition of certain phrases, such as
those heard on television programs or from a parent (Palilalia and echolalia 2009).
Along with the other similarities, these could be misleading and should be looked at
carefully if they come up during the diagnosis process or in studies.
In order to be sure the correct diagnosis is made, the similarities between
ASD’s and tics/TD should be looked at closely. A misdiagnosis will only add more
complication to the diagnosis and would not benefit the treatment of the individual.
The study in this article will help decipher the differences between the disorders and
how common it may be. However, it is only one study and many more will need to
be down to concrete the results. These steps are important in getting individuals the
right treatment and the right diagnosis.
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References
Canitano, R., & Vivanti, G. (2007). Tics and tourette syndrome in autism spectrum
disorders. Autism, 11(1), Retrieved from http://aut.sagepub.com.ezproxy.ycp
.edu:8000/cgi/content/abstract/ 11/1/19
Medical Review Board. (2005, February 27). Autism treatments. Retrieved from
http://pediatrics.about.com/od/autism/a/05_autism_rx.htm
Palilalia and echolalia: verbal symptoms of autism and asperger's syndrome. (2009,
August 12). Bright Hub, Retrieved from http://www.brighthub.com/education/
special/articles/45331.aspx
Schoenstadt, A. (2006, June 28). Autism spectrum disorder symptoms. Retrieved
from http://autism.emedtv.com/autism-spectrum-disorders/autism-spectrum
-disorder-symptoms.html
Smith, S. (2009, December 19). Nearly 1 percent of us children have autism, report
indicates. Retrieved from http://www.boston.com/news/nation/articles/2009/
12/19/nearly_1_percent_of_us_children_have_autism_report_indicates