At this point, information from different mediums have already made it clear that Tourette Syndrome is a neurological disorder characterized by motor and vocal tics. As a review, it is very evident that the disorder displays a pattern of many different motor and phonic symptoms. But at this point, it is of utmost importance to understand that there is no diagnostic tests for TS. Effective diagnosis is based on HISTORY and OBSERVATION. For parents or guardians especially the individual himself, history and observation are two very important considerations. Tracking back the symptoms and observing its frequency and severity will make it easier for the doctor to diagnose the disorder. According to Dr. Scahill, you need to:
LISTEN
WATCH
LISTEN
Another important point is that "swearing is not required for diagnosis". The prevalence of TS is influenced by diagnostic threshold. Moreover, moderate to severe TS affects 1 to 6 per 1000 in school- age children. The onset of the disorder is again in childhood with motor tics coming in before the vocal symptoms specifically 5-7 years and 7-9 years respectively. By age 10, the urge to initiate the movement is already very evident, this is what we also call the premonitory sensations. Individuals with TS can suppress the tics, however, only up to a limited degree. It is also expected that tics tend to decline with age. If it doesn't, there needs to be a lifestyle check and again the importance of history and observation comes to the picture.
It is already proven that Tourette Syndrome can really debilitate the person. The impairment is dependent on the classification of the disorder meaning whether it be mild, moderate or severe. If mild, you can expect minimal interference. But if the disorder is classified as moderate or severe it may already be bothersome because of the urge, the suppressing tics and frustration. It may also interfere with daily activities which can also be a reason for their frustration. And it may already be noticeable which causes some teasing, bullying, and in most severe cases--social isolation.
TS IS NOT JUST TICS. Individuals diagnosed with the disorder may also exhibit impulsiveness, distractibility, hyperactivity, oppositional and defiant behavior, repetitive behaviors, low frustration tolerance and explosive outbursts, anxiety and depressed mood and learning problems.
In the clinical picture:
50%- 66% of children with TS have ADHD
50% have Obsessive- Compulsive symptoms
30% have Obsessive- Compulsive Disorder
It follows that if the individual is diagnosed with Tourette Syndrome plus any of the two co-morbidity (OCD or ADHD), the impairment is GREATER.
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The article above was written by the author based on the presentation made by Lawrence Scahill, MSN,Ph.D. in the TSA National Conference in USA, 2008 entitled "Tourette Syndrome Workshop: Parent Training"