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Are Tourette’s Syndrome and Asperger’s Syndrome Related?

What is Asperger’s Syndrome?

Asperger’s Syndrome is a developmental disorder. The name Asperger’s Syndrome has been discontinued and the symptoms of Asperger’s Syndrome are now included in a condition called Autism Spectrum Disorder (ASD). Many people still use the term Asperger’s Syndrome when talking about the condition.  Young people with Asperger’s Syndrome or ASD have a difficult time relating to others socially and their behavior and thinking patterns can be rigid and repetitive.

Often, children and teens with Asperger’s Syndrome can speak more easily with adults rather than their peers. People with Asperger’s Syndrome may perform fairly well in school and sometimes have trouble understanding social situations and less direct methods of communication such as body language, humor and sarcasm.  They might also seem singularly focused on one topic or interest or a small range of activities.  These interests can become obsessive and can interfere with everyday life, rather than giving the child a healthy social or recreational outlet.

ASD is more than four times more common among boys than among girls. Most cases are diagnosed between the ages of five and nine, with some diagnosed as early as age three. https://www.nationwidechildrens.org/conditions/aspergers-syndrome

The Centers for Disease Control and Prevention (CDC) now estimates 1 in 44 children has been identified with ASD. Some people with ASD have a known difference, such as a genetic condition. Other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to alter the trajectory of development. https://www.cdc.gov/ncbddd/autism/facts.html

Are TS and ASD connected?

Tourette Syndrome (TS) and Autism Spectrum Disorder (ASD) present similarly in certain aspects such as in the movements which are associated with each condition, the prevalence among males versus females, and in relation to other co-occurring conditions. https://www.tourettes-action.org.uk/storage/downloads/1610981978_Tourette’s-&-Autism-article.pdf.  It is believed that the relationship between autism and tic disorders is likely related to both genetic and neurobiological factors. According to a study headed by UC San Francisco and published on June 22, 2017, in the Journal of the American Academy of Child and Adolescent Psychiatry it was found that approximately one in five children with TS also met the criteria for autism. However, this strong overlap may in part be due to difficulty in discriminating complex tics and ASD symptoms.

TS is believed to be a genetic, inherited neurological condition in which people experience both vocal (sound) and motor (movement) tics, which can affect their wellbeing and learning. https://njcts.org/research/ticgenetics/ . ASD is a pervasive developmental disorder with a range of deficits in social communication and social interaction.

People with ASD often soothe or comfort themselves by stimming. Stimming appears when the individual is stressed, nervous, or overstimulated in an environment. Tics associated with TS are different because they are commonly involuntary and harder to suppress. They involve an involuntary movement of body parts, such as flapping hands, repeating words, rocking, or blinking. https://carmenbpingree.com/blog/tics-and-autism-whats-the-connection/

One of the similarities that ASD and TS share is the evolution of the understanding and acceptance of both conditions. However, it could be argued that TS is still behind in this regard. ASD was once considered to be a rare condition, but prevalence estimates have risen. TS was also seen as rare, whereas now it is estimated that it affects 1 in 100 school children.

Another similarity is that both TS and ASD are conditions that begin during childhood and mostly affect males. The male to female ratio is approximately 3:1 in TS. Besides similarities in terms of prevalence and gender ratio, research has also found that there are a significant proportion of TS patients who also have ASD. The rate of TS in children and adolescents with ASD has been reported by some researchers to range between 6 and 8%. Others have found much higher rates up to 22% for comorbid tic disorders in ASD.

The symptoms of TS, namely tics, tend to wane as those afflicted enter adulthood. The symptoms of ASD do not tend to abate.

What about the relationship of TS with other disorders like OCD and ADHD?

The same study at UC San Francisco, looked at autism symptoms in patients with Tourette’s, including those whose diagnosis was coupled with obsessive-compulsive disorder (OCD) or attention deficit hyperactivity disorder (ADHD), conditions that frequently co-occur. Tourette’s, OCD and ADHD have been shown to share common symptoms and genetic relationships in a recent study by the same researchers.

“Assessing autism symptom patterns in a large Tourette’s sample may be helpful in determining whether some of this overlap is due to symptoms found in both disorders, rather than an overlapping etiology,” said first author Sabrina Darrow, PhD, assistant professor in the department of psychiatry and a member of the UCSF Weill Institute for Neurosciences.

“Our results suggest that although autism diagnoses were higher in individuals with Tourette’s, some of the increase may be due to autism-like symptoms, especially repetitive behaviors that are more strongly related to obsessive-compulsive disorder.”

For more information on research being conducted about genetic causes for TS and the relationship of TS to other disorders, go to https://njcts.org/research/ticgenetics/.

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