Tourette's syndrome - Problems associated with Tourette's syndrome

Tourette's syndrome is often associated with psychological and behavioural problems, as well as learning difficulties.

However, Tourette's syndrome does not usually affect a person's intelligence.

Obsessive compulsive disorder

Up to 60% of children with Tourette’s syndrome also develop obsessive compulsive disorder (OCD).

OCD is a long-term mental health condition where a person has obsessive thoughts and compulsive behaviours.

In children with Tourette’s syndrome, the symptoms of OCD usually take the following forms:

constantly checking things – for example, checking windows are locked or the door is not left open
a desire for order and symmetry – for example, their toys have to be lined up on the shelf in a specific way (if the order is disrupted, the child may become very upset)
hoarding – holding on to objects that have no real value, such as bus tickets or flyers for takeaways
cleaning – constantly cleaning due to an obsessive fear of disease and contamination (this often takes the form of compulsive hand-cleaning)

A physical tic and compulsive behaviour may be combined. For example, the child might constantly pick up an object and then place it down, or repeatedly open and close a door.

OCD is treated using a combination of medication, such as selective serotonin reuptake inhibitors (SSRIs) and psychological therapy, such as behavioural therapy.

With treatment, most people's symptoms will improve and some people will achieve a complete cure.

Attention deficit hyperactivity disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) is another condition that often affects children with Tourette’s syndrome. It is thought to affect up to 70% of children with the syndrome.

ADHD is a behavioural condition causing problems with attention span, ability to control impulses, and ability to concentrate and plan ahead.

Children with Tourette’s syndrome and ADHD usually find it very difficult to focus on specific tasks for a prolonged period of time and are often easily distracted.

Behavioural problems

Other behavioural problems that can affect children with Tourette's syndrome include:

irritability
anxiety
antisocial behaviour
flying into sudden rages
self-harming behaviour (less commonly)
inappropriate behaviour to others

As a child gets older, this inappropriate behaviour can often take the form of making inappropriate sexual remarks or acting in a sexually aggressive manner.

These types of problems often improve once a child begins treatment for Tourette’s syndrome and their tics start to be better controlled.

Learning difficulties

Tourette’s syndrome can be associated with learning difficulties, particularly if a person also has ADHD or OCD.

Many people with Tourette’s syndrome find it difficult to learn through habit (this is how a child usually learns to read, for example). This is because the basal ganglia is the part of the brain that controls habit learning, and it is also the part most associated with Tourette’s syndrome.

Therefore, children with Tourette’s syndrome may have difficulty mastering skills and activities that other children pick up as a matter of routine, such as reading, writing and simple maths (adding and subtracting).

Some children with Tourette’s syndrome may require additional specialised educational support. Your local education authority (LEA) can arrange an assessment of your child’s educational requirements before drawing up a plan to meet their needs.

Read more about special educational needs (SEN).