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Question 25: My 4 year old son....currently has a diagnosis of impulsive-type ADHD, OCD issues, and multiple verbal tics. My question is whether through your research you have found any information on developmental language disorders associated with TS as he also has this diagnosis.... My favorite of my son's vocal tics is, "Good steak," which I think came from, "For goodness sake," but his language problems got in the way! J.M., Nevada, USA.


Hello J.M.:

Unfortunately there is not a lot of research to be found (in either medical or psychological archives) on the connections between TS and communication disorders (which, in the DSM-IV -- the most recent edition of the standard diagnostic manual used by doctors -- include stuttering, expressive language disorder, mixed receptive/expressive language disorder, phonological disorder, and communication disorder not otherwise specified).

There is relatively more to be found on the associations between learning disorders (LD's: written, reading, mathematics) -- and TS: 22% of TS'ers have one (most often a disorder of written expression or a mathematics disorder is diagnosed in this 22%).

There is, however, a link between expressive language disorders and ADHD which you mentioned your son has -- you may have more luck searching for literature discussing this connection. Even the link between TS and LD's is believed to exist through ADHD (a very high percentage of individuals with TS have ADHD). Language delay is associated with the frontal (specifically premotor) areas of the brain -- frontal areas seem to be more of a primary problem in ADHD than TS. While frontal areas are also implicated in TS these problems may be secondary: connections exist to the frontal lobes from various subcortical structures that are not working as they do in 'normies' in individuals with TS.

I would suggest reading a book by Dr. David Comings (information found at www.lifesatwitch.com/books.html) -- he discusses links between TS, ADHD, LD's, expressive speech disorders and stuttering. He also submitted a journal comment on the topic:

Coming, DE: Comings, BG (1994). TS, learning, and speech problems. Journal of the American Academy of Child & Adolescent Psychiatry, 33(3), 429-430.

I hope this helps J.M. Please email me with the province/state you are from for my records thanks!

cheers,
Dr. Dunc.

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Last updated on January 11, 2007

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