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Aspergers and Tourette's

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  • Aspergers and Tourette's

    I've had Tourette's since I was twoish(strange for a girl) didn't get diagnosed til I was 21. Can't get a license to drive because I tic alot when I sit and wait...driving is just waiting for me. I have the same problem on plane trips, during lectures, anywhere when I am waiting for something else to happen. I don't have OCD or add but I do have Aspergers to a degree. anyone else out there with the same combo?

  • #2
    Re: Aspergers and Tourette's

    I have heard of these two being linked. What are your symptoms from aspergers?
    Check out my tic ridden blog:


    • #3
      Re: Aspergers and Tourette's

      From the website:


      In 1994, Asperger's Disorder (AD) was recognized as a distinct clinical entity in the DSM-IV (the diagnostic reference that mental health professionals in the U.S. use; the DSM-IV also provides the diagnostic criteria for Asperger's Disorder). Since in the past, many children with Asperger's Disorder were diagnosed as having autism, one would expect to see certain features in common with autism, but also a pattern that distinguishes Asperger's Disorder (AD) from autism.

      Whereas the features of autism are generally severe and noticeable within the first years of life, children with Asperger's have a more typical development. In general, a child with Asperger's Disorder does not have the language delays seen in autism (although they may have some atypical speech), and the Asperger's child functions at a higher level than the typical child with autism. Many children with Asperger's Disorder have normal intelligence.

      While children with autism may have no interaction with peers, children with Asperger's do interact with peers, but may experience significant difficulty in social relationships. Children with AD often seem to be loners and their stereotypic behaviors or intense focus on their narrow interests may lead to isolation and/or peer rejection. An individual with AD may think and react to the literal meaning of others' communications, and may experience difficulty "reading" others' intentions or needs (this difficulty inferring others' mental states is known as "Theory of Mind"). But stating that individuals with AD have problems inferring others' mental or emotional states does not tell us the source of the problem. Is there just one deficit or a number of factors that contribute to this problem?

      One skill that appears to be impaired relates to face gaze, and a number of studies have noted abnormal patterns (see, for example, Trepagnier et al., 2002). Individuals with AD do not seem to derive the same information from facial features (such as eyes) as their non-AD peers, and generally do not spend as much time watching others' eyes during conversations. Interestingly, some recent research suggests that those who watch lips are more socially competent than those who don't. Perhaps the AD individual who is unable to "read" eyes learns to compensate by getting more information from watching the lips and mouth.

      But what about auditory tasks? Can children and adults with AD derive as much meaning from social communication cues such as tone, volume, and pitch as their non-AD peers? A pilot study by Rutherford et al. (2002) suggests that they are impaired in extracting such cues, and that this impairment may also contribute to difficulties drawing inferences about others' mental states (Theory of Mind).

      Swedish physician Christopher Gillberg categorizes the features of Asperger's into six main domains of impairment:

      -- Social impairment with extreme egocentricity, which may include:

      Inability to interact with peers
      Lack of desire to interact with peers
      Poor appreciation of social cues
      Socially and emotionally inappropriate responses
      -- Limited interests and preoccupations, including:

      More rote than meaning
      Relatively exclusive of other interests
      Repetitive adherence
      -- Repetitive routines or rituals, that may be:

      Imposed on self, or
      Imposed on others
      -- Speech and language peculiarities, such as:

      Superficially perfect expressive language
      Odd prosody, peculiar voice characteristics
      -- Impaired comprehension including misinterpretation of literal and implied meanings.

      -- Nonverbal communication problems, such as:

      Limited use of gesture
      Clumsy body language
      Limited or inappropriate facial expression
      Peculiar "stiff" gaze
      Difficulty adjusting physical proximity
      -- Motor clumsiness -- may not be present in all cases.

      As suggested by the above, individuals with AD are more likely to experience problems that are not confined to just one factor or deficit. In addition to impairment in deriving accurate inferences from facial cues and auditory cues, individuals with AD are also more likely to experience difficulty in taking chunks of information and integrating them into a coherent whole so that full meaning is derived (Jolliffe & Baron-Cohen, 2000). Thus, even on a content level, individuals with AD may not be able to derive the same information as a non-AD peer, leading to incorrect inferences about others' states and inappropriate responses.

      Another social impairment that has been suggested is that individuals with AD are too verbose (wordy), but the research on this issue has yielded somewhat contradictory results. A study by Adams et al. (2002) found that AD children were not more verbose in general than the control group of Conduct Disorder children. They also performed comparably in conversations that involved questioning and answering. Where they differed significantly, however, was that AD children experienced more difficulty in general conversations, and made more problematic comments in conversations about socially loaded or emotionally loaded topics.

      Motor clumsiness is also characteristic of AD, and can lead to peer impairment as the AD child may be less adept at sports and less likely to participate in group sports that are part of normal social development.

      In a survey of middle-class mothers of children with Asperger's Disorder or nonverbal learning disabilities (NVLD), Little (2002) reported an overall yearly prevalence rate of victimization by peers or siblings or peer shunning of 94%. A reported 10% of the children had been attacked by a gang in the past year and 15% were reported to have been victims of nonsexual assaults to the genitals. A third of the children had not been invited to a single birthday party in the past year, and many were eating alone at lunch or were picked last for teams. Peer shunning was significantly correlated with peer bullying and assault.

      Because the data were parental reports based on an Internet survey, it is possible that the reported rates are an overestimate of the true population values for children with Asperger's, but it is interesting to note that these rates are significantly higher than those reported by parents of children and adolescents with Tourette's Syndrome in another Internet-based survey. In the latter study (Packer, 2002, in press), peer teasing and some rejection were reported, but more children had been invited to birthday parties and there was only one report of a child being physically assaulted because of their tics. Thus, even allowing for design limitations, Little's data are consistent with clinical reports suggesting significant social impairment associated with Asperger's Disorder.

      In second report by Little (2002), based on the same sample of middle-class mothers, difficulties in parenting a child with Asperger's or NVLD were evident, as 58% of the mothers reported using used physical (corporal) punishment and 95% reported employing psychological aggression (such as verbal abuse) in dealing with their children's misbehavior.

      On a day-to-day level, then, children and adolescents with Asperger's may experience significant problems and their parents may need extensive support, which might include parent education and training in effective environmental supports and interventions for dealing with problematic behaviors. On a positive note, Sofronoff and Farbotko (2002) provide some data suggesting that parenting workshops may be of benefit to parents of children with Asperger's Disorder.

      While children with Asperger's will often have special education needs, many of them will do well academically and go on to attend college. Many will also be able to develop meaningful relationships with family and friends, although the quality of the relationships may be different than what most people experience. Many adults with AD will experience significant impairment socially, however. In a recent study of adults with AD, Soderstrom, Rastam, and Gillberg (2002) compared the self-reports of 31 adults with AD to age- and sex-matched controls. Those with AD scored significantly higher on harm avoidance and lower on self-directedness and cooperativeness. As a group, they also scored significantly higher on scores reflecting idiosyncratic perspectives. The most common temperament configurations were 'obsessional', 'passive-dependent' and'explosive'. Their findings, then, indicate that adults with AD are more likely to have anxious personalities, more likely to experience coping difficulties in social interaction, and less likely to be self-directeded.

      As one adult with AD commented to me sadly one time, "My wife shouldn't have to hold up a sign that says 'Hug me now' when she's upset, but even when she tells me that she's upset, I never seem to know what to say or do." Social skills training for adults with AD and counseling that involves spouses and family members may be of benefit to adults with AD, and over the past few years, more and more resources have appeared.


      • #4
        Re: Aspergers and Tourette's

        Thanks for the info Patti,
        my Aspergers symptoms are mainly residual now compared to when I was younger. On the surface I seem socially able though a bit odd. I have to work hard at it though. I remind myself to wait for my turn in conversations, and fake eye contact when I have to. I do look at facial expressions when I don't know someone very well but can generally gage someone else's mood from their voice tone. i am overly verbose and tend not to like being around crowds. Hate people touching me and squeaky noises etc. I also have problems with food textures, and some obssessiveness. (though not OCD like in nature)


        • #5
          Re: Aspergers and Tourette's

          My son was thought to have Asperger's but then at the Glenrose Hospital they said he didn't fall on the spectrum according to the ADOS test. Chase did get a diagnosis of Tourette's tho and he is newly on a medication Risperdal.