Tourette Syndrome and related Behavior Disorders in a Special Education Population

Grant Type
Grant Year
Institution Location
Institution Organization Name
University of Rochester
Investigators Name
Kurlan, Roger, MD

Tourette’s Syndrome (TS) can be considered to represent a clinical spectrum disorder, including both motor and behavioral features. Although the boundaries of the TS behavioral spectrum remain to be clearly delineated, it is clear that a variety of clinical features associated with TS may impair learning skills and contribute to academic failure for children with the disorder. For example, one study found that children with TS are 5 times more likely to require special educational services than the general childhood population. Since TS has traditionally been considered a rare condition, its possible contribution to the large population of learning disabled children has not received serious consideration. However, mounting evidence indicates that TS and related tic disorders are much more common than generally appreciated. A recent epidemiologic study involving a California school district found that a remarkable 28% of children attending special education classes had evidence of tics. Based on these considerations, we hypothesize that TS is a common, misdiagnosed, and often overlooked disorder that is an important contributor to school problems in the childhood population at-large. The presence of tics is suspected of being associated with academic failure and signifying an underlying dysfunction of neurological development. Thus, children requiring special educational services are expected to represent a high-risk population for identifying TS. This notion is important since many of the major clinical features of TS (i.e., tics, obsessive-compulsive disorder, attention deficit hyperactivity disorder) are treatable and prompt recognition of the diagnosis and institution of appropriate therapy could have a favorable impact on school performance. In order to address these hypotheses, we will carry out an epidemiologic study in a single representative school district in Monroe County (Rochester), New York whereby all children receiving special educational services (estimated to number about 200 pupils) and a control population of 100 students with a regular classroom placement will be directly interviewed and examined for the presence of tics and associated behavioral disorders. We consider this a pilot study to be carried out in preparation for a much larger scale epidemiological assessment of the entire Monroe County student population. The possibility that TS, a hereditary and potentially treatable disorder, is responsible for a substantial fraction of learning problems in the childhood population at-large might have profound educational, medical and socioeconomic implications. Roger Kurlan, M.D. University of Rochester School of Medicine, Rochester, NY Award $38,500 Tourette Association of America Inc. – Research Grant Award 1991