The psychosocial, psychoeducational, and neuropsychological data from 65 unmedicated, school-aged children with Tourette’s syndrome (some with TS only and others with TS & ADHD) and 27 comparison children were analysed at the Kennedy Krieger Institute and School of Medicine, Johns Hopkins University, Baltimore, MD. Leasrning disabilities were present in 23% of the total TS sample, but not in the TS-only group. The TS-only group had the highest mean FSIQ (117), exceeding the mean IQ of their parents. The TS+ADHD group had the lowest FSIQ All TS groups had a poor performance on measures of choice reaction time, suggesting a deficit in preparedness to act or respond. The TS-only group was significantly weak in executive function or letter word fluency, but had age-appropriate scores on a timed neuromotor examination, and was better than TS+ADHD groups on untimed measures of visual-spatial skill. [1]

COMMENT. The authors suggest that in this sample of TS children, school difficulties are not synonymous with learning disability. Academic achievement could be related to timed linguistic efficiency, and cognitive slowing (so-called “bradyphrenia”) may be out of proportion to cognitive impairment. A subtle “bradyphrenia” in patients with TS may account for some academic problems. Medications such as clonidine used to suppress tics may add to the cognitive slowing.