The early course of tics and behavioral disturbances in 101 children with Tourette’s syndrome, aged 12 years (range, 8 to 21 years), are reported from the University of Rochester School of Medicine, Rochester, NY. The age at onset was 6.4 + or- 3.1 years. At initial evaluation, 45% already had ADHD and 50% had obsessive-compulsive disorder (OCD). During the observation period of 1.6 years (range, 0.5 to 7 years), tics became controlled with medication in 81%, 13% developed ADHD, 8% OCD, 28% disruptive behavior, and 25% school problems. Of those with behavioral disorders initially, about 50% were controlled over time with treatment. Tic suppressants were withdrawn from 12% of patients. 
COMMENT. If ADHD and OCD are absent at the onset of tics, it is unusual for these behaviors to develop later. Disruptive behavior and school problems are more likely to develop over time.