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AD/HD and Coexisting Conditions: Tics and Tourette Syndrome
Contributed by: National Resource Center for ADHD (Posted on 2008-06-23)

AD/HD is a common neurobiological condition affecting 3-7 percent of elementary school age children.1 More recent studies, however, indicate that the incidence of AD/HD may be higher.2 However, in only about 30 percent of these children, is AD/HD the only diagnosis. Thus, two thirds of children with AD/HD have at least one other coexisting condition.3

Any disorder can coexist with AD/HD, but certain disorders seem to occur more commonly.4 These disorders include tics and Tourette Syndrome. It is important to diagnose and, if necessary, to treat these other conditions in addition to the AD/HD, because, just as untreated AD/HD can have lasting effects, so too, can these other disorders. Left undiagnosed, they may cause unnecessary suffering in individuals with AD/HD and their families.

HowAreTheseCoexisting ConditionsIdentified?

As part of the diagnostic process for AD/HD, the physician or mental health professional must then determine whether there are any other psychiatric or

neurological disorders affecting the individual. Often, the symptoms of AD/HD may overlap with other disorders. The challenge for the clinician is to discern whether a symptom belongs to AD/HD, to a different disorder, or to both disorders at the same time. For some individuals, the overlap of symptoms among the various disorders makes multiple diagnoses possible.

By conducting a complete evaluation, a physician or mental health professional familiar with AD/HD and these other disorders will be able to diagnose both the AD/HD and these related conditions. Interviews and questionnaires are often used to obtain information from the patient, the patient’s family and his or her teachers to screen for these other disorders.

In the case of tics, the intermittent nature of the condition may make it difficult to pinpoint in the early stages of the disorder, however, over time, a pattern of motor tics and other behaviors will emerge. During the assessment process, it is important to determine the intensity and frequency of the symptoms. In addition,

it is essential to ascertain the degree to which the tics and other behaviors impair functioning and affect self-esteem from the viewpoint of parents, peers, school personnel, and the child with the condition. Patterns associated with the tics (for example, are they brought on or made worse by stress or tiredness) may also be key in recommending appropriate modifications or strategies to deal with them. Significant impairments may be seen with both chronic tic disorder and Tourette Syndrome.