The article presents the results of the study of the influence of Tic Disorders (TD) on the formation of motor skills in children aged 4-6 years with autism spectrum disorders (ASD). The study involved 79 children. They were divided into two groups: the main group (38) - children with ASD and comorbid TD, and control group (41) - children with PTS without present comorbid disorders. The influence of comorbid TD on the development of motor skills in children with ASD has been demonstrated.
Childhood-onset neuropsychiatric disorders, commonly lumped together under the concept of
neurodevelopmental disorders (NDDs), affect at least 7–10% of all children [
Autism Spectrum Disorder (ASD) and Tic disorder (TD) were assigned to the ESSENCE group of disorders
along with ADHD and ODD
These disorders are sharing clinical and behavioral features as well as affecting children’s development
[
PDD – pervasive develop disorders; TD – tics disorders; RM – repetitive movements.
The aim of the study was to describe the effect of tics on delay in development of motor skills, speech, and cognitive functions.
This study demonstrates the preliminary results. On the moment were randomized 79 children 48-72-month-old (M=59,73 SD=7,63) with Autism Spectrum Disorder (ASD). Among these children, 38 had a diagnosis of comorbid Tic disorder (TD) and were characterized as having severe quality motor function impairments (fine motor skills and hand-eye coordination).
Development and Well-Being Assessment (DAWBA) was used in all children for the screening of ASD and possible comorbidities. All children with IQ less than 50 and presence of other comorbid disorders except Tic disorder were excluded from the study. The presence of ASD was confirmed according to the results of Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS) and ICD-10 criteria, while the presence of Tic disorder was confirmed according to Yale Global Tic Severity Scale (YGTSS) and ICD-10 criteria. The development of motor skills, speech, and cognitive function was assessed by Psycho-Educational Profile-Revised (PEP-R) and Vineland Adaptive Behavior Scales—Second Edition (Vineland II).
Statistical analysis was performed in SPSS. Descriptive statistics were performed for both groups. All data were checked for normality with Kolmogorov-Smirnov test. T-test for unpaired samples was used to compare groups with normal distribution and U Mann-Whitney for samples with not normal distribution.
In children with ASD and comorbid TD was noted retardation of formation of gross motor skills in
comparison with the control group by PEP-R. It was also noted delay in the formation of skills in
receptive speech and gross motor skills in accordance with the results of evaluation by using
Vineland-II. Results of the analysis are presented in
ASD (M (SD) or 95% CI) | ASD+TIC ((M (SD) or 95% CI) | P value | ||
---|---|---|---|---|
Age (months) | 58,83 (56,52; 61,13) | 60,71 (58,09; 63,33) | .295 | |
PEP-R | Imitation | 39,54 (36,86; 42,21) | 37,66 (34,16; 41,15) | .343 |
Fine motor skills | 42,73 (39,38; 46,08) | 37,87 (35,02; 40,72) | .031 | |
Gross motor skills | 47,85 (44,58; 51,13) | 46,50 (42,57; 50,43) | .496 | |
Hand-eye coordination | 50,46 (47,35; 53,58) | 42,63 (39,40; 45,87) | .001 | |
Communication of speech | 38,41 (35,60; 41,23) | 31,97 (29,23; 34,72) | .004 | |
Vineland II | Receptive | 47,15 (42,80; 51,49) | 45,95 (42,01; 49,89) | .839 |
Expressive | 34,71 (32,58; 36,83) | 30,58 (28,65; 32,51) | .01 | |
Interpersonal relationship | 27,27 (24,59; 29,94) | 24,39 (22,19; 26,60) | .22 | |
Play and leisure | 31,90 (29,76; 34,04) | 26,74 (24,45; 29,02) | .001 | |
Coping skills | 44,24 (41,27; 47,22) | 37,21 (33,60; 40,82) | .003 | |
Gross motor skills | 36,78 (33,72; 39,84) | 36,87 (33,62; 40,12) | .847 | |
Fine motor skills | 34,66 (31,61; 37,71) | 32,34 (29,83; 34,85) | .296 |
This study doesn’t describe the relationship between TD and ASD impairments, but the impact of tics on development delay on motor functions, speech, and socialization.
The results of the study are preliminary and further results will be corrected with the growth of the sample.
Most of ASD children are diagnosed as having tics at age of 5-6 years, while many of children without ASD are described as having transitory tics after the age of 2 years. It is important to note that many of children with ASD and TD at the age of 2-3 years were described as having different severe repetitive patterns of behavior.
We had not found any difference between two groups in Fine motor skills on Vineland, while on PEP-R two groups were significantly different. One of the possible explanations is that Vineland-II measures only those fine motor skills that are important for socialization.
Children with ASD and comorbid TD are often at the age of 2-3 years (Peak time of ASD symptoms recognition) are described as having various repetitive disorders (stereotyped movements and echolalia) instead of the motor or vocal tics.
The author declares that no competing interests exist.