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Life's A Twitch! Celebrating 15 years.
1998 - 2018
Life's A Twitch! Celebrating 15 years.

 

Question 59: Your answer to the TS-Rett's [i.e. is there a connection between TS and Rett's Disorder] was possibly where I got a little intrigued. When you say it belongs with the Autism/ Asperger's cluster, I thought that those 2 disorders are related to TS because of some of the similarities. We saw a video on Autism....and I was spellbound at how many qualities related to Autism that I have, although nowhere near as strongly as most Autistics do. I realize the fact that the 2 syndrome names are close is just coincidental. G.B., ON, Canada.


My original (brief) response to you, G.B, was that Rett's has nothing to do with TS (Rett's is only diagnosed in females, involves loss of head circumference growth and motor coordination in hand skill and gait, and fits in the Asperger/Autism cluster in the 4th edition of the Diagnostic and Statistical Manual -- DSM-IV). While I'm by no stretch of the imagination an expert in Rett's Disorder, allow me to elaborate a little further now though........

You are of course right that there are many aspects of Austism/Aspergers that people with disinhibition disorders also experience (particularly the overstimulation stuff -- getting internally overloaded by sensory information, or overwhelmed by one's own amplified neurology, etc,). If backed into a corner I would likely say that Austism/Aspergers would probably have more in common with TS than Rett's would. I had the pleasure of sharing an office with a high-functioning autistic woman (also getting her Ph.D.) during my graduate training and we often remarked, as have you, about the many similarities autism and TS have. I also get many questions at my presentations concerning the relationship of these two disorders.

Pervasive Developmental Disorders (autism/aspergers/retts/childhood disintegrative disorder), while they share many of the features of disinhibition, go further than this though. These disorders can severely compromise ABILITY -- disinhibition is about leaky brakes alone. People with PDD's can experience leaky brakes, PLUS deficits in cognition, language abilities (expressive and receptive language difficulties in Rett's, for instance), and motor problems in the area of intentional movements (while those with TS have tics, they are intermittant -- our actual willed motor abilities aren't sacrificed the way they are in Rett's for example).

Some researchers suggest that the fundamental difference in PDD's and disinhibition-type disorders is that the latter is about intention editing alone (in other words having a good "goalie" to keep things from slipping past the posts when you don't want them to) while the former involve "theory of mind" problems in addition to these frontal lobe issues (a disruption in thinking, in essence).

All that being said, most people with PDD's seem to display disinhibition because they are further "up" the spectrum than TS, but most people with disinhibition problems DON'T have PDD's because they are "lower" on the spectrum (this is analogous to how most people with TS demonstrate features of ADHD even though most people with ADHD do not demonstrate features of TS). One study I read suggested that 6.5% of individuals with Autism warrant an actual diagnosis of TS. I wonder, based on conversations with my old office-mate though, if this underestimates the occasions that tics are part of PDD.

I hope this clarifies sir! Take good care G.B.,

Dr. Dunc.

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Last updated on March 25, 2022

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