Language function in children with Tourette syndrome

In this study, the psycholinguistic abilities of children with Tourette Syndrome (TS) were investigated. Assessment of oral and written language included measures of syntactic comprehension, verbal fluency, oral and written story narration, word recognition and spelling, and writing to dictation and copy. Seventeen children, aged 10-16 years, composed the TS experimental group. The comparison group consisted of 12 children who were siblings of a child with TS. In comparison to the sibling group, children with TS demonstrated adequate syntactic comprehension, verbal fluency, story recall, and word recognition. Significant differences between the two groups were observed on written language measures, including the story generation task and word spelling. Children in the TS group used a story grammar model, but their written stories contained fewer clauses and fewer story components. Differences between the two groups were not statistically significant on handwriting measures; however, qualitative analysis of writing skills revealed the children in the TS group to have poorer handwriting, and to make more frequent errors in capitalization, punctuation, and spacing. The difficulty which the children with TS had on the written story task might be attributed to their poorer handwriting. Children in the TS group may have restricted their responses to the written task, thus reducing the potential content of their stories. In addition to mechanical writing skills, the picture story task requires the execution of a number of linguistic and cognitive abilities. The child is required to analyze the three picture story sequence and infer the intended meaning. Thus, the picture story task may have been sensitive to difficulties which children with TS may have in perceiving and comprehending complex visual information. The child must then generate a story in which the events are organized in appropriate temporal, spatial, and causal sequence. An acceptable written story must contain appropriate vocabulary and the correct application of rules of syntax and morphology, as well as spelling, capitaiization, and punctuation. This type of task appears to tap the child's ability to integrate all aspects of language knowledge. The TS children in this study demonstrated a pattern of language abilities and deficits which is similar to clinical descriptions of children who have been identified as having nonverbal learning disabilities (Rourke, 1987). This study demonstrated the potential contribution of discourse analysis in the investigation of higher order psycholinguistic abilities. This type of analysis might also be applied in the study of other learning disabled populations.