41.1 UNDERSTANDING PSYCHOSOCIAL FUNCTIONING IN TIC DISORDERS THROUGH NEUROPSYCHOLOGICAL EVALUATION

Abstract

Tic spectrum disorders have been linked to atypical development or dysregulation within parallel pathways comprising the cortico-striatal-thalamo-cortical (CSTC) network. These pathways regulate cognitive, motor, and affective processing, likely accounting for the high rates of comorbidity between Tourette’s disorder (TD), OCD, and ADHD. The emotional, social, and behavioral challenges shared by children and adolescents with these diagnoses can impair functioning at home, at school, and with peers, potentially increasing the risk for secondary mental health disorders (eg, depression). Neuropsychological testing is an important tool in characterizing an individual child’s functioning to determine the risk for psychosocial difficulties and points of intervention across a child’s functional domains. Drawing from published literature and clinical experience, an overview of neuropsychological testing and areas to target when evaluating children and adolescents who have tic spectrum disorders will be provided. Although most children and adolescents have typical intellectual functioning, children and adolescents who have tic spectrum disorders may present with select weaknesses in cognitive functioning, including attentional regulation and cognitive efficiency. There may also be higher rates of difficulties with motor skills, learning, and social communication. Identification of a child or adolescent’s specific vulnerabilities through neuropsychological evaluation can lead to tailored interventions at home, at school, and in social domains. Focusing on bolstering executive functioning and improving social skills is particularly important in improving quality of life and outcomes in youth with these challenging neurodevelopmental conditions.