ADD affects some 2 percent to 9 percent of all school-age children and is ten times more common among males than females. Symptoms include difficulty with concentrating, completing tasks, listening, thinking before acting, sitting still, and staying focused. Most children at times display some of these symptoms. A child with ADD displays them excessively and continuously, so that they persist for at least 6 months and significantly impair the child's ability to function.
Less common than ADD, TS also typically appears during childhood and is three to four times more common in males than females. The disorder is characterized by repeated and involuntary body movements and uncontrollable vocal sounds called tics. Tics may be simple, involving eye blinking, head jerking, shoulder shrugging, facial grimacing, throat clearing, or yelping and other noises. Tics may also be complex, involving jumping, touching other people or things, twirling, hitting or biting oneself, uttering words or phrases out of context, or cursing. These irresistible urges, similar to the urge to sneeze, can sometimes be suppressed. However, if suppressed, they will build up and need even more vehement expression later. Stress often exacerbates symptoms. Relaxation often decreases them. About 100,000 people suffer full-blown TS. As many as one in two hundred people are affected by less severe or transient symptoms.
The symptoms of both ADD and TS can lessen with age and treatment. However,
half of all ADD and about two-thirds of all TS patients continue to have
symptoms into adulthood.
Often it is difficult to distinguish the uncontrollable symptoms associated
with ADD and TS from simple misbehavior. Further, public understanding,
even among those who suffer these disorders, is quite low. Those
afflicted with ADD or TS generally are as intelligent as the general population.
However because they are unable to recognize social cues they often act
in bizarre and socially unacceptable ways. Aware that the child is intelligent,
adults often expect an afflicted child to “know better,” and then
punish the child for behavioral problems that are neurologic in origin.
Treatment for ADD and TS starts with a correct diagnosis by a qualified doctor or psychologist. Certain prescription drugs can help control tics in TS patients and improve concentration and reduce hyperactivity in people with ADD. But drugs do not cure these disorders—they just help control the symptoms. Also, diagnosis is not always easy. Many people with TS and ADD initially are diagnosed only with ADD. However, Ritalin, a common medication used to treat ADD, exacerbates tics in 30 percent to 40 percent of people with tics, leading to a refined diagnosis of TS.
Because medications rarely fully control these conditions and because
the conditions are publicly misunderstood, people newly diagnosed with
ADD or TS and even their families often benefit from psychological counseling.
Counseling can help those affected deal with the emotional turmoil the
disorder has caused in their lives and develop new behaviors and approaches
around the disorder.
Support groups for both ADD and TS patients and their families and
caregivers can also be tremendously helpful, providing treatment resources,
strategies for dealing with common symptoms and scenarios, and emotional
support.
People with TS and ADD often have special educational and vocational
needs as well. They may require extra time on tests, tools to help
them focus, and opportunity to express tics. Under federal law, these impairments
may entitle a student to an Individual Education Plan (IEP) to address
specific educational problems, including, if necessary, placement in a
special school
Under the Americans with Disabilities Act, adults with ADD and TS may
be entitled to reasonable accommodation in the workplace, provided the
condition does not prevent them from performing the essential functions
of their jobs.
For extreme cases where symptoms prevent the adult from working
or severely interfere with the child's ability to function, people with
ADD and TS may qualify for Social Security disability benefits. However,
in the majority of cases, appropriate identification, treatment, and support
can significantly reduce ADD and TS symptoms and provide the basis to lead
productive and successful lives.