Clinical characteristics of comorbid tic disorders in autism spectrum disorder: exploratory analysis.
Expect tics in roughly 1 in 5 ASD clients—especially those with IQ ≥70—and monitor for amplified social and obsessive-compulsive symptoms.
01Research in Context
What this study did
Kim et al. (2023) asked how many kids with autism also have tics. They sent surveys to parents and doctors. The sample was youth already diagnosed with autism spectrum disorder.
The team then looked at whether IQ and other autism traits changed when tics showed up.
What they found
Roughly 1 in 5 youth with autism had tics. Kids with tics often had higher IQ scores. They also showed stronger autism features and more obsessive-compulsive behaviors.
How this fits with other research
Canitano et al. (2007) saw the same 1-in-5 rate years earlier. That study linked worse tics to lower IQ. The new data flip the link: higher IQ went with worse tics. The difference is method: the 2007 paper used clinic charts; the 2023 paper used parent surveys. Higher-IQ youth may simply be better at reporting or showing tics.
Sterling et al. (2008) found higher-IQ adults with autism felt more depression. Kim’s team now shows higher-IQ youth feel more tic and OCD symptoms. The pattern is the same: brighter autistic individuals often feel extra psychiatric burdens.
Rosa et al. (2016) saw lower IQ predict ADHD in autism. Taken together, IQ does not protect from comorbidity; it just shifts which extra problems appear.
Why it matters
If you work with autistic clients, add a quick tic screen to your intake. Watch eye blinks, throat clears, or shoulder jerks, especially in youth with IQ above 70. When tics show up, also track OCD signs like rigid routines or repeated questions. Share findings with the medical team; behavior plans may need tweaks to reduce stress that can spike tics.
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02At a glance
03Original abstract
The frequency, clinical characteristics, and associated symptoms of comorbid tic disorders in individuals with autism spectrum disorder (ASD) remain unclear. We included subsets of individuals from a larger genetic study who were diagnosed with ASD (n = 679; age: 4–18 years) and completed the Yale Global Tic Severity Scale (YGTSS) questionnaire. Based on the YGTSS score, the individuals were divided into two groups: ASD only (n = 554) and ASD with tics (n = 125). Individuals were assessed using the verbal and non-verbal intelligence quotient (IQ), Vineland Adaptive Behavior Scale (VABS-2), Social Responsiveness Scale-2 (SRS-2), Child Behavior Checklists (CBCL), and Yale-Brown Obsessive–Compulsive Scale (YBOCS), followed by between-group comparisons. All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 26. Tic symptoms were observed in 125 (18.4%) participants; among them, most participants presented both motor and vocal tics (n = 40, 40.0%). The ASD with tics group had a significantly higher average age and full-scale IQ score than the ASD only group. After adjusting for age, the ASD with tics group had significantly higher scores in the SRS-2, CBCL, and YBOCS subdomains than the ASD only group. Furthermore, all variables except the non-verbal IQ and VABS-2 scores were positively correlated with the YGTSS total score. Finally, the proportion of tic symptoms was significantly higher among individuals with a higher IQ score (≥ 70). The IQ score was positively correlated with the proportion of tic symptoms among individuals with ASD. Moreover, the severity of the core and comorbid symptoms of ASD was associated with the occurrence and severity of tic disorders. Our findings suggest the need for appropriate clinical interventions for individuals with ASD. Trial registration This study retrospectively registered participants The online version contains supplementary material available at 10.1186/s13034-023-00625-8.
Child and Adolescent Psychiatry and Mental Health, 2023 · doi:10.1186/s13034-023-00625-8