Arithmetic performance in children with Tourette syndrome: Relative contribution of cognitive and attentional factors

Abstract

The study addressed the issue of arithmetic deficiencies in children with Tourette syndrome (TS) as well as explanations for such deficiencies. A total of 47 children with TS were assigned to three subgroups based on a composite attention score from the Test of Variables of Attention (TOVA). These children, along with 17 normal controls between 8 and 16 years of age, were tested on standardized measures of IQ, attention, visuospatial ability, and arithmetic achievement. The children also were administered an experimental calculation task with two levels of structure. Children with TS scored below controls on tests of IQ, attention, and arithmetic achievement but not visuospatial ability. The TS subgroup with the greatest impairment of attention accounted for most of the differences in arithmetic achievement. Regression analysis, based on the 47 children with TS, indicated that IQ and TOVA scores were the best predictors of arithmetic achievement. Likewise, the experimental calculation task indicated that the poor performance of some children with TS could be attributed to deficient attention. Irrespective of structure, children in the TS subgroup with the greatest attentional impairment made more attention (but not visuospatial) errors than did controls on the experimental task. Thus, on both the standardized and the experimental tasks, poor arithmetic skill was found only in children with TS who had significant attentional deficits.

Cognitive and behavioral attention in children with math difficulties

“…Other studies have shown a relation between cognitive measures of attention and mathematical performance (Huckeba, Chapieski, Hiscock, & Glaze, 2008; Lindsay, Tomazic, Levine, & Accardo, 2001; van der Sluis, de Jong, & van der Leij, 2004). Although behavioral and cognitive assessments measure attention using different methods, both demonstrate a relation to math achievement and math difficulties.…”

“…In a sample of children with Tourette syndrome (TS) and an age-matched comparison group, Huckeba et al (2008) found that attentional deficits were significantly related to poor arithmetic skill. Children were given various math measures as well as the Test of Variables of Attention (TOVA; Greenberg, 1990, 1993).…”

“…Only the low-attention subgroup differed significantly from the comparison group on all three TOVA variables. Response time was most closely associated with arithmetic performance in the Tourette syndrome group and may reflect deficient arousal to stimuli (Huckeba et al, 2008). …”

European clinical guidelines for Tourette Syndrome and other tic disorders. Part I: assessment

“…However, it is unclear how much of the negative effects of ADHD on disability and social/academic functioning in TS patients is caused by ADHD-related intellectual dysfunction. ADHD comorbidity seems to impact on the general intellectual function of children with TS, as the majority of reports suggest that a lower Full-Scale IQ is accounted for by the presence of the comorbidity [138–140]. Moreover, learning disabilities and other problems concerning academic achievement are estimated to occur in approximately 23% of children with a diagnosis of TS and appear to be highly influenced by coexisting ADHD [140, 141].…”

“…ADHD comorbidity seems to impact on the general intellectual function of children with TS, as the majority of reports suggest that a lower Full-Scale IQ is accounted for by the presence of the comorbidity [138–140]. Moreover, learning disabilities and other problems concerning academic achievement are estimated to occur in approximately 23% of children with a diagnosis of TS and appear to be highly influenced by coexisting ADHD [140, 141]. Specifically, numerical skills [140] and written language [134] have been highlighted as prevalent in TS.…”