Early developmental milestones associated with tics and psychopathological comorbidity: An EMTICS study.

Researchers studied 383 children with tics to see if delays in early milestones (like walking or first words) were linked to other conditions. They found that children who were late to say their first words were more likely to have ADHD, behaviour problems, or autism traits. Children who walked late were more likely to develop obsessive-compulsive behaviours. While the connections were small, this research suggests that tracking early development might help identify children who may need extra support.

This observational study examined 383 children aged 3-16 years with chronic tic disorders from the European EMTICS cohort to investigate relationships between early developmental milestones and later psychopathological comorbidities. Researchers analyzed retrospective data on six developmental milestones (sitting, walking, first words, sentence completion, bladder/bowel control) alongside tic severity and comorbid conditions including ADHD, autism spectrum disorder, OCD, and oppositional defiant disorder. Results showed small but significant correlations between delayed milestones and tic severity. Importantly, delayed first words was associated with increased odds of ADHD, ODD, and suspected ASD, while delayed walking was linked to OCD.

These findings suggest early developmental patterns may help identify children at risk for specific comorbidities.

Early developmental milestone tracking in children with tics may help identify those at risk for specific comorbidities. Delayed language development appears particularly important for predicting ADHD, behavioural issues, and autism traits. This could inform early intervention strategies and guide more targeted screening protocols in pediatric populations with tic disorders.

Retrospective design relies on parental recall of early milestones, which may be subject to bias. The study shows associations but cannot establish causation. Effect sizes were small, and the clinical significance of these relationships requires further validation.

Chronic Tic disorders (CTD) including Tourette Syndrome (TS), are associated with psychopathological comorbidities. Attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and other comorbidities have been linked to delays in early developmental milestones. Few studies have investigated the relationship between early developmental milestones, tic severity, and related comorbidities. 383 participants aged 3-16 years (76.8%, n = 294 boys) with CTD from the baseline assessment of the European Multicenter Tics in Children Study (EMTICS), were evaluated for: retrospective early developmental milestones (sitting, walking, first words, complete a sentence, bladder and bowel control), tic severity, tic-related functional impairment, obsessive-compulsive disorder (OCD), ADHD, oppositional defiant disorder (ODD) and suspected ASD. Data was collected using gold-standard self and clinician reporting instruments.

Analyses included Pearson correlations and logistic regressions. Correlations between the acquisition of developmental milestones and tic severity or impairment were significant with small effect sizes (severity of motor tics and tic impairment were correlated with walking (r = .11), while vocal tics were correlated with first words (r = .12)). Logistic regression revealed that delayed acquisition of first words was significantly associated with ADHD, ODD and suspected ASD (Odds Ratio (ROR): 1-1.13, 1.04-1.22, 1.05-1.21, respectively), while delayed walking acquisition was associated with OCD (ROR: 1.01-1.27). This study highlights the association between early developmental milestones and later psychopathological comorbidities in CTD patients.

These findings emphasize the need for further research to distinguish between children with only tics and those with tics and psychopathological comorbidities, to improve early detection of individuals at risk.