Objective: To analyze whether the presence of a tic disorder is associated with an increased risk for developing poor academic performance overtime.

Background: Tic disorders are associated with neuro-psychiatric disorders that can potentially interfere with academic success. To date there is no longitudinal follow up of children with tic disorders to assess the natural history of academic performance in this population.

Methods: Mainstream population-based, exposed pupils (with tics) and non-exposed (without tics) cohort study from different types of schools and educational levels. Individuals were evaluated at baseline (2008,2009) and at follow-up (2014). Poor academic performance was defined as grade retention since 2010 and tic disorders were defined based on DSM-IV-TR criteria. Children with and without tics and children with and without poor academic performance were compared in terms of demographics, clinical features, school, and environmental characteristics. Adjusted hazard ratios (HRs) with 95% confidence intervals for tic disorders associated with poor academic performance risk were calculated using multivariate Cox proportional hazard analyses after adjusting for confounding variables.

Results: 264 pupils were included (mean age 14.0 +/- 1.71), 148 (56%) males. Tics were present in 77 (29.2%) and grade retention in 34 (12.8%) of those 13 (41%) with tics, and 19 (59%) without tics (p=0.44). Overall, pupils with and without tics with grade retention presented more frequently with lower IQ (p=0.02), higher scores for behavior, generalized anxiety and autism spectrum disorders (p=0.002; 0.009; 0.008, respectively), lower parental educational level (p<0.0001), lower sport performance, higher TV viewing (p=0.001, 0.02), and lower frequency of psychological support at school (p=0.001). In the Cox regression analysis, the adjusted hazard ratio over the 4-year survey period, grade retention was only associated with lower frequency of psychological support (HRs=17.5 95% CI 5.7-53.9) and lower sport performance (HRs=4.02, 95% CI 1.3-11.8).

Conclusions: After adjusting for other covariates, the presence of tic disorders was not associated with poor academic performance. Early academic support and modification of environmental characteristics are needed for children at higher risk for school dysfunction.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-follow-up-of-the-association-of-tic-disorders-with-poor-academic-performance/