{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:13:33Z","timestamp":1792804413501,"version":"4.5.0"},"reference-count":33,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,7,1]]},"abstract":"<jats:p>Objective.\u2003Prevalence studies indicate a 10-fold higher rate of Tourette syndrome (TS) among children compared with adults. The purpose of this investigation was to examine the course of tic severity during the first 2 decades of life.<\/jats:p>\n                  <jats:p>Method.\u2003A birth-year cohort of 42 TS patients followed at the Yale Child Study Center was recontacted an average of 7.3 years after their initial clinical evaluation. Data concerning the onset and course of tic severity until 18 years of age were available on 36 TS patients. A variety of statistical techniques were used to model aspects of the temporal patterning of tic severity.<\/jats:p>\n                  <jats:p>Results.\u2003Mean (SD) tic onset at 5.6 (2.3) years of age was followed by a progressive pattern of tic worsening. On average, the most severe period of tic severity occurred at 10.0 (2.4) years of age. In eight cases (22%), the frequency and forcefulness of the tics reached a severe level during the worst-ever period such that functioning in school was impossible or in serious jeopardy. In almost every case this period was followed by a steady decline in tic severity. By 18 years of age nearly half of the cohort was virtually tic-free. The onset of puberty was not associated with either the timing or severity of tics.<\/jats:p>\n                  <jats:p>Conclusions.\u2003A majority of TS patients displayed a consistent time course of tic severity. This consistency can be accurately modeled mathematically and may reflect normal neurobiological processes. Determination of the model parameters that describe each patient's course of tic severity may be of prognostic value and assist in the identification of factors that differentially influence the course of tic severity.<\/jats:p>","DOI":"10.1542\/peds.102.1.14","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T19:44:32Z","timestamp":1092426272000},"page":"14-19","source":"Crossref","is-referenced-by-count":598,"title":["Course of Tic Severity in Tourette Syndrome: The First Two Decades"],"prefix":"10.1542","volume":"102","author":[{"given":"James F.","family":"Leckman","sequence":"first","affiliation":[{"name":"From the Child Study Center, the Children's Clinical Research Center, and the Departments of Pediatrics and Psychiatry; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, the Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Vitale","sequence":"additional","affiliation":[{"name":"From the Child Study Center, the Children's Clinical Research Center, and the Departments of Pediatrics and Psychiatry; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Lahnin","sequence":"additional","affiliation":[{"name":"From the Child Study Center, the Children's Clinical Research Center, and the Departments of Pediatrics and Psychiatry; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Lynch","sequence":"additional","affiliation":[{"name":"From the Child Study Center, the Children's Clinical Research Center, and the Departments of Pediatrics and Psychiatry; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Bondi","sequence":"additional","affiliation":[{"name":"From the Child Study Center, the Children's Clinical Research Center, and the Departments of Pediatrics and Psychiatry; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Shin","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Child Study Center, the Children's Clinical Research Center, and the Departments of Pediatrics and Psychiatry; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley S.","family":"Peterson","sequence":"additional","affiliation":[{"name":"From the Child Study Center, the Children's Clinical Research Center, and the Departments of Pediatrics and Psychiatry; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1998,7,1]]},"reference":[{"key":"2021121010153762300_B1","first-page":"463","article-title":"An epidemiological study of Tourette's syndrome in a single school district.","volume":"51","author":"Comings","year":"1990","journal-title":"J Clin Psychiatry."},{"key":"2021121010153762300_B2","first-page":"649","article-title":"An epidemiological study of tics.","volume":"44","author":"Nomoto","year":"1990","journal-title":"Japan J Psychiatry Neurol."},{"key":"2021121010153762300_B3","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1001\/archpsyc.1993.01820210068008","article-title":"An epidemiological study of Gilles de la Tourette's syndrome in Israel.","volume":"50","author":"Apter","year":"1993","journal-title":"Arch Gen Psychiatry."},{"key":"2021121010153762300_B4","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/S0002-7138(10)60016-7","article-title":"A prevalence study of Gilles de la Tourette's syndrome in North Dakota school-age children.","volume":"25","author":"Burd","year":"1986","journal-title":"J Am Acad Child Psychiatry."},{"key":"2021121010153762300_B5","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1192\/bjp.164.2.263","article-title":"Tourette's syndrome in New Zealand: a postal survey.","volume":"164","author":"Robertson","year":"1994","journal-title":"Br J Psychiatry."},{"key":"2021121010153762300_B6","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1176\/ajp.143.6.787","article-title":"Prevalence of Gilles de la Tourette's syndromes in North Dakota adults.","volume":"143","author":"Burd","year":"1986","journal-title":"Am J Psychiatry."},{"key":"2021121010153762300_B7","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1002\/ana.410220317","article-title":"The natural history of Tourette's syndrome: a follow-up study.","volume":"22","author":"Erenberg","year":"1987","journal-title":"Ann Neurol."},{"key":"2021121010153762300_B8","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1212\/WNL.42.4.784","article-title":"Adult tics in Gilles de la Tourette's syndrome: description and risk factors.","volume":"42","author":"Goetz","year":"1992","journal-title":"Neurology."},{"key":"2021121010153762300_B9"},{"key":"2021121010153762300_B10","first-page":"197","article-title":"Lang A. 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