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Can children with Gilles de la Tourette syndrome edit their intentions?1

Published online by Cambridge University Press:  09 July 2009

S. Baron-Cohen ,
P. Cross ,
M. Crowson  and
M. Robertson
S. Baron-Cohen*
Affiliation:
Departments of Psychology and Child Psychiatry, Institute of Psychiatry; and Department of Neuropsychiatry, Institute of Neurology, London
P. Cross
Affiliation:
Departments of Psychology and Child Psychiatry, Institute of Psychiatry; and Department of Neuropsychiatry, Institute of Neurology, London
M. Crowson
Affiliation:
Departments of Psychology and Child Psychiatry, Institute of Psychiatry; and Department of Neuropsychiatry, Institute of Neurology, London
M. Robertson
Affiliation:
Departments of Psychology and Child Psychiatry, Institute of Psychiatry; and Department of Neuropsychiatry, Institute of Neurology, London
*
2Address for correspondence: Dr Simon Baron-Cohen, Department of Psychology and Child Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
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Synopsis

In this paper we describe a cognitive mechanism, the Intention Editor, which is triggered whenever there are several intentions competing in parallel with each other. This mechanism is hypothesized to be a subcomponent of a larger mechanism, the Supervisory Attentional System (SAS: Shallice, 1988) which serves inhibition in general. The Intention Editor interrupts one of several simultaneously activated intentions, preventing it from executing its action, utterance, or thought. This mechanism appears to develop during the first five to six years of life. We propose that an impairment in the development of this mechanism may account for the triad of symptoms in children with Gilles de la Tourette Syndrome (GTS): involuntary movements, involuntary utterances, and obsessive thoughts. This mechanism is tested with normal children aged 3–6 years old, and with children with GTS, in two experiments.

In Experiment 1, subjects were required to make one hand movement while inhibiting making a (different) hand movement that the other hand was simultaneously making. In Experiment 2, they were asked to say one thing while inhibiting saying something else. On both tasks, normal 6-year-olds were significantly better than normal 4-year-olds, but children with GTS performed worse than normal 6-year-olds, despite having a mean age of 12 years. These results constitute preliminary evidence for the theory that the Intention Editor is dysfunctional in GTS.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 1 , February 1994 , pp. 29 - 40
Copyright
Copyright © Cambridge University Press 1994

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Footnotes

1

Some parts of this paper were presented in invited lectures by the first author at the University of Rochester, New York (October 1991), the Charing Cross Hospital and the Institute of Neurology (September 1992), London.

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