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Some individuals with Tourette syndrome (TS) have severe motoric and vocal tics that interfere with all aspects of their lives, while others have mild tics that pose few problems. We hypothesize that observed tic severity reflects a combination of factors, including the degree to which dopaminergic (DA) and/or noradrenergic (NE) neurotransmitter systems have been affected by the disorder, and the degree to which the child can exert cognitive control to suppress unwanted tics. To explore these hypotheses, we collected behavioral and eyetracking data from 26 patients with TS and 26 controls between ages 7 and 14, both at rest and while they performed a test of cognitive control. To our knowledge, this is the first study to use eyetracking measures in patients with TS. We measured spontaneous eyeblink rate as well as pupil diameter, which have been linked, respectively, to DA and NE levels in the central nervous system. Here, we report a number of key findings that held when we restricted analyses to unmedicated patients. First, patients' accuracy on our test of cognitive control accounted for fully 50% of the variance in parentally reported tic severity. Second, patients exhibited elevated spontaneous eyeblink rates compared to controls, both during task performance and at rest, consistent with heightened DA transmission. Third, although neither task-evoked pupil dilation nor resting pupil diameter differed between TS patients and controls, pupil diameter was positively related to parentally reported anxiety levels in patients, suggesting heightened NE transmission in patients with comorbid anxiety. Thus, with the behavioral and eyetracking data gathered from a single task, we can gather objective data that are related both to tic severity and anxiety levels in pediatric patients with TS, and that likely reflect patients' underlying neurochemical disturbances.

Changelings contains proceedings from two panels occasioned by Maurice Sendak's visit to the UC Berkeley campus as visiting Avenali Professor in the Humanities in the Spring of 1996. Best known as a writer and illustrator of children's books (Where the Wild Things Are, In the Night Kitchen, Chicken Soup with Rice), Mr. Sendak's appearances on campus provoked lively discussion on a broad range of topics. In "They Know Everything: Children and Suffering," Dr. Herbert Schreier of Oakland's Children's Hospital highlights clinical knowledge about the durability of trauma and the frequent inability of onlookers, especially parents, to see the effects of trauma both on children and on adults. Maurice Sendak follows this talk with a discussion of how his own awareness, as a child, of the Lindbergh kidnapping led, finally, to the writing and illustrating of Outside Over There, a work in which the theme of the stolen child plays an important role. The open discussion that follows this panel returns to the issues of personal and community trauma, and the transformation of such suffering in art created for children.In the second part of this volume, "Mozart, Shakespeare and the Art of Maurice Sendak," Professors Stephen Greenblatt and Wye Allanbrook engage with Maurice Sendak in a discussion of Mozart and Shakespeare that is also an exploration of how Sendak's interpretation of the themes of childhood, adolescence and transformation into adulthood enhances our experience of these canonical artists. The panel begins with Stephen Greenblatt's discussion of folkloric tales of changelings (the ugly creatures left in place of the beautiful stolen children), and the role of changelings in Shakespeare's imagination. Focusing on the peculiar role of the changeling boy in the dispute between Oberon and Titania in A Midsummer Night's Dream, Professor Greenblatt asks why the thematic of the stolen and the replaced child so captured Shakespeare's attention, why the boy is so important even though he never appears on stage. Wye Allanbrook's discussion examines the similarities between Mozart's The Magic Flute and Sendak's playfully erotic In the Night Kitchen. She traces Mickey's mysterious transformation from mere material, Aristotelian hule, to mensch, a process which she sees as parallel with the growth experienced by Pamina and Tamino in The Magic Flute. The following conversation between Sendak and the presenters draws out these themes and focuses on the importance of a child's ability to see and understand meanings that often escape disbelieving adult eyes. Finally, questions from the audience expand further the consideration of Maurice Sendak's perspectives on opera, ballet, and other art forms.