Evaluating the reliability and validity of a videotaped observation system for tics associated with TS: A Cross Condition, Multi-Site Investigation

Grant Type
Grant Year
Institution Location
Institution Organization Name
University of California
Investigators Name
Piacentini, John, PhD

To determine the effectiveness of any treatment for TS, researchers often conduct large–scale studies at many different locations throughout the country. However, to do so, they also need a reliable and valid way of measuring improvement that is consistent across the different sites. The primary purpose of this study is to establish a reliable and valid direct observation procedure for measuring the severity of TS symptoms in children that is consistent across observation sites. This research will develop and maintain cross-site (and test-retest) reliability through the use of expert consensus ratings, “gold-standard” criterion videotapes, and real-time quality control procedures. If effective, this methodology will serve as the cornerstone of assessment measures for future multi-site treatment proposals involving children with TS. To complete this study, 60 children between the ages of 8 and 17 will be recruited for participation at UCLA and the University of Wisconsin-Milwaukee. Three in-home, and three clinic-based visits will be conducted for each participant in order to collect information about tic occurrence. All sessions will be videotaped, and all tapes will be scored to determine the level of tics in each child. In addition to the videotaped observations, self-report and clinician completed scales will be administered to determine how informative such scales are when compared to actual tic occurrence. In addition to the primary goal described above, the study will also address two secondary aims related to parameters of observation procedures. The first issue is tic reactivity that is the reduction of tics exhibited by children when they are observed. Reactivity to clinical assessment is a significant issue for observational researchers and, given the heightened reactivity characteristic of many with tics, the problem is even more magnified in research with this population. The other secondary goal of the study is to determine the optimal tic-coding interval by examining the reliability and validity of various observational interval lengths (e.g., 2-min, 3-min, 5-min, 10-min). Taken together, the results from the secondary aims will be used to further refine and optimize our standardized direct observation protocol. The project is now in its second year of TSA funding. Currently, 17 children have completed the study and recruitment efforts for additional participants are underway. Preliminary results are promising and were recently presented at the annual meeting of the Association for Behavior Analysis. Preliminary results show that tic rates obtained via event frequency scoring and those obtained using 10-second partial-interval scoring are highly related, suggesting that either scoring method can be effectively used to measure tic occurrence. The relationship between direct observation procedures and clinician-administered instruments, however, shows that the clinician-administered measures traditionally used to measure tics may not be sensitive enough to fully capture tic occurrence. This suggests that direct observation procedures are important for obtaining an accurate measure of tics. In addition, results show that direct observation measures of tics are stable across time (one and two week stability) and setting (home and clinic), suggesting that observations can be made either at the clinic or at home. One other interesting finding is that childrens’ rate of tics appears to be reactive to the presence of others, i.e. they demonstrate fewer tics when the researcher is in the room than when videotaped alone. John Piacentini, Ph.D., Neuropsychiatric Institute, University of California, Los Angeles, CA Douglas A. Woods, Ph.D., Dept of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI Award: $34,000 This study is being funded through the generous contributions of the Baker Family and Friends in loving memory of Virginia Graeme Baker Tourette Association of America Inc. – Research Grant Award 2003-2004