Toward a Better Evaluation of Treatment Outcome in TS

Grant Type
Grant Year
Institution Location
Institution Organization Name
Yale Child Study Center
Investigators Name
Scahill, Lawrence, MSN, MPH

The overall aim of this project is to improve the measurement of tic severity for treatment studies in children and adults with TS. As with all areas of medicine, judging improvement with treatment relies on measuring severity before and after starting treatment to determine whether the treatment has worked. For the past twenty years the Yale Global Tic Severity Scale (YGTSS) has been considered the best available method for evaluatingthe efficacy of treatment of tics in children and adults with TS. The basic considerations for any clinical measure are whether it is reliable and valid. Reliable means that the measure gives similar information when repeated or when measured by a different person. Valid means that the scale is actually measuring what it was intended to assess. Another consideration is whether the measure is sensitive to change. Although prior studies indicate that the YGTSS is reliable, valid and sensitive to change, after 20 years, the time is right to examine these critical properties again. In addition, we have information from two large, multi-site treatment studies that can be used to evaluate the YGTSS in a careful way. The first large study examined the benefits in 126 children of a comprehensive behavioral intervention for tics. The second study, which is ongoing, is evaluating this same treatment in 120 adolescents and adults. In both of these studies we have trained clinicians who administer the YGTSS before and after 10 weeks of treatment. A set of 50 recordings will be sent to clinicians at each site in order to examine whether the YGTSS is reliable. We will also have an expert panel review the results of these multiple ratings to help determine whether some components of the YGTSS are in need of revision. Through these methods we hope to improve the precision of the YGTSS to measure severity and improvement in tics over time. Lawrence Scahill, MSN, Ph.D. Yale Child Study Center, New Haven, CT Award: $61,275 Tourette Association of America Inc. – Research Grant Award 2008-2009