Validation of a Functional Assessment Interview Procedure for Childhood Tic Disorders

Grant Type
Grant Year
Institution Location
Institution Organization Name
Tel Aviv University Israel
Investigators Name
Apter, Alan, MD

It is clear that tics are often sensitive to environmental/ behavioral factors. Research and clinical observation, have identified multiple tic-exacerbating factors including boredom, social demands, tic-related conversation, being noticed and other stress-provoking situations. The reliable identification of these tic exacerbating factors has clear treatment implications. However, the effects of the influence of any given environmental factor, is highly individualized. As a result, successful behavioral intervention to minimize environmentallytriggered tics requires the use of flexible, yet valid methods for identifying those factors most relevant to a given individual and/or situation. The functional assessment interview (FAI) is designed to address this problem. This procedure systematically examines how tics are influenced by the environment for each specific child. The process by which one systematically determines functional relationships between behavior and specific environmental antecedents and consequences is known as a functional assessment. Based on the assessment, function-based treatments can be customized to systematically modify the environment for therapeutic benefit. Thirty children (ages 7-15) with tics will be recruited for this study. Participation will require each child to attend two separate, 2-hour sessions. During the initial session, each child will receive a detailed functional assessment interview (FAI) in order to identify environmental events that exacerbate tics. During the second visit, the results of each child’s functional assessment will be validated by monitoring the systematic introduction and removal of various environmental or behavioral factors that were reported to exacerbate tics on the FAI. Direct observation and videotaping of tics will serve as the primary outcome measures. If our method of identifying environmental factors which specifically affect tics is found to be valid and reliable, it will provide the basis for developing psychological treatments for this condition thus reducing the need for medications which often have unwanted side effects. Aside from treatment utility, meaningful findings in this regard may both enhance efforts to better understand the biophychosocial mechanisms underlying tic expression as well as lead to new research initiatives investigating this critical area. Alan Apter, M.D., Tel Aviv University, Petah Tikva, Israel John Piacentini, Ph.D., ABPP, University of California, Los Angeles, CA Douglas Woods, Ph.D., University of Wisconsin- Milwaukee, Milwaukee, WI Award: $43,042 Tourette Association of America Inc. – Research Grant Award 2006-2007