Screening for Tics and Tic Disorders

Heather Adams, PhD, University of Rochester (Funded 2016-2017)

Tic Disorders and associated conditions may be associated with adverse impacts including mood and behavioral disorders, impaired interpersonal relationships, physical injury, and reduced academic and vocational attainment. Therefore, accurate, early identification and treatment is essential to reduce these impacts. Prior work by the applicant and collaborators has identified that current diagnostic tools may under-identify children with tics and tic disorders. Therefore, the major objective of the proposed project is to improve identification of tics, tic disorders, and co-occurring conditions in children, by evaluating new screening and diagnostic measures. The primary specific research aims are to determine the sensitivity and specificity of: 1. a new tic screen tool regarding the presence/absence of tics (RFA Objective 1); 2. the Description of Tic Symptoms (DoTS) and the Diagnostic Interview Schedule for Children-5th edition (DISC-5) Tic Module regarding presence/absence of TD diagnoses (RFA Objective 2); 3. the DISC-5 ADHD module regarding the presence/absence of a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD), a common comorbidity of TD (RFA Objective 4). Two exploratory specific aims are also proposed – to determine: 1. the best combinations of new measures (DoTS, tic screen, DISC-5) to identify children with TD (RFA Objective 3), and 2. the tic screen’s ability to predict symptoms of ADHD and other TD comorbidities (RFA Objective 5). The proposed project is an observational, cross-sectional study of n = 110 children with Tic Disorders (TD) and n = 110 children from a general pediatric population. Using clinician-experts to establish a reference standard for tics and DSM-5 diagnoses of Tic Disorders and ADHD, the investigators will compare the proportion of children meeting this standard, to those identified using the index measures of the DoTS, the forthcoming DISC-5, and the new screen tool (in development). The overarching goal is to support development of tools that will enhance access to care, health, and quality of life for affected individuals.