The Child Tourette Syndrome Impairment Scale (CTIM) rates 37 problems in school, social, and home domains separately for tics and for comorbid diagnoses. However, a shorter version would be easier to implement in busy clinics. Using published data from 85 children with Tourette syndrome, 92 controls, and parents, factor analysis was used to generate a "mini-CTIM" composed of 12 items applied to tic and comorbid diagnoses. Child- and parent-rated mini-CTIM scores were compared and correlated across raters and accounting for clinician-rated tic severity and presence of attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). The mini-CTIM achieved domain Cronbach alphas ranging from 0.71 to 0.94 and intra-item correlation coefficients ranging from 0.84 to 0.96. The resulting scale correlated with clinician-rated tic severity and reflected the presence of ADHD and OCD. The mini-CTIM appears promising as a practical assessment tool for tic- and non-tic-related impairment in children with Tourette syndrome.
Functional impairment is an important factor in Tic Disorder treatment decisions. We evaluated the mini Child Tourette Syndrome Impairment Scale (mini-CTIM) for correlation with symptom severity and association with interventions. A total of 61 randomly selected tic encounters were retrospectively analyzed for mini-CTIM correlation with symptom severity scores and compared between patients who received treatment and those who did not. Regression models identified factors associated with treatment decisions. Mini-CTIM-tic scores correlated with tic severity and mini-CTIM-non-tic scores correlated with attention-deficit hyperactivity disorder (ADHD) severity. Tic treatment was associated with higher child, but not parent, mini-CTIM-tic scores. Regression models identified that comorbidity treatment was predicted by ADHD severity, obsessive compulsive disorder severity, and parent but not child mini-CTIM-non-tic scores. These findings suggest children have valuable insight into their tic-related impairment, but parent assessment is important for evaluating comorbidity-related impairment. The mini-CTIM may be a useful clinical tool for assessing tic-related impairment.
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