CeH Assessment of Tic Score (CHATS)

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CeH Assessment of Tic Score (CHATS) - 12 Weeks

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Children's e-Hospital Identity Number *

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Child's Name *

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Yes

I consent to the data from this form being used for research and publication purposes (anonymised data)

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Yes

How many different type of tics does your child have? *

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None

Single tic

Multiple discreet tics (2-5)

Multiple discreet tics (>5)

Multiple discrete tics plus at least one orchestrated pattern of multiple simultaneous or sequential tics that where it is difficult to distinguish discrete tics

Multiple discrete tics plus several (>2) orchestrated paroxysms of multiple simultaneous or sequential tics where it is difficult to distinguish discrete tics

How often do the Tics occurs? *

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None - no evidence of specific tic behaviours

Rarely - specific tic behaviours have been present during previous week. These behaviours occur infrequently, often not on a daily basis. If bouts of tics occur, they are brief and uncommon.

Occasionally - specific tic behaviours are usually present on a daily basis, but there are long tic free intervals during the day. Bouts of tics may occur on occasion and are not sustained for more than a few minutes at a time.

Frequently - specific tic behaviours are present on a daily basis. Tic free intervals as long as 3 hours are not uncommon. Bouts of tics occur regularly but may be limited to a single setting.

Almost always - specific tic behaviours are present virtually every waking hour of every day, and periods of sustained tic behaviours occur regularly. Bouts of tics are common and are not limited to a single setting.

Always - specific tic behaviours are present virtually all the time. Tic free intervals are difficult to identify and do not last more than 5 to 10 minutes at most.

How intense are the Tics? *

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Absent

Minimal intensity - tics not visible or audible (based solely on patient's private experience) or tics are less forceful than comparable voluntary actions and are typically not noticed because of their intensity.

Mild intensity - tics are not more forceful than comparable voluntary actions or utterances and are typically not noticed because of their intensity.

Moderate intensity - tics are more forceful than comparable voluntary actions but are not outside the range of normal expression for comparable voluntary actions or utterances. They may call attention to the individual because of their forceful character.

Marked intensity - tics are more forceful than comparable voluntary actions or utterances and typically have an "exaggerated" character. Such tics frequently call attention to the individual because of their forceful and exaggerated character.

Severe intensity - tics are extremely forceful and exaggerated in expression. These tics call attention to the individual and may result in physical injury (accidental, provoked, or self inflicted) because of their forceful expression.

How complex are the Tics? *

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None - if present, all tics are clearly "simple" (sudden, brief, purposeless) in character.

Borderline - some tics are not clearly "simple" in character.

Mild - some tics are clearly "complex" (purposive in appearance) and mimic brief "automatic" behaviours, such as grooming, syllables, or brief meaningful utterances such as "ah huh", "hi" that could be readily camouflaged.

Moderate - some tics are more "complex" (more purposive and sustained in appearance) and may occur in orchestrated bouts that would be difficult to camouflage but could be rationalised or "explained" as normal behaviour or speech (picking, tapping, saying "you bet" or "honey", brief echolalia).

Marked - some tics are very "complex" in character and tend to occur in sustained orchestrated bouts that would be difficult to camouflage and could not easily be rationalised as normal behaviour or speech because of their duration and/or their unusual, inappropriate, bizarre or obscene character ( a lengthy facial contortion, touching genitals, echolalia, speech atypicalities, longer bouts of saying "what do you mean" repeatedly, or saying "fu" or "sh").

Severe - some tics involve lengthy bouts of orchestrated behaviour or speech that would be impossible to camouflage or successfully rationalise as normal because of their duration and/or extremely unusual, inappropriate, bizarre or obscene character (lengthy displays or utterances often involving copropraxia, self-abusive behaviour, or coprolalia).

How much do the Tics interfere with day to day living? *

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None

Minimal - when tics are present, they do not interrupt the flow of behaviour or speech.

Mild - when tics are present, they occasionally interrupt the flow of behaviour or speech.

Moderate - when tics are present, they frequently interrupt the flow of behaviour or speech.

Marked - when tics are present, they frequently interrupt the flow of behaviour or speech, and they occasionally disrupt intended action or communication.

Severe - when tics are present, they frequently disrupt intended action or communication.

What impact are the Tics having on your child's day to day living? *

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None

Minimal - tics associated with subtle difficulties in self-esteem, family life, social acceptance, or school or job functioning (infrequent upset or concern about tics vis a vis the future, periodic, slight increase in family tensions because of tics, friends or acquaintances may occasionally notice or comment about tics in an upsetting way).

Mild - tics associated with minor difficulties in self-esteem, family life, social acceptance, or school or job functioning.

Moderate - tics associated with some clear problems in self-esteem, family life, social acceptance, or school or job functioning (episodes of dysphoria, periodic distress and upheaval in the family, frequent teasing by peers or episodic social avoidance, periodic interference in school or job performance because of tics).

Marked - tics associated with major difficulties in self-esteem, family life, social acceptance, or school or job functioning.

Severe - tics associated with extreme difficulties in self-esteem, family life, social acceptance, or school or job functioning (severe depression with suicidal ideation, disruption of the family (separation or divorce, residential placement), disruption of social tics - severely restricted life because of social stigma and social avoidance, removal from school or loss of job).

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