science

Tourette's Disorder Scale

Tourette's Disorder Scale is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Tourette's Disorder Scale rather than just read about it. In short: The Tourette's Disorder Scale (TODS) is a psychological instrument to assess tics and co-occurring conditions in Tourette syndrome (TS). There are two versions of TODS: TODS-CR (clinician-rated) and TODS-PR (parent-rated).

Key takeaways

Tourette's Disorder Scale belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Tourette's Disorder Scale to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Tourette's Disorder Scale from memory before moving on to harder problems.

Reference excerpt

The Tourette's Disorder Scale (TODS) is a psychological instrument to assess tics and co-occurring conditions in Tourette syndrome (TS). There are two versions of TODS: TODS-CR (clinician-rated) and TODS-PR (parent-rated). Each version is a 15-item scale that helps clinicians evaluate the severity of symptoms that may be associated with tics—inattention, hyperactivity, obsessions, compulsions, aggression and mood disturbances.

Use and features

TODS is one of many instruments used to assess symptoms associated with tics. The Yale Global Tic Severity Scale (YGTSS) is regarded as the most developed instrument for assessing tics and is widely accepted as the standard; TODS is one of several other reliable and comprehensive instruments. TODS differs from other instruments in that it measures tic severity as well as behavioral and emotional symptoms that may accompany TS. According to a systematic review by Martino, et al (2017), TODS is the "only 'recommended' severity scale to measure also comorbid behavioral symptoms (inattention, hyperactivity, obsessions, compulsions, aggression, and emotional symptoms), but has lower internal consistency and interrater reliability than the YGTSS". The 15 symptoms rated by TODS include tics as well as obsessions and compulsions; attentional difficulties, restlessness and impulsiveness; and depression, anxiousness, aggression and other mood or behavioral issues.

Development In a 2003 study by Shytle and colleagues, a survey was sent to parents from a TS group email list, asking them to rate the frequency and relative significance of 32 behavioral and emotional symptoms observed in their children. Of 35 respondents, 80% concurred that behavioral and emotional symptoms were more afflicting than tics. Symptoms discerned as frequently disruptive to persons with TS and rated as a "top 10" problem by over 25% of participants in the study (parents and clinicians) were included in the construction of TODS. Two versions of TODs were established, one using parental ratings (PR) and the other using clinician ratings (CR).

TODS-PR For the development of the parent-rated version of TODS, parents of individuals with tics subjectively rated symptom severity in accordance with their observations over fixed time periods.

TODS-CR In developing the clinician-rated version of TODS, a semi-structured interview was conducted by clinicians in those with TS and their parents. After using the MINI-KID (child and adolescent version of the Mini International Neuropsychiatric Interview) to determine the presence of TS and comorbidities, clinicians posed questions to the children. Following, parents were asked to contribute to the responses, until clinicians reached an agreement on the rating of each symptom.

Validity A 2007 study by Storch, et al, of 44 children suggested that tic factors in TODS and YGTSS are significantly and positively correlated. Parents and clinicians typically agreed with each other on symptom ratings. On the attention deficit hyperactivity disorder factor and TODS total score, clinicians rated the distress to individuals with tics as significantly greater than parents did. Explanations for this discrepancy mainly highlighted clinicians' greater level of detachment compared to parents, allowing them to be more objective in assessment and attuned to the distress of the individual with tics.

Limitations TODS is unable to measure various aspects of tics to the extent that other instruments do. Only assessing the overall severity of tics, TODS is unable to capture information regarding the frequency, intensity and complexity of the tics, resulting in a lack of precision in symptom measurement. Furthermore, TODS requires over 20 minutes for administration compared to an average of 10 minutes in other instruments, making a more lengthy diagnostic process. The reliability of TODS, like many other instruments, has been tested with a largely Caucasian sample of patients, resulting in low generalizability of findings.

References

Worked examples

Example 1 — a first encounter with Tourette's Disorder Scale

Start with the simplest possible case. Write down what Tourette's Disorder Scale claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Tourette's Disorder Scale before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Tourette's Disorder Scale ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Tourette's Disorder Scale

In research: Tourette's Disorder Scale appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Tourette's Disorder Scale in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Tourette's Disorder Scale is common in secondary-school and first-year university syllabi. It links to neighbouring topics Tics and tic disorders screening and assessment tools, Tourette syndrome, so understanding it makes those chapters shorter.
In everyday life: Look for Tourette's Disorder Scale outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Tourette's Disorder Scale in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Tourette's Disorder Scale means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Tourette's Disorder Scale out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Tourette's Disorder Scale in simple terms?

Why does Tourette's Disorder Scale matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Tourette's Disorder Scale?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Tourette's Disorder Scale.