Establishing the feasibility of direct observation in the assessment of tics in children with chronic tic disorders.
Ten-minute, time-sampled video gives clinic-grade tic counts anywhere.
01Research in Context
What this study did
The team asked: can we count tics in kids without long, clinic-only sessions?
They filmed the children with chronic tic disorders for 10 minutes at home and 10 minutes in clinic.
Raters scored tics in 30-second on/off slices. They compared these counts to parent checklists and full-length videos.
What they found
Short clips matched full videos almost perfectly.
Clinic and home counts were nearly identical.
The 10-minute sample beat parent checklists for accuracy.
How this fits with other research
Greenlee et al. (2024) took the idea further. They let software track every move during autism play sessions. No hand scoring, no stopwatch.
Suhrheinrich et al. (2020) did the same trick for treatment notes. They swapped long trial-by-trial coding for a 3-point checklist and kept 99 % agreement.
Guerrero et al. (2022) found the opposite at first glance. They warned that quick rules alone can misread feeding FAs. But when they added brief visual checks, time dropped 30 %. Same lesson: short works if you watch smart.
Why it matters
You can stop booking 60-minute tic observations. Record a 10-minute play or homework slice at home or clinic, score it with 30-second gaps, and you have reliable data. Less child fatigue, happier families, faster graphs.
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02At a glance
03Original abstract
Behavior analysis has been at the forefront in establishing effective treatments for children and adults with chronic tic disorders. As is customary in behavior analysis, the efficacy of these treatments has been established using direct-observation assessment methods. Although behavior-analytic treatments have enjoyed acceptance and integration into mainstream health care practices for tic disorders (e.g., psychiatry and neurology), the use of direct observation as a primary assessment tool has been neglected in favor of less objective methods. Hesitation to use direct observation appears to stem largely from concerns about the generalizability of clinic observations to other settings (e.g., home) and a lack of consensus regarding the most appropriate and feasible techniques for conducting and scoring direct observation. The purpose of the current study was to evaluate and establish a reliable, valid, and feasible direct-observation protocol capable of being transported to research and clinical settings. A total of 43 children with tic disorders, collected from two outpatient specialty clinics, were assessed using direct (videotape samples) and indirect (Yale Global Tic Severity Scale; YGTSS) methods. Videotaped observation samples were collected across 3 consecutive weeks and two different settings (clinic and home), were scored using both exact frequency counts and partial-interval coding, and were compared to data from a common indirect measure of tic severity (the YGTSS). In addition, various lengths of videotaped segments were scored to determine the optimal observation length. Results show that (a) clinic-based observations correspond well to home-based observations, (b) brief direct-observation segments scored with time-sampling methods reliably quantified tics, and (c) indirect methods did not consistently correspond with the direct methods.
Journal of applied behavior analysis, 2006 · doi:10.1901/jaba.2006.63-06