oe QOO YGTSS Yale Global Tic Severity Scale Yale Child Study Center Reprinted by permission of the author, James Leckman, M.D. (tober 1992 versionYALE GLOBAL TIC SEVERITY SCALE NAME: RATER: TODAY'S DATE: LoL MOTOR TIC SYMPTOM CHECKLIST (Chock motor tics prosont during past week and worst ever period.) CURRENT +Simple Motor Tics (Rapid, Darting, "Meaningless Eye blinking Eye movements Nose movements Mouth movements Facial grimace Head jerks/movements Shoulder shrugs Arm movements: Hand movements Abdominal tensing Leg, foot, or toe movements Other (describe): ooceoouoooLcD Eye movements Mouth movements Facial movements or expressions Head gestures or movements Shoulder movements Arm movements Hand movements Writing tics, Dystonic postures Bending or gyrating Rotating, Leg or foot or toe movements Blocking Tic related compulsive behaviors (touching, tapping, grooming, evening-up) coococeooeceeoo QQ Copropraxia Q Self-abusive behavior Q —_Paroxysms of ties (displays), duration __ seconds Q_Disinhibited behavior (describe):* Other (describe) ‘Complex Motor Tics (Slower, "Purposeful": WORST EVER Eye blinking Eye movements Nose movements Mouth movements Facial grimace Head jerks/movements Shoulder shrugs Arm movements Hand movements Abdominal tensing Leg, foot, or toe movements Other (describe): ooooouvceooo Eye movements Mouth movements Facial movements or expressions Head gestures or movements Shoulder movements Arm movements Hand movements Writing ties Dystonic postures Bending or gyrating Rotating Leg or foot or toe movements Blocking Tic related compulsive behaviors ouching, Lapping, grooming, evening-up) Copropraxia Self-abusive behavior Paroxysms of ties (displays), ration __ seconds Disinhibited behavior (describe):* a os000F000000CKC00K00 (Other (describe):PHONIC TIC SYMPTOM CHECKLIST (Check phonic tics for past week and worst ever period.) CURRENT WORST EVER +Simple Phonic Symptoms (Fast, "Meaningless" Sounds): Q “Sounds, noises D Sounds, noises (circle: coughing, throat clearing, (circle: coughing, throat clearing, sniffing, or animal or bird noises) sniffing, or animal or bird noises) Q Other (list): Q Other (list) *Complex Phonic Symptoms (Words, Phrases, Statements): Q Syllables (list) DQ Syllables (list) Q Words (ist) Words (ist) — Coprolalia (ist) Q — Coprolalia (list) Q — Echolalia Q — Echolalia Q Palalalia Palalalia Q Blocking Q Blocking Q Speech atypicalities (describe) Q Speech atypicalities (describe) Q _ Disinhibited speech (deseriey> DDisinhibited speech (descrbey* * Do not incl jons in ratings of tic behaviors NUMBER None Singh We Multiple dicrte tes @5) Multiple discrete tics (3) Malkiple discrete tics plus as rast one orchestrated pattern of multiple simuRiancous oF soquontial te whore iis difficult to distinguish discrete tics Multiple discrete ics plus several (©2) orchestrated paroxysmis of multiple simultaneous | 5 | 5 | 5 | 5 ‘or sequential ies that where iis lficull to distinguish disrete tes FREQUENCY ae] Paar NONE No evidence of apevile tx behaviors ofofote TRARELY Specific ic behaviors have heen present during prs 7)ata)4 behaviors ofr infrequently, often not ona daly hase. If ote of| are brief and uncommon, OCCASIONALLY Specific tc behaviors are usually present ona daily basis, but there | 2 | 2 | 2 | 2 are long tic-froe intervals during the day. Bouls of ies may occur on occasion and are not sustained for more than a few minutes ata time. FREQUENTLY Specific tic behaviors are present ona daily basis. Te feeinenvawas | 3 | 3 | 3 | 3 Tong, as 3 hours are not uncommon, Bouts of tics occur regularly but may be limited to a single eotting. ‘ALMOST ALWAYS Specific lic behaviors are prosent virtually every wakinghourl | 4 | 4 | 4 | @ every day, and periods of sustained tie behaviors occur regularly. Bouts of ties are common and are not limited to a single setting. ALWAYS Specific tic bohaviors are present virually alte time. Three intervasare | 5 | 5 | 5 | 8 difficult to wentfy and do not last more than 5 to 10/munutes at mestINTENSITY Current Worst Ever ‘AUSENT 0 0 MINIMAL INTENSITY Tics nol visible or audible (based solely on patients experience) or tics ure lese forceful than comparable voluntary actions and are typically nol noticed hecause of their intonsit 1 1 MILD INTENSITY Tics are not more forceful than comparable voluntary actions oF utterances and are typically not noticed because oftheir 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 ullerances. They may call altention to Ue individual because of Uhvir forceful character MARKED INTENSITY Tics are more forceful than comparable voluntary actions oF tullorances and typically have an “exaggerated” charactor. Such tes frequently call attention to the individual because of their forceful and exaggerated character. ‘SEVERE INTENSITY Tics are oxtremoly forceful and exaggerated in expression, These tics call attention to the individual and may result in risk of physical injury (accidental, _provoked, or self-inflicted) because of their forceful expression. COMPLEXITY NONE If present, all tics are early "simple (sudden, Priel, purposeless) in character BORDERLINE Some tics aro not clearly "simple" in character, MILD Some tis are cearly “complex” (purposive in appearance) and mimic brie automatic" behaviors, such as grooming, syllables, or brief meani as ‘ah huh," *hi that could be readily camouflaged. MODERATE Some tics are more "complex" (more parposive and sustained in appearance) and may occur in orchestrated bouts that would be dificult to camouflage bbut could be rationalized or “explained! as normal behavior or specch (picking, Lapping, w honey" hei vcholalia). saying "yon bot MARKED Some tics are very "complex" in charactor and lend lo occur in sustained ‘orchestrated bouts that would be difficult to camouflaye and vould not be easily rationalized as normal behavior or speech because of their duration and/or their ‘unusual, appropriate, bizarre or obscene character (a lengthy facial contortion, touching genitals, echolalia, speech atypiealities, longer bouts of saying "what do you mean repeatedly, or saying, "fu" of "sh" 'SEVERE Some tis involve longghy Route of orchestrated bohasior arcpewch that woul be impossible to camouflage or successfully rationalize as normal because of their duration and/or extremely unusual, appropriate, bizarre or obscene character (lengthy displays or ullerances often involving copropraxia,sel-abusive behavior, or coprolalia). INTERFERENCE NONE MINIMAL When tice are present, they de not interrupt the low al behavior or spewh MILD When tics ure procent, they accasionully interrupt the flow of behavior speech MODERATE When tics are present, they frequently inl speech, rapt the flow of Kohavior or w/o MARKED When tics are prosnl, they frequonlly interrupt the low of Behavior or speech, and they occasionally disrupt intended action or communication . ‘SEVERE When tics are present, they frequently disrupt intended action oF communication.IMPAIRMENT Current | Worst ‘NONE 0 0 MINIMAL Tics accocated with subile dficuiics in sal-cstoom, family ile socialacceplance, or] 10 | 10 schoo! ar jab functioning, infrequent upset or cancer ahout tics vi avis the future, perio. 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 selrestcem, family hie, social acceptance, OF 2 | 20 school or job functioning. "MODERATE Tics associated with some clear problems in seli-esteem family ie, social 30 | 30 acceptance, or school or job functioning (episodes of dysphoria, periodic distress and upheaval in the family, frequent toasing hy pwoors ar episodic social avoidance, poridicintorforonce in school ‘or job performance hecause of tics) MARKED Tics associated with major difficulties in selLesteem, family fe, socal acceptance, or | 40 | 40 school or job functioning. ‘SEVERE Tics associated with extreme dificultes in selfestoom, family ile, socal acceptance, or | 50 | 50 school or fob functioning (severe depression with suicidal ideation, disruption of the famuly (separation/divorce, residential placement) disruption of social ties severcly restricted life Ihecimise of social stigaa and sacial avoidance, removal from school or lass of oh).