ARCHETYPE Yale Global Tic Severity Scale - Revised (YGTSS-R) (openEHR-EHR-OBSERVATION.ygtss_revised.v1)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.ygtss_revised.v1
ConceptYale Global Tic Severity Scale - Revised (YGTSS-R)
DescriptionAssessment tool used to quantify the severity of tic symptoms.
UseUse to record the results for each component parameter, the Total tic score and the Global severity score.
PurposeTo record the results for each component parameter, the Total tic score and the Global severity score.
ReferencesLeckman, J. F., Riddle, M. A., Hardin, M. T., Ort, S. I., Swartz, K. L., Stevenson, J. O. H. N., & Cohen, D. J. (1989). The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. Journal of the American Academy of Child & Adolescent Psychiatry, 28(4), 566-573

Storch, Eric A.,Murphy, Tanya K.,Geffken, Gary R.,Sajid, Muhammad,Allen, Pam,Roberti, Jonathan W.,Goodman, Wayne K. (2005). Reliability and validity of the Yale Global Tic Severity Scale. Psychological Assessment, 17(4), 486–491.

Canadian Paediatric society. Revised Version, September 2017. Access date 16.11.21. Retrieved from: https://cps.ca/en/mental-health-screening-tools.

Norwegian translation by Heike Eichele (2021), Regionalt fagmiljø for autisme, ADHD, Tourettes syndrom og narkolepsi Helse Vest, after permission from J. Leckman og J. McGuire. https://www.helsebiblioteket.no/psykisk-helse/skaringsverktoy/ygtss-r-yale-global-tic-severity-scale-revidert?lenkedetaljer=vis
Copyright© Nasjonal IKT HF, openEHR Foundation
AuthorsAuthor name: John Tore Valand
Organisation: Helse Vest IKT AS
Email: john.tore.valand@helse-vest-ikt.no
Date originally authored: 2020-11-16
Other Details LanguageAuthor name: John Tore Valand
Organisation: Helse Vest IKT AS
Email: john.tore.valand@helse-vest-ikt.no
Date originally authored: 2020-11-16
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=openEHR Foundation, references=Leckman, J. F., Riddle, M. A., Hardin, M. T., Ort, S. I., Swartz, K. L., Stevenson, J. O. H. N., & Cohen, D. J. (1989). The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. Journal of the American Academy of Child & Adolescent Psychiatry, 28(4), 566-573 Storch, Eric A.,Murphy, Tanya K.,Geffken, Gary R.,Sajid, Muhammad,Allen, Pam,Roberti, Jonathan W.,Goodman, Wayne K. (2005). Reliability and validity of the Yale Global Tic Severity Scale. Psychological Assessment, 17(4), 486–491. Canadian Paediatric society. Revised Version, September 2017. Access date 16.11.21. Retrieved from: https://cps.ca/en/mental-health-screening-tools. Norwegian translation by Heike Eichele (2021), Regionalt fagmiljø for autisme, ADHD, Tourettes syndrom og narkolepsi Helse Vest, after permission from J. Leckman og J. McGuire. https://www.helsebiblioteket.no/psykisk-helse/skaringsverktoy/ygtss-r-yale-global-tic-severity-scale-revidert?lenkedetaljer=vis, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=CA8BDF6F34305BF58BFB1C4C0EC4ABEA, build_uid=c95b116a-0c82-4572-bd67-461050561680, revision=1.0.0}
Keywordstics, score
Lifecyclepublished
UID0a37f3b6-1424-44c9-a78c-8615389f1d22
Language useden
Citeable Identifier1013.1.5066
Revision Number1.0.0
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Assessment tool used to quantify the severity of tic symptoms., archetypeConceptComment=null, otherContributors=Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor)
Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor)
Terje Bektesevic Holmlund, UiT Norges arktiske universitet, Norway
SB Bhattacharyya, Bhattacharyyas Clinical Records Research & Informatics LLP, India
Heike Eichele, Regionalt fagmiljø for autimse, ADHD, Tourettes syndrom og narkolepsi Helse Vest, Kronstad DPS, Haukeland universitetssykehus, Bergen, Norway
Heather Grain, Llewelyn Grain Informatics, Australia
Mikkel Johan Gaup Grønmo, Forvaltningssenter EPJ, Helse-Nord, Norway (openEHR Editor)
Evelyn Hovenga, EJSH Consulting, Australia
Liv Laugen, ​Oslo University Hospital, Norway, Norway (openEHR Editor)
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
May Lisbeth Østerbøe, Helse-Bergen, HAVO, Norway
Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor)
Mikael Nyström, Cambio Healthcare Systems AB, Sweden
Jack Schjelderup, Helse-Bergen, HAVO, Norway
Norwegian Review Summary, Nasjonal IKT HF, Norway
Rikke Tverberg, Helse-Bergen, HAVO, Norway
John Tore Valand, Helse Bergen, Norway (openEHR Editor)
Marit Alice Venheim, Helse Vest IKT, Norway (openEHR Editor)
Lise Å Boye, Helse-Bergen, HAVO, Norway, originalLanguage=en, translators=
  • Norwegian Bokmål: John Tore Valand, Marit Alice Venheim, Helse Bergen, Helse Vest IKT, john.tore.valand@helse-vest-ikt.no, marit.alice.venheim@helse-vest-ikt.no

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extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0068]/items[at0082], code=at0082, itemType=ELEMENT, level=5, text=Chirping or other bird noises, description=For example: screeching., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0068]/items[at0159], code=at0159, itemType=ELEMENT, level=5, text=Chirping or other bird noises description, description=Narrative description of the chirping or other bird noises., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, 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dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0068]/items[at0086], code=at0086, itemType=ELEMENT, level=5, text=Other animal noises, description=For example: squealing., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0068]/items[at0207], code=at0207, itemType=ELEMENT, level=5, text=Other animal noises description, description=Narrative description of the other animal noises., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0068]/items[at0087], code=at0087, itemType=CLUSTER, level=5, text=Other simple phonic tics, description=List and describe., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0068]/items[at0087]/items[at0088], code=at0088, itemType=ELEMENT, level=6, text=Name, description=The name of other simple phonic tic., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, 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bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0090], code=at0090, itemType=ELEMENT, level=5, text=Syllables, description=For example: "ahhh", "woo", "hmmm"., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0161], code=at0161, itemType=ELEMENT, level=5, text=Syllables descripion, description=Narrative description of the syllables., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0091], code=at0091, itemType=ELEMENT, level=5, text=Words, description=For example: "what", "dang", "Okay"., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0162], code=at0162, itemType=ELEMENT, level=5, text=Words description, description=Narrative description of the words., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], 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ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0093], code=at0093, itemType=ELEMENT, level=5, text=Coprolalia, description=For example: obscene words., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0164], code=at0164, itemType=ELEMENT, level=5, text=Coprolalia description, description=Narrative description of the coprolalia., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem 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[path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0095], code=at0095, itemType=ELEMENT, level=5, text=Palalalia, description=For example: repeating self., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0209], code=at0209, itemType=ELEMENT, level=5, text=Palalalia description, description=Narrative description of the palalalia., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0096], code=at0096, itemType=ELEMENT, level=5, text=Blocking, description=For example: halted speech blocked speech, stuttering., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0210], code=at0210, itemType=ELEMENT, level=5, text=Blocking description, description=Narrative description of the blocking., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0097], code=at0097, itemType=ELEMENT, level=5, text=Speech atypicalities, description=For example: slow/fast speech rate, nasal speech, quivering voice, high or low pitch/tone/volume., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0165], code=at0165, itemType=ELEMENT, level=5, text=Speech atypicalities description, description=Narrative description of the speech atypicalities., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0098], code=at0098, itemType=ELEMENT, level=5, text=Disinhibited speech, description=For example: blurting out words, talking excessively., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0166], code=at0166, itemType=ELEMENT, level=5, text=Disinhibited speech description, description=Narrative description of the disinhibited speech., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0099], code=at0099, itemType=CLUSTER, level=5, text=Other complex phonic tics, description=List and describe., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0099]/items[at0100], code=at0100, itemType=ELEMENT, level=6, text=Name, description=The name of other complex phonic tic., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0067]/items[at0099]/items[at0101], code=at0101, itemType=ELEMENT, level=6, text=Description, description=Description of other complex phonic tic., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0107], code=at0107, itemType=CLUSTER, level=4, text=(Score), description=, comment=null, uncommonOntologyItems=null, occurencesFormal=0..2, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Runtime name constraint:
    • Motor score []
    • Phonic score []
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0107]/items[at0108], code=at0108, itemType=ELEMENT, level=5, text=Number, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: None [No tics present.]
    1: Minimal [Single tic present.]
    2: Mild [Multiple discrete tics (2-5).]
    3: Moderate [Multiple discrete tics (>5).]
    4: Marked [Multiple discrete tics plus as least one orchestrated pattem of multiple simultaneous or sequential tics, where it is difficult to distinguish discrete tics.]
    5: Severe [Multiple discrete tics plus several (>2) orchestrated paroxysms of multiple simultaneous or sequential tics, where it is difficult to distinguish discrete tics.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0107]/items[at0115], code=at0115, itemType=ELEMENT, level=5, text=Frequency, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: None [No tics present.]
    1: Minimal [Specific tics are usually present on a daily basis, but there are long tic-free intervals during the day. Bouts of tics may occur on occasion, but are not sustained for more than a few minutes at a time.]
    2: Mild [Specific tics are present on a daily basis. Tic free intervals as long as 3 hours are not uncommon. Bouts of tics occur regularly, but generally limited to a single setting.]
    3: Moderate [Specific tics are present virtually every waking hour of every day. Bouts of tics are common and may not be limited to a single setting.]
    4: Marked [Specific tics are present every waking hour. Bouts of tics are common and may occur in multiple settings.]
    5: Severe [Specific tics are present virtually all the time. Tic free intervals are difficult to identify and do not last more than 5 to 10 minutes. Bouts of tics are very common and occur in multiple settings.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0107]/items[at0122], code=at0122, itemType=ELEMENT, level=5, text=Intensity, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: None [No tics present.]
    1: Minimal [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.]
    2: Mild [Tics are not more forceful than comparable voluntary actions or utterances, and are typically not noticed because of their intensity.]
    3: Moderate [Tics are more forceful than comparable voluntary actions, but are not outside the range of normal expression for comparable voluntary actions or utterances.]
    4: Marked [Tics are more forceful than comparable voluntary actions or utterances and typically have an "exaggerated" character.]
    5: Severe [Tics are extremely 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.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0107]/items[at0129], code=at0129, itemType=ELEMENT, level=5, text=Complexity, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: None [No tics present.]
    1: Minimal [If present, all tics are clearly "simple" (sudden, brief, purposeless) in character.]
    2: Mild [Some tics are not clearly "simple" in character.]
    3: Moderate [Some tics are clearly "complex" (purposive in appearance) and mimic brief "automatic" behaviors, such as grooming, syllables, or brief meaningful utterances such as "ah huh" or "hi" that could be camouflaged.]
    4: Marked [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 rationalized or "explained" as normal behavior or speech (tapping, saying "you bet", "honey", "FF", "sh", or brief echolalia).]
    5: Severe [Some tics are very "complex" in character and tend to occur in sustained orchestrated bouts that would be difficult to camouflage and could not be easily rationalized as normal behavior or speech because of their duration and/ or their unusual, inappropriate, bizarre or obscene character (a lengthy facial contortion, touching genitals, echolalia, speech atypicalities, bouts of copropraxia, self-abusive behavior, coprolalia).]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0107]/items[at0136], code=at0136, itemType=ELEMENT, level=5, text=Interference, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: None [No tics present.]
    1: Minimal [When ties are present, they do not interrupt the flow of behavior or speech.]
    2: Mild [When tics are present, they occasionally interrupt the flow of behavior or speech.]
    3: Moderate [When tics are present, they frequently interrupt the flow of behavior or speech, but do not disrupt intended behavior or speech.]
    4: Marked [When tics are present, they frequently interrupt the flow of behavior or speech, and they occasionally disrupt intended action or communication.]
    5: Severe [When tics are present, they frequently disrupt intended action or communication.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0143], code=at0143, itemType=ELEMENT, level=4, text=Impairment scale, description=, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: None
    10: Minimal [Tics associated with subtle difficulties in self-esteem, family life, social acceptance, oi school oi 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).]
    20: Mild [Tics associated with minor difficulties in self-esteem, family life, social acceptance, or school or Job functioning.]
    30: 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 die family, frequent teasing by peers or episodic social avoidance, periodic interference in school or Job performance because of tics).]
    40: Marked [Tics associated with major difficulties in self-esteem, family life, social acceptance, or school or Job functioning.]
    50: Severe [Tics associated with extreme difficulties in self-esteem, family life, social acceptance, or school or Job functioning (severe depression with suicidai ideation, disruption of the family (separation/divorce, residential placement), disruption of social ties - severely restricted life because of social stigma and social avoidance, removal from school or loss of job).]
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