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Abstract：
Youth with intellectual and developmental disabilities typically have higher rates of tics and stereotypies compared to children with otherwise typical development. Differentiating between these two pediatric movement disorders can be challenging due to overlapping clinical features, but is relevant due to distinct treatment modalities. The current study evaluated sensitivity and specificity of a tic screening measure, the Motor or Vocal Inventory of Tics (MOVeIT) in a pediatric sample enriched for stereotypy and tics. Children (n=199, age 2-15 years old) receiving care in a developmental-behavioral pediatrics clinic underwent a gold-standard diagnostic assessment by a tic expert; these evaluations were compared to the MOVeIT. The MOVeIT demonstrated good sensitivity (89.8%) and relatively lower specificity (57.1%) compared to tic expert for detecting tics in the overall sample. Specificity of the MOVeIT to identify tics improved to 75% when excluding children with co-occurring stereotypy. For children with tics and co-occurring stereotypy, sensitivity remained high (91.9%) but specificity was low (39.1%). The area under the curve (AUC) value to detect tics on the MOVeIT compared to the tic expert gold standard was significantly higher for children without stereotypy (AUC=85.7%) than those with stereotypy (AUC=64.3%, p <0.01). Overall, the ability to detect tics was better in those without co-occurring stereotypy symptoms. Further work is needed to establish the utility of the MOVeIT in populations where there is a high likelihood of co-occurring tics and stereotypy and in general population settings. Accurate distinction between tics and stereotypy will guide choices for intervention and anticipatory guidance for families.
摘要：
与具有其他典型发育的儿童相比，具有智力和发育障碍的青年通常有更高的抽动率和陈规定型观念。由于重叠的临床特征，区分这两种儿科运动障碍可能具有挑战性。但由于不同的治疗方式而相关。目前的研究评估了抽动筛查措施的敏感性和特异性，儿童样本中的运动型或声乐抽动量表(MOVEIT)，富含刻板印象和抽动。在发育行为儿科诊所接受护理的儿童（n=199，年龄2-15岁）接受了tic专家的黄金标准诊断评估；这些评估与MOVeIT进行了比较。与tic专家相比，MOVeIT在检测整个样品中的tic表现出良好的灵敏度（89.8％）和相对较低的特异性（57.1％）。当排除具有共同发生的刻板印象的儿童时，MOVeIT识别抽动的特异性提高到75％。对于有抽搐和共存刻板印象的孩子，敏感性仍然较高(91.9%),但特异性较低(39.1%).与tic专家金标准相比，在MOVeIT上检测tic的曲线下面积（AUC）值对于没有刻板印象的儿童（AUC=85.7％）明显高于有刻板印象的儿童（AUC=64.3％，p<0.01)。总的来说,在没有共同发生的刻板印象症状的人群中，抽动的检测能力更好。需要进一步的工作来确定MOVeIT在很有可能同时发生抽动和刻板印象的人群以及一般人群环境中的实用性。准确区分抽搐和刻板印象将指导家庭的干预选择和预期指导。
