A functional-analytic approach to the diagnosis of a transient tic disorder.

The diagnostic utility of functional analyses has been demonstrated with a variety of behaviors including tics. Whereas previous analyses have focused on the discovery of maintaining variables to aid in treatment prescription, we employed a functional analysis to confirm a clinical diagnosis. An 11 year old male student, who had not been previously diagnosed with a tic disorder, exhibited multiple vocal tic-like behaviors which had persisted over a period of time. Teacher reports conflicted regarding the possible etiology of these behaviors. Hence, a functional analysis was conducted in the classroom to determine if the behaviors were maintained by operant variables. Our hypothesis stated that the occurrence of vocal behaviors across experimental conditions would strongly indicate the presence of a tic disorder. The functional analysis included the following conditions: attention, escape, alone, freeplay, and high sensory stimulation. We used a multi-element design to evaluate the effects of the different stimulus conditions on vocal-behavior frequency. Data indicated the student exhibited vocal behaviors in all conditions. However, the behaviors were partially exacerbated in the attention and escape conditions. Results supported the diagnosis of a transient tic disorder affected by operant variables.