Feasibility of reliable, remote assessment of a 13-year-old boy who stopped talking
Creators: name: Kadubandi, Neeraj
name: Elshourbagy, Abdelwahab
name: Balousha, Abrar
name: Smith, Landon
name: Tacik, Pawel
name: Barnett, Jacqueline
name: Brasic, James
Publisher: name: Zenodo
Year: 2025
Subjects: Catatonia
Rating scale
Virtual

description: Neeraj Kadubandi, Abdelwahab Elshourbagy, Abrar Balousha, Landon Smith, Pawel Tacik, Jacqueline Barnett, James Robert Brašić 

Construction of rating scale 

The initial protocol was performed utilizing three rating tools suitable for children with catatonia (American Psychiatric Association, 2013; Benarous, et al., 2016; Bush, et al., 1996). On their own monitors in different locations, three investigators viewed an edited video of clinical assessments of a 16-year-old boy displayed by the coordinator. The edited video was shown to all raters together once before each rater independently completed rating of each scale. If an item could not be scored based on the clinical video, raters scored the item with and X. First, they rated Bush, et al., 1996, then, Benarous, et al., 2016, and finally, American Psychiatric Association, 2013. After each scale was completed, the coordinator obtained the independent scores of all raters and conducted a consensus conference to attain agreement on the scores for each item. If the raters did not agree on a score, then the consensus score was . (period) to indicate lack of agreement.  The investigators then sought to conduct a comprehensive review of all rating scales for catatonia to construct an optimal scale including the crucial items from extant scales. A recent systematic review (Hirjak, et al., 2024) identified two clinical criteria (American Psychiatric Association, 2013; ICD-11 for Mortality and Morbidity Statistics, 2024) and two scales (Bush, et al., 1996; Northoff, et al., 2001) as the most widely utilized scales so those scales were used to construct our optimal scale. Since we aimed to rate videos of a child, we also utilized the Pediatric Catatonia Rating Scale (Benarous, et al., 2016). 

We then constructed a spreadsheet with the key criteria for each scale and each of the scales identified with a column as follows: ICD11 (ICD-11 for Mortality and Morbidity Statistics, 2024), DSM5 (American Psychiatric Association, 2013), BFCRS (Bush, et al., 1996), NCRS (Northoff, et al., 2001), and PCRS (Benarous, et al., 2016) (Table 1).

Because many scales included many specific items, Table 1 was expanded to include all the detailed items of the five target rating procedures (American Psychiatric Association, 2013; Benarous, et al., 2016; Bush, et al., 1996; ICD-11 for Mortality and Morbidity Statistics, 2024; Northoff, et al., 2001) (Table 2). 

The authors then sought to construct a checklist of behaviors that could be identified on remote viewing of a video of a prior motor assessment of a patient. Since the patient could not be interviewed to determine subjective experiences, items were limited to objective movements and utterances. Since clinical motor assessment examinations were viewed on videotapes, specific durations and repetitions actions and utterances were omitted. The goal was to construct a checklist for items to identify as present with a 1 or absent with a 0 on viewing the videotape (Table 3).  The authors then sought to organize the rating form in a manner that could be readily scored by raters viewing virtual motor assessments once (Table 4).