Feasibility of reliable, remote assessment of a 13-year-old boy who stopped talking

Construction of rating scale

The initial protocol was performed utilizing three rating scales suitable for children with catatonia (American Psychiatric Association, 2013; Benarous et al., 2016; Bush et al., 1996). On their own monitors in different locations, all raters viewed an edited video of clinical assessments of a 16-year-old boy displayed by the coordinator. The video was shown once before the raters independently completed 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 authors 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 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 Northoff, et al., 2001) (Table 1). Since some subtleties of subcategories were missing, we construct a more detail spreadsheet including major and minor criteria in the scales (Table 2). 

Legends for Figures and Tables

Table 1. Representation of key criteria for catatonia in leading clinical criteria and rating scales suitable for children. ICD11 (ICD-11 for Mortality and Morbidity Statistics, 2024); DSM5American Psychiatric Association, 2013), BFCRS (Bush, et al., 1996), NCRS (Northoff, et al., 2001), PCRS Northoff, et al., 2001). 1 = present, 0 = absent.

Table 2. Representation of detailed criteria for catatonia in leading clinical criteria and rating scales suitable for children. ICD11 (ICD-11 for Mortality and Morbidity Statistics, 2024); DSM5American Psychiatric Association, 2013), BFCRS (Bush, et al., 1996), NCRS (Northoff, et al., 2001), PCRS Northoff, et al., 2001). 1 = present, 0 = absent, empty cell = absent.