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Dear reader of alt.support.tourette,

My name is Andre Zawallich and I'm a graduate student at the
University of Alberta, Canada. I'm conducting research on
how Tourette's Syndrome affects the lives of 1) people with
Tourette's Syndrome and 2) their family members. I would
like to request your help in filling out a brief survey:

1)   If you are person with Tourette's Syndrome, please
describe how whatever symptoms you have have affected your
day-to-day life, socially, occupationally, recreationally,
and personally. Give as many examples as you can. For each
example, please be as brief as possible, and as specific as
possible.

For example, saying "I got into trouble with the law" is not
as good as "One evening a police officer tried to arrest me
because I was ticcing and swearing in public." Give as many
examples as you can think of, preferably with each new
example as a separate line or paragraph.

Once you have come up with as many examples as you can think
of, please rate how severely Tourette's Syndrome has
affected your life on the following scale:

1     2     3     4     4     6     7     8     9     10
not at all                               very negatively

2)   If you are a family member of a person with Tourette's
Syndrome, please describe how that person's symptoms have
affected your day-to-day life, socially, occupationally,
recreationally, personally. When giving examples, please be
as brief as possible, and as specific as possible.

For example, saying "We don't go to certain public places"
is not as good as "One evening we were asked to leave a
restaurant because our child's tics were disturbing other
customers." Give as many examples as you can think of,
preferably with each new example as a separate line or
paragraph.

Once you have come up with as many examples as you can think
of, please rate how severely your family member's
Tourette's Syndrome has affected your life on the
following scale:

1     2     3     4     4     6     7     8     9     10
not at all                               very negatively

Please tell us about yourself:

1)  Age                 _____

2)  Sex (M or F)        _____

3)  Occupation          _____

4)  Do you have Tourette's Syndrome? (Y or N) _____

5)  Are you a family member of someone
    with Tourette's Syndrome? (Y or N) _____

6)  If you answered yes to (5), what is your 
    relationship to that person? __________________________

7)  How did you learn that you or your
    family member had Tourette's Syndrome? ________________

8)  If you, or your family member with Tourette's Syndrome,
    have any other neurological or psychiatric disorders,
    please list them: ______________________________________

Thanks for your help. Please e-mail your replies to:

azawalli@gpu.srv.ualberta.ca

All responses will be kept anonymous and confidential. If
you have any questions, please feel free to e-mail me at the
above address. Thank you for your help.

Andre Zawallich
Department of Educational Psychology
University of Alberta

supervisor: Dr. Peter Calder
Department of Educational Psychology
6-102 Education North
University of Alberta
Edmonton, Alberta, Canada T6G 2G5

(403) 492-3696 (office)
PETER.CALDER@UALBERTA.CA (internet)


Andre Zawallich
Department of Educational Psychology
University of Alberta, Edmonton, Canada
e-mail: azawalli@gpu.srv.ualberta.ca