mornin' researchers,

gotta kiddo's psych report that lists ADHD along with "TBA" as a
second diagnosis.  what is that?  guesses welcome but could you float
your answer (yeah, yeah, I know you're not supposed to) in the clarification
area in case I need to give it the jeopardy buzzer.  need a reference
link for documentation, please.

ever grateful,
GB

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Request for Question Clarification by tar_heel_v-ga on 10 Dec 2002 09:48 PST

Granny...

Could it be Transdisciplinary Play-Based Assessment? 
http://www.nauticom.net/www/eita/TPBASpring,98.html

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Clarification of Question by badabing-ga on 10 Dec 2002 09:55 PST

in that it was a diagnosis and doc didn't do a play-based assessment,
don't think so.  this was an older kiddo -- early teens.  hate to do
it but ... eeeeekkkkk.  care to try again?  granny's thinkin' the "b"
is behavior but what's the rest?  grrr.

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Request for Question Clarification by tar_heel_v-ga on 10 Dec 2002 10:10 PST

I took a chance that maybe it wasn't in the diagnosis..oh well...how
about the possibility that he meant TBI as in traumatic brain injury? 
I have found one source (a school system) abbreviating TBI with TBA. 
Just a stab.

-THV

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Request for Question Clarification by answerfinder-ga on 10 Dec 2002 10:17 PST

Could it be 'to be assessed' ?
answerfinder-ga

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Clarification of Question by badabing-ga on 10 Dec 2002 10:19 PST

could be but there was no mention of one.  is there maybe a truancy
behavior dx?  this one has granny stumpified.

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Clarification of Question by badabing-ga on 10 Dec 2002 10:23 PST

could be af.  okay if granny take more guesses first?  maybe something
out there we haven't considered.  this is a terrible way to handle a
question, granny knows and she's so ashamed.

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Clarification of Question by badabing-ga on 11 Dec 2002 08:18 PST

thanks for your guess, denco, but granny actually needs another
diagnosis, preferrably one that fits the DSM-IV
http://www.psychnet-uk.com/dsm_iv/_misc/complete_tables.htm

the only other possibilities I've figured out are pretty lame:
transient behavioral adjustment (moving to new city/school), altho I
haven't found a reference.
TbA = tobacco addiction (told ya it was lame)

can I keep the question open for a month and see if anyone comes up
with anything else?  I'll choose the one most plausible one and have
you post it as an answer.  thanks for playing "name that
abbreviation," folks!  granny so appreciates all your hard work.

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Request for Question Clarification by luciaphile-ga on 11 Dec 2002 11:31 PST

There are a handful of references in the psychological literature,
that seem to relate to theories of behavior, which sounds like it fits
in with what you're looking at.

One of the citations I found has it standing for "teacher based
assessment" in the abstract. Could that be it?

Regards,
luciaphile-ga

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Request for Question Clarification by omnivorous-ga on 11 Dec 2002 13:10 PST

His mechanical parts are wearing out and the doctor, who's really a
mechanic masquerading as a sawbones, meant "TBO" or "time before
overhaul."

Best regards,

O

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Clarification of Question by badabing-ga on 11 Dec 2002 13:34 PST

hi luciaphile,

thanks for your lending a hand here but the teacher-based assessment,
like THV's transdisciplinary play-based assessment are tests, rather
than an actual diagnosis.  both would be included under a heading of
"diagnostic tests" rather than included in the Axis I, II, or III
categories.

granny's not trying to be difficult but the docs rarely use "to be
assessed."  usually it's "diagnosis/condition deferred on Axis I" or
"unspecified mental disorder (nonpsychotic)" or "no diagnosis on Axis
I."  also if an assessment is pending but there is a definite
diagnostic code for a patient, they might use "NOS (not otherwise
specified, i.e. adjustment disorder, NOS.

I'd call the doc but I forgot who gave me this stumper that kept
granny, and hopefully no one else, up last night.

granny also was mulling over:
1)  tumultuous behavior/assault and 2)  teenage boy (with an) attitude
;-) although they don't fit nicely with any DSM classification and
would probably be coded as "conduct disorder" anyway.

a = autism?

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Request for Question Clarification by feilong-ga on 11 Dec 2002 13:44 PST

It could just simply mean "to be announced", meaning that you will
need to wait for confirmation if a second diagnosis is needed.

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Clarification of Question by badabing-ga on 11 Dec 2002 21:27 PST

hello fsw,

if I could give you a bit of a glimpse into granny's day  ... hundreds
of reports from hundreds of doctors from 3 states pop up on her
screen.  she fills in mysterioso blanks no one can decipher.  we're
always on an unbelieveable clock to get the reports back to the docs
before they squawk. it's all very sweatshop, assembly line stuff. 
fast, fast, fast.  and granny never sees a hard copy of these reports.

if she can't determine what the word/abbreviation is, she puts a blank
in the report with what it sounds like, then she's on to the next
blank.  if they're abbreviations, these need to to be spelled out in
the report. usually granny jots down the oddities of the day and
researches them in the evening in case these ever get repeated.  she
didn't know this one was going to be so difficult.

TVH's guess of "traumatic brain injury" sounds the closest, but I
don't recall any head injury for the kiddo, only ADHD.  doesn't mean
he didn't have one since I didn't read the whole report, but I do
remember he skipped school and the family moved a lot.

thanks, fsw, for your "truancy behavior of adolescence."  hadn't
thought of that one.  would you please post that as an answer?  granny
only gets these stumpers once every couple months, thank goodness! 
she will try to write the doctor's name with the oddity du jour but
some days granny can't find her keyboard, let alone a pen/paper.  bear
with me.

thanks everyone for the input and the linkage.  I've written all of
these tests as I didn't have them either.

the very tired and spacy,
GB

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Request for Question Clarification by fsw-ga on 12 Dec 2002 13:36 PST

Hi again Granny,

Thank you for your kind offer to accept my comment as an answer, but
I'm going to respectfully decline. The more I think about it, the less
I think TBA has anything to do with truancy.  Perhaps another
researcher can better demystify this for you.

I still think you're dealing with an erroneous set of letters. Any
chance it should have been TCA for tricyclic antidepressant? As you
know, that wouldn't belong in the diagnostic section of the report
unless the medication was thought to be the cause of the secondary
diagnosis.

I picked the brains of a few of my colleagues at work and they were as
stumped as I was.

Best wishes,
fsw

---

Clarification of Question by badabing-ga on 12 Dec 2002 14:06 PST

thanks for your integrity, fsw, and for checking with your colleagues.
 nope, only letter in question is maybe the "A."  while your offering
was the most plausible so far, it was still gnawing at in granny's
brain cage.

seems lots of folks differ with granny's opinion but I have to work it
from personal experience what sounds right and what does not -- from
"my guy's perspective."  very subjective reasoning, I know.

if anyone comes up with any brainstorms, I'll gladly repost this
stumporama.

truly, thanks a lot for everyone's help with this,
GB

For whatever it is worth...

According to:

Pathology Abbreviations and Acronyms
Jules J. Berman, Ph.D., M.D.

http://www.pathinfo.com/abbtwo.htm

tba = thiobarbituric acid
tba = to be absorbed
tba = to be announced


According to:

ABBREVIATIONS AND ACRONYMS COMMONLY USED IN
BIOMEDICAL RESEARCH AND PRACTICE 

http://gfc.nauta.it/mm/abbreviations.html

TBA : tetrabutylammonium chloride


A cursory search did not seem to indicate
that either tetrabutylammonium chloride or
thiobarbituric acid are used to treat ADHD.

Granny...
I worked in the mental health field for over 20 years
and know of no formal diagnosis corresponding with TBA.
I'd have to agree with answerfinder, that this is the
therapists way of deferring a secondary diagnosis until
they have more information. Although there is a 'formal'
coding for 'deferred', many times informal notations are
used. Are they that hard to get ahold of, that you can't
just phone them up and ask? I'd say 'To Be Assessed".

{see above}

Hello Granny!

This is indeed a stumper! I work in mental health and I checked my
DSM-IV-TR and I don't see anything which would be appropriately
abbreviated TBA. I checked ICD-9 and ICD-10 codes and nothing seemed
obvious there either.

I agree with you that it's unlikely to be an abbreviation for “to be
announced” or any kind of deferred diagnosis. I wonder, rather, if it
is an error in transcription and should have been something like TBI,
as suggested above by Tar_Heel_V. It isn't unusual to see
transcription errors in reports, especially when abbreviations are
used. It's a lot harder to discern a set of spoken letters than a
spoken word when you're transcribing someone's dictation.

I like your creativity in coming up alternatives. Smoking probably
would have been noted with “nicotine” rather than tobacco. And the
behavioral adjustment due to change in schools would likely be noted
on Axis IV under Psychosocial Stressors rather than receiving mention
as a diagnosis. But it's an admirable guess on your part!

One other thought ... Rather than being an error of misunderstanding
in transcription, it could be that the doctor uses TBA as his own
informal abbreviation for “truancy behavior of adolescence.” While
that isn't a formal DSM-IV-TR diagnosis, it's possible that it made
its way by error into the report when his dictation or notes were
transcribed.

Does kiddo have any physical conditions which may be appropriate to
list on Axis III? If so, TBA may refer to an ICD code with which I am
unfamiliar, or it may be an error in transcription for an ICD code.

Alphabetical Listing of ICD-10 Codes for Conditions starting with “T”
http://www.ilds.org/icd10/bydisorder/T.html

ICD-10 T-Codes
http://www.ilds.org/icd10/bycode/T.html


I think your best bet is to figure out where this report came from,
and contact the examiner for the diagnosis. To jog your memory, please
look at the end of the report for a set of initials. One may be the
transcriber's and the other set is probably the clinician's who did
the evaluation. They often look like this:

ABC/def 

"ABC" is usually the doctor or clinician who performed the evaluation.
"def" is usually the person who did the transcribing. Maybe ABC is
enough to jog your memory regarding who gave you this report?

Best wishes,

fsw
Google Answers Researcher