Abstract
The Comprehensive Behavioral Intervention for Tic Disorders (CBIT) has demonstrated efficacy in large randomized controlled trials for children (≥9 yrs), adolescents and adults with Tourette Syndrome and Chronic Tic Disorders. Given the early age of onset for tic disorders, a large portion of affected individuals with chronic tic disorders are less than 9 years of age and appropriate developmental adaptations of behavioral treatment have not yet been tested. The goal of this study was to adapt and evaluate the acceptability and utility of a family-based adaptation of CBIT for children under 9 years of age. Children 5–8 years of age (N = 15) with chronic tics were recruited from three study sites. CBIT was adapted for use with young children and included habit reversal strategies introduced in a developmentally appropriate game format and function-based interventions to reduce family accommodation of and attention to tic symptoms. Children and parents described high level of treatment satisfaction and study retention rate was 100%. Treatment response rate was 54% (CGI-I = 1 or 2) with a significant decrease in the YGTSS total score (Cohen's d = 0.73) that was largely maintained at 3-month and 1-year follow-up assessments. Treatment was associated with reduction of some symptoms of tic-related comorbid syndromes and with changes in parental accommodation and attention to tics. Future research should determine if parental attention to tics and symptom accommodation are important mediators of treatment outcome, or if participating in this intervention at a younger age may prevent the chronic course of tic symptoms.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 659-669 |
| Number of pages | 11 |
| Journal | Behavior Therapy |
| Volume | 51 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jul 2020 |
Funding
☆ Funding Source: Tourette Association of AmericaThe authors would like to acknowledge Jennifer Schild, B.S. and Shannon Gasparro, B.A. for their assistance in manuscript preparation and formatting, and the Tourette Association of America for funding this study. ☆☆ Statement of DisclosuresShannon Bennett, Ph.D. has received grant funding from the Tourette Association of America. She is a member of the Medical Advisory Board of the Tourette Association of America and has received honoraria from the Tourette Association of America for speaking engagements and as a trainer in the Tourette Syndrome Behavior Therapy Institutes.Matthew Capriotti, Ph.D. has received grant funding from a Clinical Research Training Fellowship co-sponsored by the Tourette Association of America and the American Academy of Neurology. He has also received honoraria from the Tourette Association of America for speaking engagements and as a trainer in the Tourette Syndrome Behavior Therapy Institutes.Christopher Bauer, MA has nothing to disclose.Susanna Chang, Ph.D. has nothing to disclose.Alex E. Keller, M.A. has nothing to disclose.John Walkup, M.D. has received past research support from the National Institute of Mental Health for federally funded studies including free drug and placebo from Pfizer in 2007 to support the Child Adolescent Anxiety Multimodal study; free medication from Abbott in 2005 for the Treatment of the Early Age Media study; free drug and placebo from Eli Lilly and Co. in 2003 for the Treatment of Adolescents with Depression study. He currently receives research support from the Tourette Association of America and The Hartwell Foundation. He has received honoraria and travel expenses for speaking engagements and meetings sponsored by the Tourette Association of America. He has received royalties from Guilford Press and Oxford University Press for multi-author books published about Tourette syndrome and from Wolters Kluwer for CME activity on childhood anxiety. Dr. Walkup has served as an unpaid advisor to the Anxiety Disorders Association of America, and the Trichotillomania Learning Center. He has served as a paid speaker for the Tourette Syndrome - Center for Disease Control and Prevention outreach educational programs, the American Academy of Child and Adolescent Psychiatry, and the American Psychiatric Association.Douglas Woods, Ph.D. receives royalties from Oxford University Press, Springer Press, and Guilford Press, and has received grant or research support from the NIMH and the Tourette Association of America. He has received speaking fees and/or travel support from the Tourette Association of America.John Piacentini, Ph.D., ABPP has received grant or research support from NIMH, the TLC Foundation for Body-focused Repetitive Behaviors, the Tourette Association of America, The Pettit Family Foundation and Pfizer Pharmaceuticals through the Duke University Clinical Research Institute Network. He receives royalties from Guilford Press and Oxford University Press. He has received speaking fees and/or travel compensation from the Tourette Association of America, the International Obsessive Compulsive Disorder Foundation, and the TLC Foundation for Body-focused Repetitive Behaviors.
Keywords
- Tourette Syndrome
- behavior therapy
- young children
ASJC Scopus subject areas
- Clinical Psychology