Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious intervention for tic disorders, yet widespread use of CBIT does not yet exist and it can be difficult for many families to find a provider adequately trained in this methodology. When functionally impairing tics are first noticed by parents, or reported to a general practitioner, there appears to be a potential knowledge gap for referral and treatment recommendations, as well as a dearth of adequate resources for families to access appropriate evidence-based interventions. Referrals are most often made to neurology or psychiatry, which can be intimidating for families, and the medication treatments typically offered by these specialists can produce unpleasant side effects. Further, treatment providers in neurology, psychiatry, and psychology are often expensive, associated with stigma, and located in metropolitan or university settings. Given early evidence that occupational therapists (OTs) can deliver CBIT effectively, a dissemination strategy using occupational therapists may improve accessibility to this treatment, at lower cost and with decreased stigma. OTs frequently receive referrals from physicians for young children with common tic co-morbidities (i.e. sensory integration difficulties, attention problems), and are often close collaborators of physicians within pediatric specialties where children with tics first present. This project would be the first step towards gathering empirical evidence for the relative efficacy of CBIT when delivered in this alternative setting. A systematic model for dissemination of CBIT to other disciplines does not yet exist. Thus the goal of this study is to develop and test a training and dissemination paradigm with OTs utilizing an expert, multi-disciplinary team at Weill Cornell/New York Presbyterian Hospital (WC/NYPH) and University of Alabama at Birmingham (UAB). This study aims to adapt the current CBIT manual for use within existing OT practices, and evaluate the feasibility, fidelity, and acceptability of the intervention with the OT infrastructure. Shannon M. Bennett Ph.D., Martha Bruce, M.P.H., Ph.D. & John Walkup, M.D. Weill Medical College of Cornell University Award: $50,000 Tourette Association of America Inc. – Research Grant Award 2013-2014