Children with Tourette’s Disorder (TD) can learn to manage their tics through behavioral reinforcement. Habit Reversal Training (HRT) is a behavioral treatment for TD that is currently being studied at several centers. Attention Deficit Hyperactivity Disorder (ADHD) is common in children who have TD. It is possible that children who have ADHD and tics may be less responsive to behavioral intervention because it is difficult for them to pay attention and focus on learning the behavioral techniques. Stimulants seem to be the most effective medications for treating ADHD symptoms in children and adolescents. Our study is designed to explore the question of whether stimulant medication, compared to placebo (a pill of similar appearance but without the medication), will be more effective in helping children with both ADHD and TD manage their tics with behavioral reinforcement. Our hypothesis is that stimulant medication will help children with both ADHD and TD control their tics using HRT because the medication will enable them to improve their attentional functioning. Very preliminary results obtained from the first year of TSA funding, suggest considerable variability in individual response to behaviorally reinforced tic management and to medication. Overall however, our pilot data suggest that stimulant medication may help children with ADHD and TD to manage their tics using behavioral therapy. This study is actively recruiting study participants. Barbara Coffey, M.D., M.S., New York University School of Medicine, New York, NY F. Xavier Castellanos, M.D. New York University School of Medicine, New York, NY Eva Petkova, Ph.D. New York University School of Medicine, New York, NY Douglas Woods, Ph.D. University of Wisconsin, Milwaukee, WI Award: $75,000 (2nd year) Commentary: Habit Reversal Training (HRT) is currently being studied as a treatment for individuals with Tourette Disorder (TD). This procedure requires the individual to pay attention and focus. Children with Attention Deficit Hyperactivity Disorder (ADHD) and tics often find this difficult to do. Therefore, in this study, Dr. Coffey and colleagues are proposing to determine whether the administration of stimulant medication, which can reduce ADHD symptoms, will allow individuals with TD and ADHD to pay more attention and focus better, so that their tics can be helped by HRT. Tourette Association of America Inc. – Research Grant Award 2009-2010