Psychosocial Intervention for Young Children with Chronic Tics

Grant Type
Grant Year
Institution Location
Institution Organization Name
University of California
Investigators Name
Piacentini, John, PhD

Our recently completed Comprehensive Behavioral Intervention for Tics (CBIT) study found behavior therapy to effectively reduce tic severity in 9-16 year-old children with TS without any of the side effects commonly associated with anti-tic medication. Based on these results, the goal of the current project is to develop a downward extension of CBIT for use with younger (e.g., 4-8 year old) children. Tics are very common in young children with over half of TS individuals reporting an onset by age 7. However, safety concerns about chronic medication use as well as the lack of well-tested behavioral treatments in young children often leave clinicians in the difficult position of taking a “wait and see” approach with the hope that the tics will dissipate on their own. This TSA research award will allow us to adapt CBIT for use with young children, manualize the new treatment (CBIT-JR), and obtain some preliminary experience with the new manual by using it to treat fifteen 4-8 year old children with chronic tic disorder. The results from this feasibility study will enable us to submit a grant proposal to the National Institute of Mental Health to support a larger, more definitive treatment trial. CBIT-JR is based on the observation that tics are often sensitive to situational factors, including the reactions of other people to the tics. Treatment will be largely parent-directed and will focus on education about tics and methods to reduce or eliminate the triggers and reactions, reported by the parents, to worsen the child’s tics. Habit Reversal Training, the primary behavioral component of CBIT, will not play a large role in CBIT-JR since most young children with tic disorders don’t have the level of self-awareness necessary to practice this technique. It is our hope that CBIT-JR will not only be effective for managing current tics, but will also reduce the likelihood of progression to a more severe tic disorder. John Piacentini, Ph.D., University of California, Los Angeles, CA Douglas Woods, Ph.D., University of Wisconsin, Milwaukee, WI John Walkup, M.D., New York Presbyterian Hospital, New York, NY Award: $62,877 Commentary: The recently completed Comprehensive Behavioral Intervention for Tics (CBIT) study was shown to be effective in reducing symptoms in children of 9 – 16 years of age. In this study, Drs. Piacentini, Walkup and Woods, plan to modify the standard CBIT treatment method so that it can be used to treat children as young as 4 years old. Unlike the standard CBIT procedure, which focuses on Habit Reversal strategies, the modified treatment will teach parents to identify triggers that worsen tics in their children and to reduce or eliminate these triggers. The investigators hope that this strategy will not only be effective for managing tics in young children, but that it may also prevent the development of a more severe tic disorder as the child gets older. Tourette Association of America Inc. – Research Grant Award 2009-2010