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Behavior therapy for children with Tourette disorder: a randomized controlled trial
John Piacentini1, Douglas W Woods, Lawrence Scahill
1UCLA Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room 68-251, Los Angeles, CA 90024, USA. jpiacentini@mednet.ucla.edu
JAMA
|May 21, 2010
Summary
A comprehensive behavioral intervention significantly reduced tic severity in children and adolescents with Tourette disorder. This effective treatment showed durable results, offering a promising alternative to antipsychotic medications.
Area of Science:
- Neurology
- Child Psychiatry
- Behavioral Science
Background:
- Tourette disorder is a chronic childhood-onset neurological condition.
- Antipsychotic medications are first-line treatments but have adverse effects.
- Behavioral interventions require evaluation in large-scale controlled trials.
Purpose of the Study:
- To determine the efficacy of a comprehensive behavioral intervention for reducing tic severity in children and adolescents.
- To compare behavioral intervention with a control treatment in a randomized trial.
Main Methods:
- A randomized, observer-blind, controlled trial involving 126 children (aged 9-17) with Tourette or chronic tic disorder.
- Participants were assigned to either a comprehensive behavioral intervention (n=61) or supportive therapy and education (n=65).
- Assessments included the Yale Global Tic Severity Scale and Clinical Global Impressions-Improvement Scale, with follow-up at 3 and 6 months.
Main Results:
- Behavioral intervention resulted in a significantly greater decrease in tic severity (Yale Global Tic Severity Scale) compared to the control group (P < .001).
- More children in the behavioral intervention group showed significant improvement (Clinical Global Impressions-Improvement scale; 52.5% vs 18.5%, P < .001).
- Treatment gains were durable, with 87% of responders maintaining benefits at 6 months, and low attrition (9.5%).
Conclusions:
- Comprehensive behavioral intervention is more effective than supportive therapy and education for improving symptom severity in children with Tourette and chronic tic disorder.
- This intervention offers a viable, effective treatment option with durable results.
- Further research should explore long-term efficacy and broader implementation.
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