Development and Open Trial of a Psychosocial Intervention for Young Children With Chronic Tics: The CBIT-JR Study

Area of Science:

• Pediatric Neurology
• Behavioral Psychology
• Child Psychiatry

Background:

• Comprehensive Behavioral Intervention for Tic Disorders (CBIT) is effective for children aged 9+, adolescents, and adults with Tourette Syndrome and Chronic Tic Disorders.
• Tic disorders often begin before age 9, necessitating adapted behavioral treatments for this younger population.
• Developmentally appropriate adaptations of CBIT for children under 9 have not been extensively studied.

Purpose of the Study:

• To adapt and evaluate the acceptability and utility of a family-based Comprehensive Behavioral Intervention for Tic Disorders (CBIT) for children aged 5-8 years.
• To assess the feasibility and effectiveness of a modified CBIT approach in a young pediatric population.

Main Methods:

• A family-based adaptation of CBIT was developed for children aged 5-8 years with chronic tics.
• Intervention included habit reversal strategies in a game format and function-based approaches to reduce family accommodation and attention to tics.
• Fifteen children (5-8 years) were recruited from three study sites.

Main Results:

• Children and parents reported high treatment satisfaction, with a 100% retention rate.
• A 54% treatment response rate was observed (CGI-I = 1 or 2), with significant reduction in Yale Global Tic Severity Scale (YGTSS) total scores (Cohen's d = 0.73).
• Treatment gains were largely maintained at 3-month and 1-year follow-ups, with reductions in tic-related comorbidities and parental accommodation.

Conclusions:

• The adapted family-based CBIT is acceptable and effective for children under 9 with chronic tic disorders.
• Early intervention with adapted CBIT may potentially prevent the chronic course of tic symptoms.
• Further research is warranted to explore parental accommodation and attention to tics as mediators of treatment outcomes.