Online Remote Behavioural Intervention for Tics (ORBIT-UK): protocol of a single cohort usability study

Area of Science:

• Clinical Psychology
• Child Psychiatry
• Digital Health Interventions

Background:

• Tourette syndrome (TS) is a common, disabling childhood-onset neurological disorder characterized by tics.
• Exposure and Response Prevention (ERP) is an effective treatment for tics, but access is limited by therapist availability and geographical distribution.
• The ORBIT trial demonstrated the clinical and cost-effectiveness of internet-delivered ERP, but the platform required adaptation for National Health Service (NHS) integration.

Purpose of the Study:

• To evaluate the usability and acceptability of a redeveloped internet-delivered ERP program (ORBIT) on an NHS-compliant platform.
• To assess preliminary clinical outcomes of the adapted ORBIT program in children and young people with tics within an NHS tic disorder service.
• To inform future adoption and implementation of digital ERP interventions for Tourette syndrome by the NHS.

Main Methods:

• A single-cohort usability study involving 20 children/young people (aged 9-17) with tics and their supporters.
• Participants received a 10-week online ERP intervention delivered by trained coaches.
• Outcomes measured included uptake, adherence, system usability, satisfaction, tic severity (Yale Global Tic Severity Scale, Parent Tic Questionnaire), Goal-Based Outcomes, and qualitative feedback via exit interviews.

Main Results:

• The study will report on uptake, adherence, and usability metrics of the adapted ORBIT platform.
• Preliminary clinical outcomes related to tic severity and goal achievement will be assessed.
• Participant satisfaction and qualitative feedback on the intervention's acceptability will be collected.

Conclusions:

• The adapted ORBIT platform shows promise for delivering accessible and effective ERP treatment for tics within the NHS.
• Findings will guide the wider implementation of digital tic disorder interventions, potentially improving care for children with Tourette syndrome.
• This study contributes to the evidence base for telehealth in managing childhood-onset neurological conditions.