Behavior Therapy has long-term, durable positive outcomes for management of tics in children

USA: A new study published in the Journal of the American Academy of Child & Adolescent Psychiatry shows that despite the limits of unmeasured factors and the accuracy of self-reported follow-up, there is credence to prescribe behavior therapy as the first-line treatment for tics.

Antipsychotic medicines and the Comprehensive Behavioral Intervention for Tics (CBIT) are now the most researched therapy approaches. Several academic/ professional organizations with a focus on the treatment of tic disorders promote CBIT as the first-line solution for those suffering from persistent tic disorders. Flint M. Espil and colleagues undertook this study to investigate the long-term durability of behavior treatment for tics in kids with Tourette syndrome and persistent (chronic) vocal or motor tic disorders.

Of the 126 kids who took part in a randomized controlled trial of behavior treatment 11 years ago, 80 were recruited for this longitudinal follow-up research. Trained evaluators interviewed consenting participants in person or remotely (through Web-based video) to evaluate the course of tics, present tic severity, and tic-related disability. Between 2014 and 2019, recruitment and data collection occurred, with an average follow-up period of 11.2 years.

The key findings of this study were as follows:

1. Tic intensity decreased dramatically throughout the group, with 40% reporting partial remission. On the Yale Global Tic Severity Scale, behavior treatment responders (n = 21) were more likely (67%) to achieve remission at follow-up (Total Tic Score = 12.52, SD = 10.75) than psychoeducation/supportive therapy responders (n = 6, 0%) at follow-up (Total Tic Score = 20.67, SD = 6.92).

2. The sample's tic-related impairment diminished, with no major differences among treatment groups or responders.

In conclusion, researchers, physicians, and organizations with an understanding of chronic tic disorders should make further efforts to raise awareness and accessibility of CBIT.

Reference: 

Espil, F. M., Woods, D. W., Specht, M. W., Bennett, S. M., Walkup, J. T., Ricketts, E. J., McGuire, J. F., Stiede, J. T., A. L., Scahill, L., Wilhelm, S., & Piacentini, J. C. (2022). Long-term Outcomes of Behavior Therapy for Youth With Tourette Disorder. In Journal of the American Academy of Child & Adolescent Psychiatry (Vol. 61, Issue 6, pp. 764–771). Elsevier BV. https://doi.org/10.1016/j.jaac.2021.08.022