Tourette's Syndrome Clinical Trial
Official title:
Psychosocial Intervention for Young Children With Chronic Tics
Analysis of data from the recently completed NIH Child Comprehensive Behavioral Intervention
for Tics (CBIT) study found a manualized behavioral treatment approach strongly superior to
psychoeducation/supportive therapy for reducing tic severity in 9-16 year-old youths with TS
or other Chronic Tic Disorders. Buoyed by the success of the NIH study, the research group
now seeks to extend and disseminate the CBIT treatment through the systematic adaptation of
the CBIT protocol for use across a broader range of ages and treatment settings.
The goal of the this project is to develop a downward extension of the CBIT therapist guide
and parent workbook for use in 4-8 year old children with chronic tics. The revised CBIT-JR
manual/workbook will be pilot tested in five children at each of the three study sites (UCLA,
UWM, Weill Cornell) in order to provide initial data regarding treatment feasibility and
acceptability as well as our ability to implement the new intervention, along with relevant
quality control procedures, consistently across sites. These pilot data will then be used to
seek R01 support for a larger controlled multisite trial examining the efficacy of CBIT-JR.
Although arguably more complex than a single-site design, we have opted for a multsite study
in order: 1) to take advantage of the established productive collaborative relationship and
collective expertise in childhood tic disorders and psychosocial treatment development across
our three sites, 2) to collect the proposed feasibility data in a much shorter period of time
than otherwise possible, and as noted above 3) to demonstrate the cross-site portability of
the treatment - which will be necessary if we are to obtain subsequent funding for a
larger-scale efficacy trial.
The overall aim of the proposed project is to develop and obtain preliminary feasibility and
acceptability data for a family-based behavioral intervention to reduce tic severity and the
negative impact of TS-related symptoms in young children (ages 4-8) with chronic tics and
Tourette syndrome. This intervention entails the use of targeted psychoeducation about tics
and related conditions and a functional analytic protocol designed to identify and correct
environmental influences thought to exacerbate and/or maintain child tic expression. Although
similar to the family-based component used in our recently completed CBITS trial for older
children, an independent body of literature supports the efficacy of functional analysis for
ameliorating a variety of both behaviorally and biologically-driven behaviors. The
investigators will work with an early child interventionist to adapt the current family-based
protocol for younger children. The new manual will then be feasibility tested in anticipation
of a larger externally-funded trial to further develop and evaluate the efficacy of this
intervention.
More specifically, the study aims are to:
1. Adapt the current CBIT Manual for use with the families of 4-8 year old children with
chronic tic disorder. Our revision will be informed by a meeting of the study PI's and
Dr. Mary O'Connor, an early childhood interventionist at UCLA to review our current
family-intervention and other treatment protocols targeting related psychopathology in
young children.
2. Document the feasibility, acceptability, and cross-site portability of the new manual in
a small open trial of 15 youngsters (five each at UCLA, UWM, and Weill Cornell).
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