Article - "Old Disorder, New Approach"
 

Just posting for your information.

"Old Disorder, New Approach

A Yale researcher applies behavioral therapy to Tourette Syndrome.
By Erica Westly, posted March 7th, 2007.

Meeting a patient with Tourette Syndrome, it’s easy for people, physicians included, to focus on the most obvious symptom: the tics. But while motor and vocal tics are telling signs of Tourette’s, they only represent part of the disease. Lawrence Scahill, Yale University professor of nursing and psychiatry, presented research on behavioral therapies that target other Tourette’s symptoms, such as anger, at a talk given at New York University’s Child Study Center on February 23."

Rest of article at http://scienceline.org/2007/03/07/he...tly_tourettes/

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J Child Neurol. 2006 Aug;21(8):650-6.

Randomized trial of parent management training in children with tic disorders and disruptive behavior.

* Scahill L,
* Sukhodolsky DG,
* Bearss K,
* Findley D,
* Hamrin V,
* Carroll DH,
* Rains AL.

Yale Child Study Center, New Haven, CT 06520-7900, USA.

Oppositional, defiant, and disruptive behaviors are common in clinical samples of children with tic disorders. In this study, we sought to evaluate the short-term efficacy of a structured parent training program in children with tic disorders accompanied by disruptive behavior. Children with tic disorders and at least a moderate level of disruptive behavior were randomly assigned to a 10-session structured parent management training program or to continue treatment as usual. Twenty-four children (18 boys and 6 girls) between the ages of 6 and 12 years (mean 8.9 +/- 2.0 years) were enrolled; 23 subjects completed the study. At baseline, subjects showed moderate to severe levels of oppositional and defiant behavior. Twenty subjects (83%) were on stable medication. The parent-rated Disruptive Behavior Rating Scale score decreased by 51% in the parent management training group compared with a decrease of 19% in the treatment as usual group (P < .05). On the Improvement scale of the Clinical Global Impression, a rater masked to treatment assignment classified 7 of 11 subjects who completed parent management training as much improved or very much improved compared with 2 of 12 subjects in the treatment as usual group (Fisher exact test, P < .05). These results suggest that parent management training is helpful for short-term improvement in disruptive behavior problems in children with tic disorders. Larger randomized clinical trials are needed.

PMID: 16970865 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

Hmmm, many interesting statements in the article.

Thanks for sharing this.

Thanks, Lara.

Of course, so many unanswered questions....why the anger?

Take care,
Tessa

Hi Tessa,
I know nothing much about this and I haven't read read the full text of the article so can't really comment too much without having done that. I remember posting this one to see what others had to say at the time. No one responded when I posted it and I was a little surprised considering the content.

Anyway, I loathe the term "Habit Reversal Training" because of the implication that tics are habits. They did mention nail-biting and hair pulling specifically in there somewhere though, so that's a whole different ballgame to me. More of a compulsion thing. I can understand using CBT to help with OC behaviours, but not with tics in little children.

It does say in the abstract "Oppositional, defiant, and disruptive behaviors are common in clinical samples of children with tic disorders". So I would guess that the children had other conditions besides their tics. Somewhere in the news article it mentions... "Attention Deficit and Hyperactivity Disorder, Obsessive Compulsive Disorder and Oppositional Defiant Disorder" plus some 83% were taking medications. Don't know what for or which type.