Successful Treatment of the Maladie des Tics

Stevens, Janice R.; Blachly, Paul H.

doi:10.1001/archpedi.1966.02090150085006

Cited by 44 publications

(8 citation statements)

References 8 publications

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“…Similar decreased frequencies of ticing behavior during manual and other competing activities have been reported in other similar cases (Barrett, 1962;Corbett, et al, 1969;Stevens & Blachly, 1966;Thomas, et al, 1971). Confronting Roger with conversation or reading, however, increased the frequency of the tics.…”

supporting

confidence: 73%

“…Many of the more behaviorally oriented treatment procedures have relied on laboratory-produced stimuli (Barrett, 1962), massed practice techniques (Yates, 1958;Clark, 1966) and/or aversive stimuli (Brierly, 1967;Rafi, 1962;Stevens & Blachly, 1966) and have reported only marginal if any success in the transfer of behavioral changes from the treatment setting to the more natural environment of S. In the present study the reinforcement of incompatible behaviors was employed as the basic treatment strategy. Tokens and social reinforcers were used in a structured situation to assess their effectiveness in reducing the rate of ticing behaviors.…”

mentioning

confidence: 96%

“…The irregularity with which neurological and EEG examinations have yielded any diagnostically reliable difference appears to be evidence against an organic basis. Some authors (Prabhakaran, 1970;Stevens & Blachly, 1966) suggest a possible interaction or combination of functional and organic faccors, based primarily on the reported success with drug treatments. As a result of Yates' (1958) early work, tics have more recently been viewed as learned responses (habits) and treated within the frarnework of Hullian learning theory (Clark, 1966;Rafi, 1962;Thomas, et al, 1971;Yates, 1970) ; or as operanc responses which could be modified by the manipulation of the response consequences (Barrett, 1962).…”

mentioning

confidence: 99%

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A Behavioral Treatment Program for the Gilles De La Tourette Syndrome

Doleys

Kurtz

1974

Psychol Rep

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The reinforcement of incompatible behavior in both strucruced and natural environmena was examined as a treatment paradigm for multiple tics displayed by an adolescent boy. The procedure was shown to be effective in reducing the frequency of the behavioral tics and in increasing the rate of more appropriate behaviors. The treatment program concentrated on procedures which maximized rhe transfer of changes occurring in the clinic to more natural environments and the utilization of nonpsychologiscs and behavioral change agents.

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supporting

confidence: 73%

mentioning

confidence: 96%

mentioning

confidence: 99%

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A Behavioral Treatment Program for the Gilles De La Tourette Syndrome

Doleys

Kurtz

1974

Psychol Rep

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“…The observation in the 1960s that haloperidol was effective in reducing tic severity led to a fundamental reconceptualization of Tourette disorder as a neurotransmitter-based neurological disorder42,43 and stimulated a generation of neurobiological research. The results of this study may prompt a similar reconceptualization of tic disorders and provide a new platform for future research.…”

Section: Discussionmentioning

confidence: 99%

Behavior Therapy for Children With Tourette Disorder

Piacentini¹,

Woods²,

Scahill³

et al. 2010

JAMA

636

573

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Context Tourette disorder is a chronic and typically impairing childhood-onset neurological condition. Antipsychotic medications, the first-line treatments for moderate to severe tics, are often associated with adverse effects. Behavioral interventions, although promising, have not been evaluated in large-scale controlled trials. Objective To determine the efficacy of a comprehensive behavioral intervention for reducing tic severity in children and adolescents. Design, Setting, Participants Randomized, observer-blind, controlled trial of 126 youngsters recruited from December, 2004 through May, 2007 and aged 9–17 years with impairing Tourette or chronic tic disorder as primary diagnosis randomized to 8 sessions over 10 weeks of behavior therapy (n=61) or a control treatment consisting of supportive therapy and education (n=65). Responders received 3 monthly treatment booster sessions and were reassessed at 3- and 6-months post-treatment. Intervention Comprehensive behavioral intervention. Main Outcome Measures Yale Global Tic Severity Scale (range 0–40, score >15 indicating clinically significant tics), Clinical Global Impression-Improvement Scale (range 1-very much improved to 8-very much worse). Results Behavioral intervention led to a significantly greater decrease on the Yale Global Tic Severity Scale (24.7; CI:23.1,26.3) to 17.1 CI:15.1,19.1) from baseline to endpoint compared to the control treatment (24.6 CI:23.2,26.0) to 21.1 CI:19.2,23.0) (P<.001; 95% CI for difference between groups: 6.2, 2.0); (effect size=0.68). Compared to children in control treatment, significantly more children receiving behavioral intervention were rated as “very much” or “much improved” on the Clinical Global Impression-Improvement scale (52.5% to 18.5%, respectively; P<0.001; number-needed-to-treat=3). Attrition was low (12/126 or 9.5%); tic worsening was reported by 4% of children (5/126). Treatment gains were durable with 87% of available responders to behavior therapy showing continued benefit 6 months post-treatment. Conclusions A comprehensive behavioral intervention, compared with supportive therapy and education, resulted in greater improvement in symptom severity among children with Tourette and chronic tic disorder.

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“…When they occur in a child with tics, the suspicion of Tourette syndrome becomes quite strong. 4. Reluctance to make the diagnosis in the absence of coprolalia and/or echolalia.…”

Section: Commentmentioning

confidence: 99%

Tourette Syndrome

Golden¹

1977

Am J Dis Child

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I report the clinical details of Tourette syndrome in 15 children. The condition typically starts at age 6 years with eyeblinking, and the child soon develops other tics and abnormal vocalizations. Coprolalia and echolalia occure but are infrequent. The average delay in correct diagnosis in this series was four years. Treatment with haloperidol produces a good or excellent response in three quarters of the patients. Many of the children have a history of encephalopathic events, "soft signs" on neurologic examination, and problems in school. Personal and social adjustmen are generally good, however.

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Successful Treatment of the Maladie des Tics

Cited by 44 publications

References 8 publications

A Behavioral Treatment Program for the Gilles De La Tourette Syndrome

A Behavioral Treatment Program for the Gilles De La Tourette Syndrome

Behavior Therapy for Children With Tourette Disorder

Tourette Syndrome

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