TicHelper: A Computerized Comprehensive Behavioral Intervention for Tics (CBIT)

Effective non-pharmacological treatment options such as comprehensive behavioral intervention
for tics (CBIT) have been shown to be effective for reducing tics in some children with
chronic tic disorders, including Tourette's disorder. Although effective, many parents and
children do not have access to a provider trained in these therapies and practical barriers
such as travel and high costs for ongoing therapy limit treatment dissemination and
utilization.The investigators recently developed an online, computerized, self-administered
version of CBIT called TicHelper.com. This program is an 8-week online program designed to
teach children and families empirically-supported tic management skills. The current study
will test the efficacy of TicHelper.com in a randomized clinical trial in which 64 children
with Tourette's Disorder or a persistent (chronic) tic disorder will be randomly assigned to
8-weeks of TicHelper.com (N=32) or an 8-week internet resource control condition (N=32). Tic
symptoms will be assessed by a condition-blind independent evaluator at baseline,
post-treatment, and 1-month follow-up. Information regarding patient acceptability of the
program will also be collected. This project will test whether TicHelper.com is an
efficacious and acceptable way to teach tic-management skills for children with tics.

Inclusion Criteria:

1. Child and parent are English speaking.

2. Child meets diagnostic criteria for Tourette's disorder or persistent (chronic) motor
or vocal tic disorder according to the criteria of the Diagnostic and Statistical
Manual of Mental Disorders - 5th Edition.

3. Child scores >70 on a brief intelligence test

4. Child currently engages in at least one motor and/or vocal tic multiple times per day

5. Clinician rated tic severity score of > 3 (mildly ill or worse)

6. Child is unmedicated for tics or associated conditions or has been on stable
psychotropic medication for at least 6 weeks with no changes or planned changes in
dosage.

7. Family has daily access to a personal computer with internet access and software
meeting TicHelper minimum system requirements.

Exclusion Criteria:

1. A Yale-Global Tic Severity Scale (YGTSS) score > 30

2. Child scores < 70 on intelligence test

3. Child meets diagnostic criteria for substance abuse or dependence or conduct disorder
(within past 3 months) according to the criteria of the Diagnostic and Statistical
Manual of Mental Disorders - 5th Edition.

4. Current or past non-drug treatment for tics that consisted of 4 or more sessions of
habit reversal training or CBIT.

5. Child has lifetime diagnosis of mania or psychotic disorder

6. Child has any serious psychiatric or neurological condition not currently being
managed, managed ineffectively, or requiring more immediate treatment other than that
provided by the study.