If you have looked into tic treatments recently, chances are you have heard about Cognitive Behaviour Therapy for Tics or CBIT (you can read more about CBIT here. This fairly new tic-targeting therapy involves recognizing when a tic is about to happen and doing a movement that makes preforming that tic difficult, a so-called compe
ting response. While it does require active participation and a high degree of self-awareness, and thus is less suitable for children under age 9, CBIT is considered a highly effective tic treatment.
A new study published in April in the Journal of Neuropsychology suggests that in addition to some children, CBIT may not be effective for another group, young people wi
th TS and ADHD. This is significant given that some 60% or more children have both conditions.
The 2015 study examined something called cognitive control, one’s voluntary control over thoughts and actions, in individuals ages 9-17 with TS, ADHD, and TS + ADHD. When one cartoon came on screen, participants were asked press a button to win a point. Similarly, when a slightly different cartoon appeared on screen, participants were asked to hold off on pushing the button to avoid losing a point. During the study, participants were hooked up to an electroencephalogram or EEG, which detected electrical activity in their brains.
The results showed that young people with ADHD did worse than those without it. Additionally, those with TS took longer to hit the button than youth without TS. Overall, cognitive control among individuals with TS + ADHD was found to be “significantly impaired”. This was not so for individuals with TS only, whose cognitive control was typical.
The study’s authors concluded that these findings have significant implications for the success of therapies designed to reduce tics since therapies like CBIT require a high degree of awareness of one’s own behaviour (an element of cognitive control). According to the authors, their findings suggest “that young people with TS + ADHD might difficulty monitoring and exerting control over their own tics, which could reduce the efficacy of therapy based tic treatments”.
What do you think about these results?
For those with ADHD and TS (or kids with both conditions) – have you tried CBIT? Did it work? Comment down below.
Shepard et al. “The effects of co-occuring ADHD symptoms on the electrophysiological correlates of cognitive control in young people with Tourette Syndrome” Journal of Neuropsychology April 20 2015.