The main purpose of this trial is to develop and investigate the effects of a modified
comprehensive behavioral intervention for tics (CBIT) protocol for children and adolescents
with chronic tic disorders and ADHD.
CBIT is a first-line behavioral treatment for individuals with tic disorders. However, the
benefit of CBIT is mitigated in those with co-occurring ADHD, as ADHD is negatively
associated with effect size in behavioral treatments for tics. Additionally, while tic
disorders are associated with reduced quality of life measures, CBIT is 'tic-specific.'
Despite improving tics, measures do not show associated improved quality of life. Currently,
there are no standardized behavioral treatments for tics that account for ADHD symptoms
and/or addresses the impact that tics and ADHD symptoms have on quality of life.
The first aim is to develop a treatment protocol that combines elements from CBIT, Cognitive
Behavioral Therapy (CBT) for ADHD and factors targeting psychosocial impairment.
The second aim is to determine the treatment feasibility and acceptability (e.g. retention,
reasons for treatment refusal and dropout, and motivation) of this modified CBIT treatment.
The investigators will evaluate and assess the randomization process, the treatment modules,
and the expectations and satisfaction of the participants and their parents.
The final aim is to use a pilot randomized control trial (RCT) design to evaluate improvement
using measures including tic, ADHD and quality of life scales as rated by a blinded
clinician. Though the investigators will evaluate efficacy of the modified protocol, the
primary purpose will remain feasibility. The hope is to use this study to develop larger
trials in the future.