Comparing fixed‐amount and progressive‐amount DRO Schedules for tic suppression in youth with chronic tic disorders

Abstract

Chronic tic disorders (CTDs) involve motor and/or vocal tics that often cause substantial distress and impairment. Differential reinforcement of other behavior (DRO) schedules of reinforcement produce robust, but incomplete, reductions in tic frequency in youth with CTDs; however, a more robust reduction may be needed to affect durable clinical change. Standard, fixed-amount DRO schedules have not commonly yielded such reductions, so we evaluated a novel, progressive-amount DRO schedule, based on its ability to facilitate sustained abstinence from functionally similar behaviors. Five youth with CTDs were exposed to periods of baseline, fixed-amount DRO (DRO-F), and progressive-amount DRO (DRO-P). Both DRO schedules produced decreases in tic rate and increases in intertic interval duration, but no systematic differences were seen between the two schedules on any dimension of tic occurrence. The DRO-F schedule was generally preferred to the DRO-P schedule. Possible procedural improvements and other future directions are discussed.

Patterns and Predictors of Tic Suppressibility in Youth With Tic Disorders

“…All authors responded to our inquiry. Data were available for 9 studies ( 5 , 9 , 10 , 12 , 13 , 15 , 19 , 27 , 28 ). Individual-level datasets were no longer available for older studies ( 8 , 14 , 18 , 20 , 26 ).…”

“…Given the central importance of voluntary tic inhibition to nonpharmacological tic management, researchers have studied various questions related to tic suppression using the Tic Suppression Task (TST) developed by Woods and Himle [( 8 ); also see ( 5 , 9 – 15 )]. In this paradigm, a participant is seated in front of a computer or token dispenser and told it is a “tic detector.” In reality, an experimenter unobtrusively observes the child (e.g., using a one-way mirror), and tic frequency is measured via direct observation coding.…”

Patterns and Predictors of Tic Suppressibility in Youth with Tic Disorders

“…All authors responded to our inquiry. Data were available for 9 studies [4,[9][10][11][12]14,18,26,27]. Individual-level datasets were no longer available for older studies [8,13,17,20,25].…”

“…Given the central importance of voluntary tic inhibition to nonpharmacological tic management, researchers have studied various questions related to tic suppression using the Tic Suppression Task (TST) developed by Woods and Himle [8] (also see [4,[9][10][11][12][13][14][15]). In this paradigm, a participant is seated in front of a computer or token dispenser and told it is a "tic detector."…”

A Review on Functional Analyses of Tics

“…Capriotti, Turkel, Johnson, Espil, and Woods (2016) suggested that further refinement of procedures used in CBIT might increase the proportion of individuals who respond to treatment. The form of assessment used during function-based intervention is one component that might benefit from further refinement (Himle et al, 2014).…”