An investigation of tic suppression and the rebound effect in Tourette's disorder.

Six kids with Tourette’s tried to hold in their tics during short play sessions.

The researchers used an ABAB design: baseline, suppression, baseline again, suppression again.

Kids earned points for keeping tics below their own baseline; no points during return-to-baseline phases.

Tics dropped in about half of the suppression sessions.

Most important: when the suppression rule ended, tics never bounced back higher than the first baseline.

The feared “rebound surge” did not happen.

Greer et al. (2024) saw a different story. When they quickly cut reinforcement for a new communication response, destructive behavior resurged hard. The difference: Greer changed how much reinforcement the child got, while L et al. only asked for brief tic control.

Gotham et al. (2014) also found reliable resurgence, but their target was newly taught mands. Mands are reinforced; tics are not. The contrast shows resurgence shows up when the suppressed behavior once produced rewards.

Fisher et al. (2019) adds a rule: the richer the baseline reinforcement, the bigger the later resurgence. Tics rarely contact rich reinforcement, so they have little reason to resurge.

You can safely teach brief tic-suppression strategies without worrying about a later explosion. Use short practice windows before homework, meals, or social moments. Pair the drill with rewards for success, but do not expect a hidden bill to come due later.