Comparing the effects of differential reinforcement of other behavior and response-cost contingencies on tics in youth with Tourette syndrome.
DRO and response-cost both slash tics with no rebound, so use whichever fits your case best.
01Research in Context
What this study did
The team worked with kids who have Tourette syndrome.
They used an alternating-treatments design.
Each child got both DRO and response-cost sessions.
The goal was to see which plan cut tics best.
What they found
Both DRO and response-cost gave large drops in tics.
No rebound showed up after either plan.
You can pick either one and expect strong results.
How this fits with other research
Austin et al. (2005) and Fine et al. (2005) say habit reversal training also works for tics.
Those reviews did not test DRO or response-cost, so the new study widens your tool box.
Ellingsen et al. (2014) later showed tics are kept going by urge relief.
That finding helps explain why DRO and response-cost work: they give kids other ways to earn relief.
Why it matters
You now have three solid choices for tics: DRO, response-cost, or habit reversal.
Pick the one that fits your setting and your client’s preference.
Both DRO and response-cost are easy to run in clinic or home sessions.
Start with the plan you can deliver with high fidelity today.
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02At a glance
03Original abstract
Tics are rapid, repetitive, stereotyped movements or vocalizations that arise from neurobiological dysfunction and are influenced by environmental factors. Although persons with tic disorders often experience aversive social reactions in response to tics, little is known about the behavioral effects of such consequences. Along several dimensions, the present study compared the effects of two treatments on tics: response cost (RC) and differential reinforcement of other behavior (DRO). Four children with Tourette syndrome were exposed to free-to-tic baseline, DRO, RC, and quasibaseline rebound evaluation conditions using an alternating treatments design. Both DRO and RC produced substantial decreases in tics from baseline levels. No differential effects of DRO and RC contingencies were seen on self-reported stress or in the strength of the reflexive motivating operation (i.e., premonitory urge) believed to trigger tics, and neither condition produced tic-rebound effects. Implications of these findings and directions for future research are discussed.
Journal of applied behavior analysis, 2012 · doi:10.1901/jaba.2012.45-251