Efficacy of Habit Reversal Training in Children With Chronic Tic Disorders: A Within-Subject Analysis.

Viefhaus et al. (2020) gave 16 weekly habit-reversal sessions to kids with Tourette syndrome. They watched each child for eight weeks first to get a clear tic baseline.

After the baseline, the kids learned awareness training, competing responses, and self-confidence skills. The team then compared tic scores before and after treatment.

Tic severity dropped enough for parents and doctors to notice. Kids also felt more in control of their tics after the 16 lessons.

Motor tics happened less often during short video clips. Standard rating scales showed the same clear improvement.

Moritz et al. (2021) tested self-help HRT for body-focused habits and saw weaker results. The drop-off was small, likely because kids taught themselves without a clinician guiding each step.

Sievers et al. (2020) used ACT instead of HRT for hair pulling and still cut symptoms. Both studies show different behavioral roads can lead to less repetitive behavior.

Coffey et al. (2021) used single-case logic to curb severe problem behavior in autism. Their tight within-subject design mirrors Paula’s pre-post method, giving extra confidence that behavioral plans can shrink tough symptoms.

If you treat tics, schedule a baseline phase first. Sixteen clinician-led HRT sessions can give clear, visible gains you can show parents on a chart. Track both tic counts and the child’s own rating of control; both moved in this study. When a family wants faster help, point to Moritz et al. (2021) and explain that self-help HRT exists but may yield smaller wins.