A Review on Functional Analyses of Tics.
Run an FA for tics—automatic reinforcement is common in Tourette's with intact language, but social functions occur too.
01Research in Context
What this study did
The authors read every published functional analysis of tics. They found 13 studies and wrote a plain story about what each one showed.
Kids and adults in the studies had Tourette syndrome or other tic disorders. Some could talk well. Others had limited language.
What they found
Most tics served an automatic, sensory function. This pattern showed up most in people with Tourette's and intact speech.
Still, a few tics were fed by social attention or escape. The mix of results tells you to test each client yourself.
How this fits with other research
Oliver et al. (2002) warned that protective gear can hide the true reason for self-injury. The same risk may apply to tics: helmets or padding could cut sensory feedback and skew your FA data.
Moya et al. (2022) looked at 21 component analyses and found only half pinpointed one key piece. Their message pairs with J et al.: run a full FA first, then peel off parts only if needed.
Frank-Crawford et al. (2018) showed that high-preference items can lose power when work gets hard. If sensory reinforcers for tics also fade under task load, your treatment might weaken—something to watch after the FA.
Why it matters
Do not guess that tics are "just neurological." Run brief alone and play conditions like any FA. If sensory reinforcement shows up, match it with competing stimulation or response blocking. When social spikes appear, teach replacement requests. Always retest after adding helmets or chewy tubes—they could mask the real payoff.
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02At a glance
03Original abstract
Tic disorders are characterized by a class of responses assumed to be neurobiological in origin. Still, several studies have shown that tic frequency can be influenced by antecedent environmental events and social consequences. Prior reviews have summarized the effects of environmental events but have not examined relations between tic diagnosis, behavioral deficits (e.g., intellectual disability), tic topography, and the consequences observed to maintain tics. These variables might be important when attempting to predict or identify relevant consequences. A more thorough understanding of the variables that maintain and give rise to tics might also be useful in predicting responsiveness to treatment and intervention refinement. We reviewed and summarized results from the 13 attempts to experimentally identify maintaining consequences for tics (i.e., functional analyses) that have been published to date. We examined patterns of functions across tic diagnoses (i.e., Tourette's syndrome or not), communication impairments (i.e., an intellectual disability or reported language difficulty), and tic topography. Results suggested that individuals with Tourette's syndrome and those without communication impairments are more likely to have functional analysis outcomes consistent with automatic reinforcement, but exceptions in both directions highlight the utility of functional analysis in treating tics.
Behavior modification, 2020 · doi:10.1177/0145445518809046