Using the internet to treat children with tics

Tics are repetitive, involuntary movements and noises. A new project is testing treatment for children using the internet. Per Andrén, psychologist and doctoral student at the Department of Clinical Neuroscience, explains how the project works.

Per Andrén, credit: Christopher Hunt.
Per Andrén, photo: Christopher Hunt

Text: Viktor Karlsson, first published in Swedish in the magazine Medicinsk Vetenskap No 3, 2016.

How common are tics and who do they affect?

"About one in a hundred people have the best-documented type – Tourette’s Syndrome – which involves both motor and vocal tics. Tourette’s is to some extent hereditary and more common in boys than in girls. Tics usually start between the ages of 3 and 9 and are usually worse at particular times and better at others. They are at their worst between the ages of 9 and 13, and there is often a distinct decline in symptoms in the later teenage years, although they may continue into adulthood."

How will your new study work?

"A group of 20 children diagnosed with Chronic Tic Disorder or Tourette’s will have ten weeks of internet-based treatment. The condition is traditionally treated using medication, but in this study we will instead be using two different types of behavioural treatment. In one of them, the child will practise becoming more aware of when a tic is coming and trying to block it with a different type of movement. In the other, the child will practise resisting their tics for a longer period without any such movement."

Why have you chosen to carry out this treatment over the internet?

"We want to develop a treatment that can be used throughout the country, even in places where there is a lack of specialist health professionals and the nearest treatment facility is a long way away. While in their own home, the child will be able to read information provided, watch instructional videos and do exercises that will all help them resist involuntary noises and movements. During the treatment, the child and their parents will have regular contact with a psychologist through a chat feature on the treatment platform. However, all assessments of the children and follow-ups will take place at our clinic."

How do you see internet treatment in the future?

"It could be an important step towards making behavioural treatment more accessible. But even if it proves effective, it is not the intention that it should replace all other types of treatment for the condition. It is likely that some people will still need alternative treatments such as medication in the future."

What can those in the child’s immediate environment do to help?

"Many people do not know a great deal about tics, and so a useful first step is to learn more about the condition. As part of our treatment, we provide the child and their parents with some basic information. They are also given advice on what they can tell their teachers, coaches and friends. It is important for people around them to understand that the child is not doing it on purpose. If people make comments about tics it can make them worse."