A sensory approach to the assessment and treatment of children with tic disorders

Abstract

Tic disorders are the most common movement disorder in childhood. Tics interfere with the child’s quality of life and functions. With 80-90% of children with tics experiencing comorbid neurodevelopmental disorders, assessing and treating children with tic disorders is complex.

Broader hypersensitivities have been reported beyond the premonitory urge in children with tics. There is limited research into sensory dysregulation in patients with tics. With no available disease-modifying or curative therapies for tics, there is a clinical need for research into the prevalence of sensory dysregulation in children with tics and to explore a sensory-based approach to reduce tics.

This thesis details four studies that aimed to improve the understanding of the prevalence of sensory dysregulation, assessment, and treatment of children with tic disorders. Children with tics (n=102) were compared with age- and sex-matched healthy controls (n=61). Children with tics and comorbidities have significant sensory dysregulation compared to healthy controls (P<0.001). A pilot study of a sensory-motor treatment with children with tic disorders (n=10) achieved tic reduction in all participants (Yale Goble Tic Severity Scale mean improvement score of 28.8).

A systematic review was conducted to identify sensory measures with good psychometric properties to comprehensively assess sensory dysregulation with children with tics. Of the 12 proxy-report sensory-based measures from 20 included articles, no measure included all sensory dysregulation experienced by study participants. A qualitative study with 16 families with children with tics was conducted. Using thematic analysis, the findings showed a need for a new proxy-report sensory-based measure for children with tics.

This research provides an extensive understanding of the prevalence of sensory dysregulation, breath of sensory experiences and the effectiveness of a sensory-motor approach to manage tics in children with tic disorders.