Creating a computerized self-administered version of Comprehensive Behavioral Int

描述（由申请人提供）：该II期SBIR计划扩展我们成功的I期活动，以完成开发并测试一种创新的基于计算机的治疗递送产品的有效性，用于慢性抽动障碍（CTD，包括抽动秽语障碍）儿童及其家庭。CTD代表了一类神经精神疾病，发生在0.6% -3%的学龄儿童中，可导致身体、社会、学术和人际功能的严重损害，并降低生活质量。目前，没有治愈CTD，但在大规模随机对照试验；一种被称为抽搐综合行为干预（CBIT）的非药物治疗被证明可以减少抽搐，而且没有与药物治疗相关的不良副作用。治疗师指导，经验验证的CBIT协议是可用的；然而，绝大多数渴望CBIT的人没有机会接触到受过这种干预训练的治疗师。考虑到需要为患有慢性阻塞性肺病的儿童提供非药物治疗方案，潜在的最终用户需要这种治疗，以及缺乏在治疗方面受过充分培训的从业人员，显然需要创新的传播模式。在我们最近完成（并且成功）的第一阶段项目之后，目前的建议是与PsycTech Ltd公司的CBIT干预的两个主要开发人员合作，最终开发和测试一个高度可访问且相对便宜的CBIT计算机自助版本。我们第一阶段项目的结果表明，TICHELPER的原型版本在可行性、可接受性和可用性方面获得了专业人员和最终用户（患有CTD的儿童及其父母）的高评价。I期试点研究的结果也表明，TICHELPER对减轻核心CTD症状有效。I期的结果有力地证明了II期的有效性，在II期期间，我们将充分开发和测试Tic Helper的疗效。该II期提案旨在(1)与最终用户一起使用迭代反馈过程，将CBIT协议的剩余核心组件（即放松训练、基于功能的干预和完全开发的习惯逆转模块，以解决核心CTD症状）开发成自我管理的在线格式；(2)在随机对照试验中比较TICHELPER与基于互联网的资源（IBR）条件的疗效。

DESCRIPTION (provided by applicant): This Phase II SBIR proposes to expand upon our successful Phase I activities to finalize development and test the efficacy of an innovative computer-based treatment-delivery product for children with Chronic Tic Disorders (CTD; including Tourette Disorder) and their families. CTD represents a class of neuropsychiatric disorders, occurring in 0.6-3% of school-aged children that can lead to significant impairments in physical, social, academic, and interpersonal functioning and reduced quality of life. Currently, there is no cure for CTD, however in large-scale randomized controlled trials; a non-pharmacological treatment known as Comprehensive Behavioral Interventions for Tics (CBIT) was shown to reduce tics without the adverse side effects associated with pharmacotherapy. A therapist-guided, empirically validated CBIT protocol is available; however the vast majority of individuals who desire CBIT do not have access to therapists trained in the delivery of this intervention. Given the need for non-pharmacological treatment options for children with CTD, a desire for such treatments by potential end-users, and the absence of practitioners adequately trained in the treatment, there is a clear need for innovative modes of dissemination. Following our recently completed (and successful) Phase I project, the current proposal partners two of the primary developers of the CBIT intervention with PsycTech Ltd., to finalized development and test a highly accessible and relatively inexpensive computerized self-help version of CBIT. Results from our Phase I project demonstrated that a prototype version of TICHELPER received high ratings from both professionals and end-users (children with CTD and their parents) on indices of feasibility, acceptability, and usability. Results from the Phase I pilot study also sho that TICHELPER was effective for reducing core CTD symptoms. Phase I results strongly justify Phase II, during which we will fully develop and test the efficacy of Tic Helper. This Phase II proposal aims to (1) use an iterative feedback process with end-users to develop the remaining core components of the CBIT protocol (i.e., relaxation training, function-based intervention, and the fully developed habit reversal module to address core CTD symptoms) into a self-administered online format, and (2) to compare the efficacy of TICHELPER to an Internet-Based Resources (IBR) condition in a randomized controlled trial.