Clinic helps kids cope with Tourette's
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New Research Study

If you are a child between the age of 7 and 19 years of age and have tics or Tourette syndrome you can help us with a study we are conducting. We are trying to determine if handwriting problems are related to tic disorders. If you want to help with this study please contact Dr. Jan Rowe- Coordinator and Principal Investigator at Jan.Rowe@childrensal.org. She can explain the study to you so you can decide if you want to participate.

Comprehensive Behavior Intervention for Tics (CBIT) is a non-drug treatment consisting of three important components:

  • training the child to be more aware of tics
  • training the child to use “competing” behavior when they feel the urge to tic
  • making changes to day to day activities in ways that can be helpful in reducing tics

Our Program

The program consists of eight weekly sessions with a focus on embedding the tic strategies or “competing responses” into everyday life. The focus of the sessions is on identification of the frequency and severity of tics and teaching alternate strategies to the child. These new strategies help the child manage his or her tic disorder with discretion and confidence. The initial visit for evaluation generally lasts about two hours. Weekly sessions are approximately 45-60 minutes in length. Our program is highly dependent on the commitment of your child adhering to the practice sessions outside of clinic time. An occupational therapy practitioner will work with your child or youth to promote active participation in activities or occupations that are meaningful in his or her daily life. Our occupational therapists will work to help your child develop a competing response for their tics, thereby limiting the interruption of tics on their health, well-being and development.

The innovative clinic housed at Children’s of Alabama and associated with the University of Alabama at Birmingham (UAB) has led to UAB and a consortium of Southern universities being named one of the 10 Tourette Syndrome Association Centers of Excellence by the Tourette Syndrome Association—Tourettecarecenters.org.

How effective is CBIT for someone with Tourette Syndrome?
Results from a large, multi-site National Institutes of Health--funded study show that over half of those who undergo CBIT will have significant reductions in tic severity along with improved ability to function. Complete elimination of all tics and other Tourette syndrome (TS) symptoms is seen occasionally in CBIT, but it is not to be expected. CBIT is not a “cure” for TS, but rather a tool that can help individuals better manage their tics and reduce the negative impact of tics upon their lives.

Additional information
If you are interested in an evaluation for your child, simply call or email for more information. Insurances are accepted, and may cover the evaluation, eight sessions and three booster sessions upon the completion of the program. A physician referral is required.

Contact Us

Phone: 205-638-6820 

Children's Park Place, 3rd Floor
1600 5th Ave. S.
Birmingham, AL 35233
Parking: 5th Avenue Parking Deck

Download the CBIT Flyer

Our Team

Jan Rowe, Dr. OT, OTR/L, FAOTA, earned her doctorate from NOVA Southeastern University in Ft. Lauderdale, FL., in 2004 and has been working exclusively with Tourette syndrome (TS) and tic disorders patients since 2010. She started the Pediatric Tourette Syndrome and Tic Disorder Clinic at UAB in January of 2010; the program is now offered through the Children’s of Alabama Physical and Occupational Therapy Department at Park Place as the CBIT (Comprehensive Behavioral Intervention for Tics) Clinic. The first occupational therapist to coordinate a comprehensive behavioral intervention program for tic disorders, Dr. Rowe now trains occupational therapists throughout the country to work with children who have Tourette syndrome or tic disorders. In addition, she has been appointed to the Medical Advisory Board for the Tourette Syndrome Association.

Leon S. Dure, MD, Division Director for Pediatric Neurology at Children’s of Alabama, has been on the UAB staff since 1994 and has a strong clinical interest in movement disorders affecting children. The Pediatric Movement Disorders Clinic at Children’s, the first of its kind in the South, addresses a variety of conditions -- the most common being tic disorders such as Tourette syndrome. (CBIT is a service of the Pediatric Movement Disorders Clinic.) Dr. Dure served on the Tourette Syndrome Association Medical Advisory Board (1997 -- 2013) and has participated as an investigator in a number of observational and intervention trials in TS.

Drs. Rowe and Dure secured a national Tourette Syndrome Association grant with Cornell Medical School in New York to develop the first CBIT manual for occupational therapists. Through Dr. Rowe’s clinic and research, “Occupational therapists have been found to be effective at delivering CBIT and offer another route to therapy for families.” (Rowe, Yuen & Dure, 2013). Dr. Rowe will continue to teach other occupational therapists the application of this protocol for a wider distribution of services. Currently patients come from all over the country to participate in her program due to the limited availability of this therapy for children with tic disorders or Tourette syndrome.

Kayla Richards and Karmen Mitchell

Karmen Mitchell, MS, OTR/L, earned her bachelor of science degree with a certificate in occupational therapy from the University of Alabama at Birmingham in 1998. In 2012, she completed her post-professional masters of science in the Occupational Therapy program at UAB as well. Karmen spent the early part of her career practicing in acute care, home health and skilled nursing facilities. In 2002,she decided to follow her passion for pediatrics. Karmen has spent the last 15 years working as a school-based occupational therapist. She has also worked as a flexipool O.T. for Children’s of Alabama in inpatient rehabilitation since 2009.

In late 2009, Karmen attended a CBIT training by Dr. Douglas Woods at the University of Alabama at Birmingham. In early 2011, Karmen began in the CBIT clinic established and directed by Dr. Jan Rowe and has continued to work closely with Dr. Rowe since that time, as a research assistant and as a qualified CBIT provider.  Karmen provides services one afternoon each week in the CBIT Clinic at COA.

Kayla Richards, OTRL, earned her master’s degree from the University of Mississippi Medical Center in Jackson, Mississippi in 2012. After working as a traveling occupational therapist in both Florida and California in a variety of populations, she and her husband moved to Birmingham, AL in October of 2016. She is currently working at Children’s on 3rd where she provides services to children with autism, sensory processing disorders, and feeding difficulties. She was trained under Dr. Douglas Woods and Dr. Jan Rowe to work with children who have tic disorders, including Tourette syndrome. Kayla has been training at the CBIT program at Children’s, Park Place since March, 2017. She is now a qualified CBIT Provider and provides services one day a week at Children’s CBIT clinic.