CBIT

Clinic helps kids cope with Tourette's
from uabnews on Vimeo.

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 

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


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.


Testimonials

Anonymous
I just wanted to let you know what a FANTASTIC experience my daughter recently had with Dr. Jan Rowe. Truly, she has been an angel in our lives, and I wanted to pass that on. Over the years my daughter has a variety of tics, with the most obvious one being eye blinking. It didn’t bother her until this year, when classmates started commenting. Dr. Dure, our physician, had told us about the alternative therapies, and with his referral we began seeing Dr. Rowe.

In the first session, she started making strides I never expected. By the sixth session her blinking tic was basically undetectable. While I've always felt fortunate to have a hospital like Children's close by, this experience brought me to a new level of gratitude. Dr. Rowe was a joy to work with and so kind to my daughter. I'm also so appreciative to Dr. Dure for his expertise and leadership in managing her tics.

What your clinic does is life-changing. Thank you for your hard work, your research, and the options you provide families. I know Dr. Rowe has done TV appearances in the past, and I hope all of you keep getting the message out, because so many families in Alabama can benefit as we have.

Jamie Mobley Hagy
My daughter is 9 and she was diagnosed last year with TS. Dr Basically told us there was nothing we could do that he didn’t drug patients to keep them from being made fun of. We went to a TS meeting TSA of Birmingham support group and found out about CBIT...got in the right hands...my daughter did her 8 weeks therapy...we go back for a booster sometime before school starts.

I cannot say enough good...we started with 6 different tics...today she has one tic and it is the original tic (we call it the OG tic) but where it used to involve her whole face and was constantly...now it is only blinking her eyes one long blink...and usually only when she is tired or sick. She still doesn’t feel tic so its hard to redirect urge to tic if you don’t feel it.

I highly recommend CBIT with Dr Rowe. She was great and everyone we worked with there was awesome!

Linda
My name is Linda and Lucas is my 17 year old son. He began with Tourette Syndrome in fourth grade. Prior to this everything was great, grades very good and was in our school's gifted program. Now everything begins to get worse no matter what we tried, declining grades, increased tics among other things. We tried everything thing including prescription meds, neuro-feedback, diet, vitamins and relaxation tapes. When he was failing ninth grade we all went to a seminar and heard about CBIT. This was a blessing! Beginning from the first session he began dropping tics one each week til all gone! Today he is doing great. No visible tics and if one starts, he knows how to address it. He is now only being treated for ADD. We can now focus on a happy future. Our thanks to Dr. Rowe & CBIT.

Laura McRae
I have 2 children that have experienced tics. My son is now 10 and was showing facial tics for a few years and my daughter who is 8 was having a hard time with a frequent abdominal tic. This program has worked for both of them in just a short period of time. I am amazed at how simple yet effective the competing response can be. I can't say enough about Dr. Jan Rowe and her gift in helping children in this way.

Joy Germanos
As a parent, I am so appreciative of the opportunity that my son had to participate in the CBIT clinic. Dr. Rowe and her clinic treated all of us with such dignity and understanding that my son felt comfortable trusting in this process to help him with his tics. I have found Dr. Rowe to be extraordinarily compassionate and knowledgeable in her approach. As a result of participating in the CBIT Clinic, I feel that the life trajectory for my son has been forever changed for the better-he is now equipped with skills that he can use anywhere to manage his tics. With these skills, he has a new sense of mastery and self-confidence which help him to thrive in all areas of his life.