Mindy Meyers, a nurse practitioner, uses behavioral techniques—and her therapy dog—to help children and teenagers with Tourette syndrome overcome tics.
It's hard to believe I was initially reluctant to study pediatric neurology. Now I can't imagine not working with children.
Early in my career, after completing my nurse and nurse practitioner degrees and a master's in mental health, I took a course in comprehensive behavioral intervention for tics (CBIT) at UCLA. This approach teaches children how to identify their tics, slow them down, and in some cases eliminate them.
Over time, children become more aware of their tics and when they might be coming on. They get a premonitory urge almost like a sneeze. If the tic is throat clearing, a child might feel a tickle in the throat beforehand. In my work with kids, I teach them to do deep belly breaths as soon as they feel the tickle. The deep breathing reroutes messages in the brain to tell the tickle it's not going to turn into throat clearing. Eventually the urge disappears.
To stop eye rolls, an involuntary movement that can appear disrespectful to parents and teachers, I instruct kids to look at the person's nose instead of the eyes. Looking down slightly keeps the child's eyes from rolling up.
Recently I've brought Ivy Joy, my therapy dog, into some sessions with children. Ivy is attuned to their emotions and can sense when they are about to have a tic storm—several tics happening at once that can debilitate a child. Ivy can anticipate tic attacks, which allows me to ask if anything might be bothering the child and contributing to the tics. During the session, Ivy will play with them and do tricks, which often helps the children control their tics. It also strengthens their ability to manage tics in other situations.
In my private practice outside Chicago, I have seen more than 500 children and teenagers, and 90 percent of them have been able to eliminate their tics after four to six months of treatment. I continue to meet with some kids for maintenance therapy to help them through certain situations as they get older. I've noticed that teenagers are not always motivated to stop tics until they're in high school and interested in relationships.
There's evidence that my success rate is not an anomaly. A study published in the Journal of the American Academy of Child and Adolescent Psychiatry in 2021 followed 80 people with Tourette syndrome for more than 11 years and found that nearly 70 percent responded to CBIT.
I used to doubt that I could help children overcome such a stigmatizing syndrome. I also wasn't sure kids with other conditions such as autism, severe ADHD, and obsessive-compulsive disorder would benefit from this therapeutic approach. Now I regularly see children blossom and thrive in ways I never thought possible.
