Assessment and treatment of vocal tics associated with Tourette's syndrome.

A functional analysis suggested that a young man's vocal tics were maintained by automatic reinforcement. A preference assessment was conducted to identify stimuli that effectively competed with the occurrence of vocal tics. When used as components of a reinforcement-based intervention, however, these stimuli were ineffective at reducing the occurrence of vocal tics. Observations conducted in a naturalistic context led to the hypothesis that variations in tics were associated with body positioning. Thus, an additional analysis was conducted to determine if vocal tics occurred less when the participant was lying down versus when he was seated upright. Results suggested that a combination of procedures might be useful in developing idiosyncratic interventions for automatically reinforced problem behavior, such as vocal tics.