Overview

The Brake Shop is a service that helps children and youth with tics and associated neurological disorders.

Examples of neurological disorders include:

  • tourette syndrome and other tic disorders (movement and sound leaky brake)
  • obsessive-compulsive disorder (thought leaky brake)
  • attention-deficit/hyperactivity disorder (attention and impulse leaky brake)
  • disruptive behaviour disorders (reactive anger or rage leaky brake, often a natural and expected extension of struggling to cope)
  • sensory integration issues (sensory input leaky brake)
  • body focused repetitive behaviours (trichotillomania and excoriation disorder; leaky brake over picking and pulling)

In the Brake Shop program, we describe “leaky brakes” as a symptom of neurological disorders. They are not a result of poor parenting or a lack of motivation or intelligence. Just like a car has brakes to stop, children and youth have brakes in their brains to help them stop certain behaviours.

When a child’s or youth’s brakes are leaky, they may have a hard time stopping certain parts of themselves.

Some of us have one leaky brake and some of us have many leaky brakes. Fortunately, the symptoms of leaky brakes can be managed and reduced to help your child reach their potential.

The Brake Shop Clinic is committed to sharing our expertise with community partners through agency-to-agency consultations, presentations on a variety of topics related to tics and disinhibition disorders, collaborative work with community clinicians, and sharing resources.

Eligibility

The Brake Shop provides assessment services for children/youth up to age18 diagnosed (or with a suspected diagnosis) of Tourette Syndrome (TS) or a Tic Disorder. Psycho-social treatment services for Tourette Syndrome, Tic Disorders and associated disinhibition disorders may be considered for children and youth depending on age, intellectual function, treatment service, and treatment readiness.

Treatments for associated neurological and/or disorders of disinhibition for children and youth who do not exhibit tics are limited to treatments for Obsessive Compulsive Disorder and Body-Focused Repetitive Behaviours (i.e., trichotillomania and excoriation/skin-picking disorder), if appropriate.

Generally, local services available to support a child/youth in their home community are accessed first (if available) before a referral to CPRI is considered. This may include a paediatrician, psychiatrist, or a child & youth mental health/developmental service provider.

How to access services

You can submit an outpatient referral form for this service if you are:

  • the child or youth’s parent
  • the child or youth in need of service
  • or a member of the child or youth’s care team (such as doctor, community agency, school, etc.) with the consent of the child or youth, parent/guardian or substitute decision maker
  • in some communities, outpatient referrals are processed through your local Single Point Access Mechanism

All referral forms must be signed by the child or youth’s doctor.

Learn more about the referral process and access referral forms.

How the Brake Shop works

We start by inviting your family to an initial service planning appointment following an assessment with one of our physicians. A clinician will provide information about “leaky brakes” in a child-friendly format.

This appointment will also introduce your family to the Brake Shop Clinic and the services we offer.

We may complete a specialized assessment and develop a treatment plan based on your child’s and family’s strengths and needs.

Where we provide service

We offer Brake Shop services in many different places and formats depending on your child’s needs. You might receive services:

  • at CPRI
  • in your home
  • at your child’s school
  • at community agencies

Many of our treatment programs are offered through videos online so you can access them from a computer anywhere and at any time. We also have videoconferencing options for assessment, consultation and treatment.

Resources

  1. Philosophy
    1. Welcome to the Brakeshop
    2. Treatment philosophy
    3. Tourette syndrome - what it is, what it isn’t
    4. Positive traits of leaky brakes
    5. Leaky braker bill of rights
    6. Welcome to Holland - thoughts on raising a child with disability
    7. Not all wheelchairs are made of metal - philosophy handout
  2. Referrals
    1. Welcome to the Brake Shop Clinic
  3. Treatment and consultation
    1. Tic management fact sheet
    2. Tic management support sheet
    3. ERP treatment fact sheet
    4. ERP treatment support sheet
    5. Self management treatment fact sheet
    6. Self management support sheet
    7. Anxiety management treatment fact sheet
    8. Body focused repetitive behaviours management treatment fact sheet
    9. Body focused repetitive behaviours management support sheet
    10. Sibling consultation fact sheet
  4. Strategy documents
    1. Putting the brakes on behaviour
    2. Putting the brakes on impulsivity
    3. Dr. Mitchell’s ADHD tip sheet
    4. Putting the brakes on inattention
    5. Putting the brakes on anxiety
    6. Putting the brakes on obsessions & compulsions
    7. Putting the brakes on organizational difficulties
    8. Putting the brakes on rage
    9. Putting the brakes on sensory integration
    10. Putting the brakes on sleep difficulties
    11. Putting the brakes on tics
    12. Putting the brakes on writing difficulties
    13. Putting the brakes on body focused repetitive behaviours
    14. Classroom and school approaches
  5. Brake Shop publications
    1. Brake Shop Clinic - 2007 program evaluation
    2. Oh What a Tangled (neural) Web We Weave: a First-person Account of Tourette Syndrome
    3. Promoting Partnerships Between Mental Health and Education to Improve Outcomes
    4. The "Brake Shop": Intervention for Co-Morbid Tourette Syndrome and Intermittent Explosive Disorder
    5. The "Brake Shop": Intervention for Co-Morbid Tourette Syndrome and Obsessive Compulsive Disorder
    6. Multi-Informant Ratings on Behaviour
    7. The Impact of CoMorbid Anxiety Symptoms
    8. Treatment Outcomes for Co-Morbid Tourette Syndrome and Associated Disorders in a Specialized Outpatient Tertiary Clinic
  6. Certificates, posters & printables
    1. Brake Shop clinic - pat on the back certificate

Web resources

Tic disorder/Tourette syndrome

Attention deficit/hyperactivity disorder/learning disorder

Obsessive compulsive disorder/anxiety

Sensory integration

Other