Instructional strategies and classroom adaptations for students with Tourette Syndrome in mainstream education: a scoping review

Sammanfattning

Background: Tourette syndrome (TS) is characterized by involuntary, repetitive, and non-rhythmic motor and vocal tics. The manifestation of symptoms is diverse and typically emerges in early childhood, often starting with eye-blinking. Notably, tics cannot be permanently suppressed, which contributes to the high levels of discomfort or stress that children with TS frequently experience in mainstream classrooms. This scoping review systematically explored and mapped existing literature on school-based strategies to help children overcome these challenges, while also assessing teachers' preparedness. Methods: A comprehensive literature search was conducted across four primary databases (PubMed, Eric, PsycINFO, and Scopus). The database search yielded 853 records. Following a rigorous screening process and the removal of duplicates, five peer-reviewed studies were selected based on predefined eligibility criteria. Data from these studies, reflecting various strategies and opinions, were synthesized. Additionally, the ICF-CY framework was chosen to capture and document the health and functioning characteristics of children with TS. Results: The included studies measured perceived usefulness ratings by teachers, students, and parents, as well as school staff opinions on training and helpful strategies. Of the five included studies, only one measured a downstream outcome attributable to an implemented classroom strategy. Furthermore, two studies reported interventions regarding attention and psychomotor functions to ease cognitive overload for children with TS, while only one study captured staff opinions on the control of voluntary movement. One study revealed success post-intervention, but the long-term sustainability remains questionable due to a short and narrow evidence base. Conclusion: Future studies regarding children with TS and their education should be more longitudinal, focusing on classroom observations, objective academic outcomes, attendance, and health-record linkage. In conclusion, this review highlights strategies that proved successful for teachers in mainstream schools, emphasizing the importance of extra education for teachers.