Indicators of School Functioning Among Children With Tourette Syndrome
Previous studies have reported various school-related problems experienced by children with Tourette syndrome (TS), including an increased risk for repeating a grade, problems with reading and writing, academic performance, and a need for educational accommodations. The presence of a co-occurring mental or developmental disorder may further impact educational outcomes. Specifically, attention-deficit/hyperactivity disorder (ADHD) is the most commonly reported co-occurring mental disorder among children with TS and may impact educational outcomes more than TS alone. Although evidence suggests that children with TS may have challenges in the education setting, most of the findings are based on convenience samples or studies with relatively small samples.
The objective of this study was to determine the relation of TS and co-occurring conditions to indicators of school functioning using the nationally representative 2011-2012 National Survey of Children’s Health (NSCH).
Methods Data on 65,548 youth 6-17 years of age from the NSCH were analyzed. Parents reported on whether a health care provider, or educator in the case of a learning disability, had ever told them their child had: TS, ADHD, behavioral or conduct problems, depression, anxiety problems, an autism spectrum disorder, developmental delay, intellectual disability, speech or language problems or a learning disability; and on indicators of school functioning. Children with and without parent-reported TS were compared on each school functioning indicator using prevalence ratios. Adjusted prevalence ratios considered the effect of age, sex, race/ethnicity, and presence of a co-occurring condition.
Results Compared to children without TS, children with TS were at least three times as likely to have each of the co-occurring conditions examined, and were at least two times as likely to have an individual education plan (IEP), and to have their parent contacted about a school problem. Children with TS were significantly less likely to care about doing well in school, or to complete all their homework. There was no difference by TS status in type of school attended (public vs. private or home school). Among US children aged 6-17 whose parent reported they ever had TS, 81% had a co-occurring mental or developmental condition. After controlling for the presence of a co-occurring condition, TS was only associated with an increase in having an IEP.
Conclusions Children with TS have significant challenges related to school, which are strongly associated with the presence of co-occurring mental and developmental conditions.