Language and communication in children with complex tourette syndrome: Insights from five mixed methods case studies

This study aimed to understand and describe language skills and day-to-day communication in five children with complex Tourette syndrome.

We conducted five scaffolded mixed methods case studies. Psychosocial functioning and language skills were measured using standardised tests. We collected information about day-to-day communication using communication log books and semi-structured qualitative interviews. Communication was considered using the bioecological model with a focus on microstructure' contexts (i.e. school, home, and peer interaction).

All children had accessed school accommodations, extra services, or alternative education options. While some parents highlighted school successes, others described significant challenges in finding a fitting school environment for their child. Managing family interaction in the home required parents to be thoughtful and proactive in their planning. Parents strategised to keep the home environment calm and productive, adopted attitudes of acceptance and understanding, and accessed outside tools and supports. In some cases, parents provided social coaching and created intentional social experiences so their child could be successful; in other cases, children were thriving socially without need for parental intervention.

The communication profiles and parent-reported experiences of children with complex Tourette syndrome are diverse. Interventions and accommodations need to be individualised to optimise language development and day-to-day communication.