In chapter one, a scoping review and narrative synthesis of empirical evidence from nine studies reporting primary data related to school-based support strategies for children and young people (CYP) with chronic Tic Disorders (TD) was carried out. Findings revealed a paucity of empirical evidence and significant heterogeneity among included studies. Four thematic sub-groups were used to discuss key findings: limited knowledge and experience of teachers and school-staff; learning: barriers, accommodations, and classroom strategies; enhancing understanding and empathy in peers of CYP with TD; and effective systemic communication.

In Chapter two, an empirical study aimed to build consensus among healthcare experts to: define and characterise a realistic service model of care with a remit of assessing, diagnosing, and treating TD in CYP; and to identify potential obstacles and facilitators to establishing and implementing said service model. A panel of ten experts participated in a three-round e-Delphi study. In Round one, experts provided free-text responses to 7 open-ended questions. Researchers qualitatively generated 28 statements from round one responses which experts rated on relative agreement and/or importance in subsequent survey iterations across Round two and three. The study was successful in gaining expert consensus on key aspects comprising the proposed model of care for CYP with TD: service configuration, funding arrangements, operational structure, interventions and barriers and facilitators to service implementation. A ranking hierarchy identifying prioritised professional roles for newly commissioned services was also created.

In Chapter three, the implications of the findings from the first two papers are collectively considered in the context of theory development, clinical practice and future research. The thesis then concludes with a reflective commentary from the first author.