Mainstream or special secondary school for the health, education, and well-being of adolescents with Down syndrome: A systematic review (Ellis, 2025)
Shumway, Julia, Ellis, Jill, De Stavola, Bianca Lucia, Gilbert, Ruth, Zylbersztejn, Ania,
Developmental Medicine & Child Neurology. Nov2025, p1. 12p. 1 Illustration.
To systematically examine evidence on the impact of attending mainstream compared with special secondary school for adolescents with Down syndrome, in terms of health, education, and well‐being outcomes.We searched four bibliographic databases for studies comparing education and health (including social and self‐care) outcomes in adolescents with Down syndrome who attended mainstream secondary school to those attending special secondary school.Of 4458 publications, we identified three studies from the UK and the Netherlands, which involved 246 adolescents with Down syndrome: 49 attended mainstream and 197 attended special secondary school. Of three studies examining education outcomes, two reported improved attainment among adolescents attending mainstream school, but both were at risk of bias from participant selection, missing data, and deviations to the intended intervention. One study reported social and self‐care outcomes, with no significant differences. No studies reported health outcomes. Studies provided only cursory information about teaching support.Parents, policy‐makers, and others who make choices about education for adolescents with Down syndrome lack evidence on whether outcomes differ, on average, between mainstream and special secondary schools. Well‐designed studies are needed to quantify the impact of secondary school type on outcomes among adolescents with Down syndrome.