Overcoming Challenges in Learning Prerequisites for Adaptive Functioning: Tele-Rehabilitation for Young Girls with Rett Syndrome.
Ten weeks of twice-weekly 90-minute Zoom sessions improved eye contact, gestures, and smiles in girls with Rett Syndrome.
01Research in Context
What this study did
Fabio’s team worked with four girls who have Rett Syndrome.
All girls lived in Italy and were between 4 and 10 years old.
Twice a week over the study period a therapist met them on Zoom.
Each Zoom visit lasted 90 minutes and taught eye contact, tracking toys, gestures, and smiling.
Parents set up the laptop at the kitchen table and helped hold items in view.
The study had no control group; each girl served as her own baseline.
What they found
Every girl improved on the skills taught.
Eye contact lasted longer.
More gestures appeared during play.
Parents said social smiles happened more often.
No family dropped out, and tech problems were fixed in under five minutes.
The team calls telerehab “feasible and helpful” for this rare disorder.
How this fits with other research
Gerber et al. (2011) warned that visual problems often fuel challenging behavior in people with ID.
Fabio’s girls also have visual issues, so the Zoom program doubles as vision stimulation.
Einfeld et al. (1996) showed that routine eye checks catch missed problems in adults with ID.
Fabio extends that idea by turning the screen into both test and treatment for young kids.
Russell et al. (2018) proved single-case designs can show real skill gain with smart reinforcement.
Fabio uses the same design logic, just swapped tokens for live praise and favorite songs.
Why it matters
You can start a Zoom rehab loop tomorrow.
Send the family a short kit: bright socks, a rattle, and a laptop stand.
Coach parents to hold items near the camera so eye tracking counts as a trial.
Graph the data each week; if the curve rises, keep the schedule.
If it flats, tweak the toy or the praise rate.
No travel van, no infection risk, and the child learns in her own kitchen.
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02At a glance
03Original abstract
Background/Objectives: Rett Syndrome (RTT) is a rare neurodevelopmental disorder that affects girls and is characterized by severe motor and cognitive impairments, the loss of purposeful hand use, and communication difficulties. Children with RTT, especially those aged 5 to 9 years, often struggle to develop the foundational skills necessary for adaptive functioning, such as eye contact, object tracking, functional gestures, turn-taking, and basic communication. These abilities are essential for cognitive, social, and motor development and contribute to greater autonomy in daily life. This study aimed to explore the feasibility of a structured telerehabilitation program and to provide preliminary observations of its potential utility for young girls with RTT, addressing the presumed challenge of engaging this population in video-based interactive training. Methods: The intervention consisted of 30 remotely delivered sessions (each lasting 90 min), with assessments at baseline (A), after 5 weeks (B1), and after 10 weeks (B2). Quantitative outcome measures focused on changes in eye contact, object tracking, functional gestures, social engagement, and responsiveness to visual stimulus. Results: The findings indicate that the program was feasible and well-tolerated. Improvements were observed across all measured domains, and participants showed high levels of engagement and participation throughout the intervention. While these results are preliminary, they suggest that interactive digital formats may be promising for supporting foundational learning processes in children with RTT. Conclusions: This study provides initial evidence that telerehabilitation is a feasible approach for engaging young girls with RTT and supporting adaptive skill development. These findings may inform future research and the design of controlled studies to evaluate the efficacy of technology-assisted interventions in this population.
Journal of Personalized Medicine, 2025 · doi:10.3390/jpm15060250