Introduction: Rett Syndrome (RTT) is a genetic disorder primarily seen in females that inhibits the use of a girl's hands in everyday activities. A girl with RTT spends the majority of her day engaged in stereotypical hand wringing/mouthing movements at midline of the body. The probable cause behind the neurological effects of RTT is a mutation in the gene that encodes for methyl-CpG protein 2 (MeCP2). The hand wringing/mouthing behaviors preclude a girl with RTT from using the upper extremities in purposeful tasks such as school work, play skills, and other activities of daily living. Objectives: To develop a virtual reality (VR)-based therapeutic intervention that 1) decreases upper extremity stereotypies (repetitive movements that serve no function) that interfere with purposeful arm and hand use and 2) promotes purposeful, goal-directed arm function; improve upper extremity motor skills in girls with RTT. Materials and Methods: Using FAAST Software and Microsoft Kinect sensor, one girl with RTT participated in a 12-week IVR intervention (1 hour/session, 3 sessions/week, 36 total hours). Pre-and post-assessments were administered to examine any changes in upper extremity function. Results: The VR intervention led to improvements in use of the upper extremities to complete self-care activities, an increased number of reaches completed in a 15-minute period, and decreased time engaged in stereotypical hand movements. Conclusion: Future work will add additional support to determine the effectiveness of virtual reality as an intervention for girls with RTT.

Introduction: Rett Syndrome is a genetic disorder that limits a girl's ability to use her upper extremities for daily activities, such as dressing and playing. One possible intervention to improve upper extremity function in this population is virtual reality, which can be used to increase activity demands during therapy sessions.Objectives: To determine the feasibility of using internet-based virtual reality intervention for Rett Syndrome (RTT-IVR), to decrease hand wringing/mouthing and increase hand and arm movements away from the midline by identifying attributes and limitations to the proposed intervention. Materials and Methods:Using FAAST Software and Microsoft Kinect sensor, RTT-IVR was trialed with 6 girls with RTT. Upper extremity movements were used to play free Internet games as means of increasing repetitions and purposeful arm movements. Data regarding attributes and limitations of the RTT-IVR intervention were collected via observation and post-session parent interviews.Results: Interviews and observation revealed successful game play when games were motivating, clearly established cause and effect, and matched level of cognitive ability of the participant. Limitations include technological glitches regarding Kinect sensor sensitivity and identifying appropriate games for each participant's interests and abilities.Conclusion: Internet based virtual reality interventions for girls with RTT should be highly individualized to increase motivation and success of intervention.