Background: The closure of all educational institutions and most rehabilitation centres represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children with RTT through an interactive school program.Methods: The Interactive School palimpsest was composed of moments in which a teacher spoke directly to children with RTT and expected a response through eye gaze, and moments in which storeys-cartoon were presented while tracking the eye gaze of children. We investigated behavioural, social and cognitive parameters.Results: Children participated in both social and cognitive tasks with the spontaneous reduction of stereotypies and with increase in attention. They recalled more significant indexes when music or a song was presented together with a cartoon or a cognitive task.Conclusions: This study provides initial insights in promoting cognitive and social interactions and in the support needs of families with a child with RTT during the COVID-19 pandemic.

Background The closure of all educational institutions and most rehabilitation centers represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children and girls with RTT, through the interactive school program Methods The Interactive School palimpsest was composed of moments in which the teacher spoke directly to the subjects with RTT and expected a response through eye gaze, and moments in which stories-cartoon were presented while tracking the eye gaze of the patients. We investigated behavioural, social and cognitive parameters. Results Patients attended both social and cognitive tasks with the spontaneous reduction of stereotypies and with the increase of attention. They recalled more significant indexes when the music or the song was presented together with the cartoon or the cognitive task. Conclusions this study provides initial insights in promoting cognitive and social interactions and into the support needs of families with a child with RTT during the COVID-19 pandemic.

The "Interactive School" project originated in a historical moment in which Italy and almost all countries in the world are experiencing and facing the fear of coronavirus disease 2019 (COVID-19) contagion. Many countries, including Italy, have imposed the closure of schools, universities, and all centers that host patients with Rett Syndrome (RTT), a rare disease that heavily impacts on autonomy, mobility, and some cognitive and communication abilities of the affected subjects. As a consequence, we decided to launch a remotely operated, Interactive School program specifically oriented to Rett patients, and in this article, we briefly provide a report of the ongoing activity. The Interactive School project exploits an easy-to-use technological system designed to be as acceptable as possible for families with RTT patients. We are currently using this system with positive feedback from both families and patients. This is encouraging and confirms the design and realization choices. Public Significance StatementThis study advances the idea that both parents and therapists working with subjects with Rett Syndrome can benefit from a remotely operated Interactive School program. This Interactive School program may be easier to incorporate into both clinical settings and patients' daily life.

Background: The closure of all educational institutions and most rehabilitation centres represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children with RTT through an interactive school program. Methods: The Interactive School palimpsest was composed of moments in which a teacher spoke directly to children with RTT and expected a response through eye gaze, and moments in which stories-cartoon were presented while tracking the eye gaze of children. We investigated behavioural, social and cognitive parameters.Results: Children participated in both social and cognitive tasks with the spontaneous reduction of stereotypies and with increase in attention. They recalled more significant indexes when music or a song was presented together with a cartoon or a cognitive task. Conclusions: This study provides initial insights in promoting cognitive and social interactions and in the support needs of families with a child with RTT during the COVID-19 pandemic.