A systematic review of 28 studies found telerehabilitation interventions generally improved language, communication, behavior, and motor skills in children and adolescents with intellectual disability, particularly when parents were involved , though study quality and long-term outcomes remain understudied.
Telerehabilitation, the delivery of rehabilitation services through digital platforms, has expanded significantly as a way to increase access to care for children and adolescents with intellectual disability (ID). This systematic review, published in Frontiers in Psychiatry, synthesized evidence from 28 studies involving 668 total participants to evaluate whether these remote interventions actually improve meaningful outcomes. The authors searched PubMed and Web of Science from inception through March 2026 and followed PRISMA guidelines, registering the review in advance with PROSPERO.
The interventions examined were diverse, spanning parent-mediated programs, cognitive training modules, behavioral interventions, and tele-coaching models. Despite this heterogeneity, a consistent pattern emerged: across the included studies, telerehabilitation showed positive associations with improvements in language and communication skills, challenging or externalizing behaviors, executive functions like working memory and attention, and motor outcomes. This breadth of positive findings across different outcome types suggests telerehabilitation may have genuine utility rather than benefiting only a narrow domain.
Parent-mediated and telehealth-delivered behavioral interventions emerged as the most evidence-supported category. These approaches specifically showed measurable reductions in externalizing behaviors (aggression, defiance, rule-breaking) and also decreased parental stress, a critical secondary outcome often overlooked in rehabilitation research. This dual benefit, affecting both child behavior and caregiver wellbeing, points to why caregiver involvement appears central to telerehabilitation effectiveness. Digital cognitive training programs demonstrated feasibility and short-term gains in working memory and attention, though the review flagged a concerning limitation: long-term effects were inconsistently measured and less durable than immediate post-intervention changes. Interventions targeting lifestyle factors and mental health showed promise but the authors appropriately labeled these results as preliminary, indicating insufficient evidence to draw firm conclusions.
However, the review identified substantial limitations across the evidence base. Studies differed markedly in design (some were randomized controlled trials, others observational), the specific protocols used, and which outcomes they measured. These differences made it impossible to pool results statistically or make direct comparisons. Methodological quality was frequently compromised by small sample sizes, lack of blinding, high dropout rates, or unclear reporting of methods. The authors did not shy away from this reality, explicitly stating that larger and more rigorously designed studies are needed before firm recommendations can be made about which telerehabilitation approaches work best, for whom, and how long benefits persist.
If you are a parent or caregiver of a child with intellectual disability, this review suggests telerehabilitation is worth discussing with your child's healthcare team as a potential complement to in-person care, particularly if in-person access is limited. The strongest evidence supports interventions where you actively participate in delivering strategies at home, which aligns with the intuitive idea that rehabilitation benefits from practice in real-world settings. Behavioral interventions appear more established than purely cognitive computer-based training, though both showed positive signals.
The review does not support telerehabilitation as a complete substitute for in-person care. The authors explicitly recommend development of "hybrid care models" integrating remote and in-person approaches. This hybrid model makes practical sense: some children may benefit from in-person assessment and initial coaching, followed by remote monitoring and reinforcement, or vice versa. You should expect that telerehabilitation interventions will likely show benefits in the short term, but long-term sustainability remains an open question that your clinician should help you plan for.
From a practical standpoint, if you are considering a telerehabilitation program, ask your provider about the evidence quality of that specific intervention. This review shows that not all telerehabilitation is equal: parent-mediated behavioral programs have more rigorous support than off-the-shelf cognitive training apps. Ask about how long benefits typically persist, what parent involvement looks like, and how the program integrates with any in-person services your child receives.
| Detail | Information |
|---|---|
| Study type | Systematic review |
| Database searched | PubMed, Web of Science |
| Studies included | 28 |
| Total participants | 668 |
| Participant age | ≤18 years with intellectual disability |
| Intervention types | Parent-mediated programs, cognitive training, behavioral interventions, tele-coaching |
| Primary outcomes | Language/communication, behavior, executive function, motor skills |
| Outcome tier | (moderate evidence from heterogeneous observational and RCT designs) |
| Key limitation | High heterogeneity, methodological limitations, limited long-term follow-up data |
| Journal | Frontiers in Psychiatry |
| Registration | PROSPERO (CRD420251005874) |
Frontiers in Psychiatry: Telerehabilitation in children and adolescents with intellectual disability: a systematic review
https://pubmed.ncbi.nlm.nih.gov/42368820/
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