Brief report: Fostering environmental control in a young child with rett syndrome: A case study

Rett syndrome is a developmental disability resulting in severe mentaland physical deficits in female children. The syndrome results in progressiveloss of cognitive and motor skills including speech and grasping. Skills arereportedly lost after the first 6 to 18 months of life (Van Acker, 1991),although the assumption of early normalcy has been questioned as moredata have become available on the early developmental histories of thesechildren (Perry, 1991). The etiology of Rett syndrome is as yet obscureand no cure is known. The syndrome may afflict as many as 10,000 girlsin the United States based on the European prevalence data, althoughabout 11% of this figure had been identified as of the mid-1980s (Moser& Naidu, 1986), presumably due to the limited awareness of the syndrome.Stereotypic hand movements are a unique characteristic of Rett syn-drome. Hand wringing occurs with high frequency and may be accompaniedby mouthing of the clasped hands or other forms of stereotyped hand action(Van Acker, 1991.) Purposeful hand movements are lacking. Attention toobjects and events in the physical environment is also reportedly poor.Clearly the lack of ability to reach and grasp objects voluntarily and toattend to external stimuli afford the child with Rett syndrome little oppor-