strive to appear normal to their peers and teachers. Life within the ataxic body can be tiring. The enhanced effort needed to maintain appearances and increased energy expended in abnormal tone and extra movements all contribute to physical and mental fatigue. As a consequence, for some a shortened school day yields real benefits. General recommendations All children with A–T need special attention to the barriers they experience in school. In the United States, this takes the form of a formal IEP (Individualized Education Program). Children with A–T tend to be excellent problem solvers. Their involvement in how to best perform tasks should be encouraged. Speech-language pathologists may facilitate communication skills that enable persons with A–T to get their messages across (using key words vs. complete sentences) and teach strategies to decrease frustration associated with the increase time needed to respond to questions (e.g., holding up a hand and informing others about the need to allow more time for responses). Rarely helpful are traditional speech therapies that focus on the production of specific sounds and strengthening of the lip and tongue muscles. Classroom aides may be appropriate, especially to help with scribing, transportation through the school, mealtimes and toileting. The impact of an aide on peer relationships should be monitored carefully. Physical therapy is useful to maintain strength and general cardiovascular health. Horseback therapy and exercises in a swimming pool are often well tolerated and fun for people with A–T. However, no amount of practice will slow the cerebellar degeneration or improve neurologic function. Exercise to the point of exhaustion should be avoided. Hearing is normal throughout life. Books on tape may be a useful adjunct to traditional school materials. Early use of computers (preschool) with word completion software should be encouraged. Practicing coordination (e.g. balance beam or cursive writing exercises) is not helpful. Occupational therapy is helpful for managing daily living skills. Allow rest time, shortened days, reduced class schedule, reduced homework, modified tests as necessary. Like all children, those with A–T need to have goals to experience the satisfaction of making progress. Social interactions with peers are important, and should be taken into consideration for class placement. For everyone long-term peer relationships can be the most rewarding part of life; for those with A–T establishing these connections in school years can be helpful. Treatment No curative medication has been approved for the treatment of inherited cerebellar ataxias, including Ataxia-Telangiectasia.