Telerehabilitation in children and adolescents with intellectual disability: a systematic review

Introduction: In recent years, telerehabilitation has been increasingly used to improve access to care for children and adolescents with intellectual disability (ID). However, the available evidence is still limited and highly heterogeneous. This systematic review aimed to evaluate the impact of telerehabilitation interventions on cognitive, behavioural, and functional outcomes in this population. Materials and methods: This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in International Prospective Register of Systematic Reviews (PROSPERO) (CRD420251005874). A comprehensive search of PubMed and Web of Science databases was performed from inception to March 12, 2026. Eligible studies included randomized controlled trials and observational studies investigating telerehabilitation interventions in children and adolescents (≤18 years) with ID. Results: A total of 28 studies involving 668 participants were included. Interventions encompassed a wide range of approaches, including parentmediated programmes, cognitive training, behavioural interventions, and telecoaching models. Across studies, telerehabilitation was generally associated with improvements in language and communication skills, challenging behaviours, executive functions, and motor outcomes. Parent-mediated and telehealthdelivered behavioural interventions showed evidence, especially in reducing externalizing behaviours and parental stress. Digital cognitive training programmes showed feasibility and short-term gains in working memory and attention, although long-term effects were less consistent. Interventions targeting lifestyle and mental health showed promising but preliminary results. However, studies differed substantially in design, intervention protocols, and outcome measures, along with frequent methodological limitations. Discussion: Telerehabilitation appears to be a feasible and potentially effective approach for supporting children and adolescents with ID, particularly when caregivers are actively involved. Larger and methodologically robust studies are needed to better define intervention characteristics and assess long-term outcomes, as well as on the development of hybrid care models integrating inperson and remote approaches.