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. n-acetyl-leucine n-acetyl-leucine is an orally administered, modified amino acid that is being developed as a novel treatment for multiple rare and common neurological disorders by intrabio inc (oxford, united kingdom). n-acetyl-leucine has been granted multiple orphan drug designations from the u.s. food & drug administration (fda) and the european medicines agency (ema) for the treatment of various genetic diseases, including ataxia-telangiectasia. n-acetyl-leucine has also been granted orphan drug designations in the us and eu for related inherited cerebellar ataxias, such as spinocerebellar ataxias. u.s. food & drug administration (fda) and the european medicines agency (ema). published case series studies have demonstrated the positive clinical benefit of treatment with n-acetyl-leucine various inherited cerebellar ataxias. a multinational clinical trial investigating n-acetyl-l-leucine for the treatment ataxia-telangiectasia began in 2019. intrabio is also conducting two parallel clinical trials with n-acetyl-l-leucine for the treatment niemann-pick disease type c and gm2 gangliosidosis (tay-sachs and sandhoff disease) future opportunities to develop n-acetyl-leucine include lewy body dementia, amyotrophic lateral sclerosis, restless leg syndrome, multiple sclerosis, and migraine. prognosis median survival in two large cohorts studies was 25 and 19 years of age, with a wide range. life expectancy does not correlate well with severity of neurological impairment. epidemiology individuals of all races and ethnicities are affected equally. the incidence worldwide is estimated to be between 1 in 40,000 and 1 in 100,000 people. research directions an open-label phase ii clinical trial studying the use of red blood cells (erythrocytes) loaded with dexamethasone sodium phosphate found that this treatment improved symptoms and appeared to be well tolerated. this treatment uses a unique delivery system for medication by using the patient's own red blood cells as the delivery vehicle for the drug.