**5. Quality of life**

Children with AT experience varying degrees of difficulty in functioning at school due to progressive neurodegeneration. There is an impairment of fine and gross motor coordination, resulting in reduced writing and computer skills. Dysarthria and delayed speech initiation, poor facial expressions, and delayed reaction time to visual and verbal cues, which limit the ability to communicate, are observed. Eye movement disorders with oculomotor apraxia limit reading ability. Mental and physical fatigue is commonly observed. People with AT, through the prism of motor disability, may additionally be perceived as intellectually impaired without actually having any impairment. Social awareness is usually normal. Although this disparity can lead to social isolation and depression, many people with AT do well to overcome these difficulties, especially in the presence of a supportive environment at school. As survival and quality of life improve, some people with AT manage to complete higher education and lead independent lives with support [85].
