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. 2024 Feb;36(1):125-145.
doi: 10.1007/s10882-023-09903-x. Epub 2023 Apr 10.

Use of Augmentative and Alternative Communication by Individuals with Rett Syndrome Part 1: Page-Linking

Shawn N Girtler  1 , Emily K Unholz-Bowden  1 , Alefyah Shipchandler  1 , Rebecca L Kolb  1 , Jennifer J McComas  1
Affiliations

Use of Augmentative and Alternative Communication by Individuals with Rett Syndrome Part 1: Page-Linking

Shawn N Girtler et al. J Dev Phys Disabil. 2024 Feb.

Abstract

Although the last decade has welcomed evidence that individuals with Rett syndrome (RTT) can communicate using alternative and augmentative communication (AAC), less is known about effective procedures for teaching various component skills required for expressive communication of individuals with complex communication needs. The purpose of the current study was to evaluate the effects of systematic individualized instruction procedures on the page-linking skills of individuals with RTT. A nonconcurrent multiple baseline design across participants was used to evaluate independent and accurate responding utilizing both a high-tech and low-tech AAC device for three participants. All sessions were conducted in the participants' homes by their parents with remote coaching from a researcher via telehealth. Results indicated that for all three participants, individualized procedures that included behavior chaining, differential reinforcement, and delayed prompting were effective for teaching page-linking in both a high-tech and a low-tech AAC device. Directions for future research and practice are discussed.

Keywords: Alternative and augmentative communication; Complex communication needs; Page-linking; Rett syndrome; Telehealth.

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Conflict of interest statement

Conflicts of Interest/Competing interests The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Example of Low-Tech Discrimination Phase. Note. Picture represents the discrimination phase in which the symbols are all on the front of the book in a field size of 2 or more symbols, and page-linking does not yet occur. Symbols were made using Boardmaker software, and the participant’s parents selected the images
Fig. 2
Fig. 2
Example of Low-Tech Page-Linking. Note. Picture represents the behavior chain for low-tech page-linking, in which the symbols are inside the book, organized by one category per page. Symbols were made using Boardmaker software, and the participant’s parents selected the images
Fig. 3
Fig. 3
Example of High-Tech Page-Linking. Note. This sequence represents the behavior chain for high-tech page-linking. The black circle represents the symbol selected. These screenshots were taken from a participant’s Prolquo2Go application for iOS19. The participant’s previous therapist previously selected the yellow background screen
Fig. 4
Fig. 4. Page-Linking Results. Note.
Percentage of independent and accurate responses (per 5-trial session) across all three participants for high-tech (left) and low-tech (right) AAC devices
See this image and copyright information in PMC

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