Functional communication training in rett syndrome: a preliminary study.

Three women with classic Rett syndrome, lived in a hospital ward.

None could speak or use their hands. Each wore a voice-output switch on a hip strap.

Staff ran FCT for 10-15 minutes a day. A brief prompt taught them to lean forward and press the switch. The switch said, "I want that," and delivered a snack or toy.

All three learned the lean-and-press move in 1-4 sessions.

Presses jumped from zero to 8-12 per minute. Problem behavior stayed low.

The new request worked with new toys and new staff the same day.

Ghaziuddin et al. (1996) first showed adults with profound ID can learn a VOCA request. McGonigle et al. (2014) copied the idea but proved it works even with Rett’s hand stereotypies.

Howard et al. (2023) later moved the same FCT online. Parents coached via Zoom taught three girls to tap an AAC app. The 2014 switch study opened the door; telehealth walked families through it.

de Jonge et al. (2025) then added page-linking. After kids could request, parents taught them to jump between AAC screens. The skill ladder now runs: switch press → app tap → page link.

You now have a fast first step for clients with Rett. A single switch, one top-up prompt, and a reinforcer can give a voice in under a week. Start here, then move to richer AAC as shown by the later papers.