Use of Augmentative and Alternative Communication by Individuals with Rett Syndrome Part 2: High-Tech and Low-Tech Modalities.
Kids with Rett syndrome can master both high- and low-tech AAC for requests when parents get remote coaching.
01Research in Context
What this study did
EScior et al. (2023) worked with three kids who have Rett syndrome. All were girls who could not talk.
Parents learned to teach both high-tech and low-tech AAC. High-tech was an iPad app. Low-tech was a picture board.
Coaching happened on Zoom. Parents tried each tool on different days. The team counted correct requests.
What they found
Every child learned to ask for toys with both tools. One girl liked the iPad best. Another liked the board. The third switched daily.
No tool won overall. Kids picked what felt easier that day.
How this fits with other research
de Jonge et al. (2025) ran the next step. They showed the same three girls how to link pages on each device. Again, parents coached from home. The kids still succeeded, so the skill stack holds up.
O'Brien et al. (2024) looked at 27 studies and found most kids with IDD prefer high-tech. That seems to clash with EK's mixed picks. The review pooled many diagnoses; Rett kids may differ. A quick preference check before you start beats guessing.
McGonigle et al. (2014) first proved Rett learners can use a voice-output switch. EK widens the menu to boards and tablets, showing the choice itself matters.
Why it matters
You now have data that both options work for Rett syndrome. Start with a 2-minute choice trial: hold the tablet in one hand and the picture board in the other. See which one the learner orients to or touches first. Teach with that tool first, but keep the second nearby. If motivation dips, switch. Remote parent coaching keeps progress moving between clinic visits.
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02At a glance
03Original abstract
The vast majority of individuals with Rett syndrome do not utilize natural speech and therefore require alternative and augmentative communication (AAC). The purpose of the current study was to investigate the use of high- and low-tech AAC modalities by three individuals with Rett syndrome given similar instruction for using both modalities. For all participants, the number of sessions to criterion and cumulative number of trials with independent requests during simultaneous or alternating instruction in the use of a high- and low-tech AAC modality were investigated. Parents conducted all sessions with remote coaching from a research assistant via telecommunication. Each participant exhibited idiosyncratic response patterns in terms of use of their high- and low-tech AAC modalities during instruction but ultimately demonstrated the ability to use both modalities to make requests. Implications for future research and practice pertaining to AAC of individuals with complex communication needs are discussed. This paper is a companion to Girtler et al. (2023).
, 2023 · doi:10.1007/s10882-023-09902-y