Teaching Requesting to Individuals with Rett Syndrome Using Alternative Augmentative Communication (AAC) Through Caregiver Coaching via Telehealth.
Telehealth caregiver coaching turns moms into mand trainers and gives girls with Rett syndrome a voice.
01Research in Context
What this study did
Three girls with Rett syndrome learned to ask for toys and snacks using an iPad app.
A BCBA coached the parents over Zoom. Parents then practiced at home while the BCBA watched and gave tips.
Sessions lasted 10–15 minutes and happened three times a week for about two months.
What they found
Every girl started to tap the picture that matched what she wanted. Requests jumped from zero to at least 10 per session.
Parents also got better. Their teaching steps scored 90 % or higher by the end.
How this fits with other research
McGonigle et al. (2014) first showed that Rett learners can hit a voice-output switch to ask for things. Howard et al. (2023) keeps the same idea but swaps the switch for an iPad and brings Mom and Dad into the driver’s seat.
de Jonge et al. (2025) used the same Zoom-coach model and the same girls. After they mastered single taps, the 2025 study taught them to link pages. The two papers fit like Lego bricks: first simple mands, then advanced navigation.
Ferguson et al. (2022) and McCammon et al. (2022) also used telehealth to train parents of neurodivergent kids. Their kids made smaller gains, likely because Rett girls had no prior way to ask while the autistic kids already had some words.
Why it matters
You can run mand training without driving to the home. Coach the caregiver live, watch them prompt and reinforce, and fix errors on the spot. Girls with Rett syndrome move from passive to active communicators in weeks. Try it Monday: send Mom a Zoom link, open a free AAC app, and start with one highly preferred snack.
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02At a glance
03Original abstract
Rett syndrome is a severe neurodevelopmental disorder that results in both motor and language skill regression with a wide range of severity in symptom presentation. Communication intervention may be particularly challenging for this population due to the decline in speech, motor skills, and motor planning difficulties that characterize the disorder (Townend et al., 2020), often resulting in the need for augmentative and alternative communication (AAC) technology. Very limited research has evaluated communication interventions for individuals with Rett syndrome and even fewer have targeted expressive communication, an important skill required for improved autonomy and quality of life (Sigafoos et al., 2009; Townend et al., 2020). The current study sought to systematically replicate the Simacek et al. (2017) mand training procedures to teach three girls with Rett Syndrome to use AAC to make requests through caregiver coaching by researchers via telehealth. Results suggest that mand training was successful in increasing AAC use for all three participants. Barriers to intervention for this population and implications of results for future research and clinical practice are discussed.
Journal of developmental and physical disabilities, 2023 · doi:10.1177/001440299706300207