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

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

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)125-145
Number of pages21
JournalJournal of Developmental and Physical Disabilities
Issue number1
StatePublished - Feb 2024

Bibliographical note

Funding Information:
This study was funded by grant #1R21DC015021.

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Alternative and augmentative communication
  • Complex communication needs
  • Page-linking
  • Rett syndrome
  • Telehealth

PubMed: MeSH publication types

  • Journal Article


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