ADAPTIVE TECHNOLOGY FOR RETT SYNDROME STUDENTS

Most individuals with Rett Syndrome, do not have functional verbal skills. So, for this population, implementation of AAC strategies EARLY will help provide the best outcomes. Volitional hand control is usually limited because of severe difficulties with apraxia. They will need additional time to generate a response, so keep that in mind when asking questions or giving a command.

Many individuals with Rett Syndrome use nonstandard behaviors for communication. For example, to make a request, a person with RETT may walk towards or lean towards an object. Some of the behaviors to be on the lookout for are: vocalizations, laughing, crying, eye gaze, head or body movements. These nonstandard behaviors are often described as prelinguistic, in that they don’t meet the criteria for symbolic communication, but if acknowledged as communicative or potentially communicative, a meaningful, symbolic act can be shaped.

The communication partner, someone who is familiar with the individual with Rett, can provide an abundance of information about interests and help you interpret the meaning of these behaviors. Consideration of alternative access for AAC using body parts other than the hands, including head, arm, or eyes should be a primary goal.

There’s lots of interest at present in using electronic eye gaze systems, and there’s some excellent research that demonstrates individuals with Rett have gaze patterns similar to typically developing children (Djukic & McDermott, 2012; Djukic et al, 2012).

HERE ARE SOME IDEAS FOR BEST PRACTICES IN AAC INTERVENTION:

  • Begin by teaching a simple requesting response
  • Ensure the targeted response is within the individual’s physical abilities – consider nonstandard behaviors
  • Touch a switch
  • Hand movement
  • Natural gesture
  • Assess use of eye gaze
  • Offer choices
  • Develop consistency across two favored objects
  • Explore expanding set to three or more choices
  • Begin with no-tech; establish a consistent, valid level of response
  • However, allow for inconsistency (remember – apraxia can affect consistent motor responses)
  • Allow time to respond – many individuals with RTT have delayed responses
  • Assess an individual and adjust your expectations
  • Move to low-tech or high-tech, depending upon:
    • Interest level
    • Skill
    • Resources
    • Contexts

SPECIFIC INTERVENTIONS:

The evidence for successful use of AAC with RTT is limited, but here are some techniques that are discussed widely in the RETT community:

AAC STRATEGIES

How to do it:

  • Observe an interaction between an individual with RTT and a familiar person
  • Provide targeted strategies to implement during familiar settings, such as:
    • Offer choices
    • Increase wait time to allow for responses
    • Acknowledge behaviors that can be potentially communicative
      • Eye gaze, open mouth, vocalization, hand and body movements
      • Ask questions or make comments that require responses

AAC PAPERS AND LINKS

PODD PRAGMATIC ORGANIZATION DYNAMIC DISPLAY:

How to do it:

  • Use immersion’ to teach language
  • A primary aim of PODDs is to promote immersion, a teaching strategy where all those around the person with CCN use their AAC system when communicating with them, for communication all the time.
  • The best way to use immersion for teaching language is to have access to lots of vocabulary. This allows other people to make the most of every opportunity to talk to the person with CCN using the symbols they are learning
  • Visit Linda J. Burkhart’s website Simplified Technology for more info and resources.

COMMUNICATION DOWNLOADS & LINKS:

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