Abstract
Evidence on effective communication interventions for persons with Rett syndrome is needed to drive the standard of care with this population. This study examined the effectiveness of an intervention package to teach multiple, aided communication requests for two persons with Rett syndrome (ages 27 and 7) through within participant, adapted multiple baseline designs across items/activities. Participants were taught graphic mode requests on speech generating devices, with access methods based on motor ability; one participant responded by pressing a touch screen, and one participant responded by fixed eye-gaze. Results are discussed in relation to the effectiveness of the intervention packages on increasing the accuracy of independent request selection responses emitted and the number of sessions required to reach an a priori performance criterion for both participants. Difficulties during initial prompting and during prompt fading with the eye-gaze response are considered. The findings suggest implications related to emerging evidence on the intervention methods to teach requesting skills to this population, and future research directions for communication intervention options for persons with severe communication impairment and limited motor repertoires.
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Ball, L., Nordness, A., Fager, S., Kersch, K., Pattee, G., & Beukelman, D. (2010). Eye-gaze access of AAC technology for persons with amyotrophic lateral sclerosis. Journal Medical Speech Language Pathology, 18, 11–23.
Baptista, P. M., Mercadante, M. T., Macedo, E. C., & Schwartzman, J. S. (2006). Cognitive performance in Rett syndrome girls: a pilot study using eyetracking technology. Journal of Intellectual Disability Research, 50, 662–666.
Beukelman, D., & Mirenda, P. (2013). Augmentative and alternative communication: Supporting children and adults with complex communication needs (4th ed.). Baltimore: Paul Brookes Publishing Co.
Beukelman, D. R., Fager, S., Ball, L., & Dietz, A. (2007). AAC for adults with acquired neurological conditions: a review. Augmentative and Alternative Communication, 23, 230–242.
Bondy, A. S., & Frost, L. A. (1994). The picture exchange communication system. Focus on Autism and Other Developmental Disabilities, 9, 1–19.
Brady, N. C., & Halle, J. W. (1997). Functional analysis of communicative behaviors. Focus on Autism and Other Developmental Disabilities, 12, 95–104.
Byiers, B. J., Dimian, A., & Symons, F. J. (2014). Functional communication intervention in rett syndrome: a preliminary study. American Journal of Intellectual and Developmental Disabilities, 119, 340–350.
Cannella, H. I., O’Reilly, M. F., & Lancioni, G. E. (2005). Choice and preference assessment research with people with severe to profound developmental disabilities: a review of the literature. Research in Developmental Disabilities, 26, 1–15.
DeLeon, I. G., & Iwata, B. A. (1996). Evaluation of a multiple‐stimulus presentation format for assessing reinforcer preferences. Journal of Applied Behavior Analysis, 29, 519–533.
Demeter, K. (2000). Assessing the developmental level in Rett syndrome: an alternative approach? European Child & Adolescent Psychiatry, 9, 227–233.
Dietz, S. M., & Malone, L. W. (1984). Stimulus control terminology. The Behavior analyst/MABA, 8, 259–264.
Ellaway, J., & Christodoulou, C. E. J. (2001). Rett syndrome: clinical characteristics and recent genetic advances. Disability & Rehabilitation, 23, 98–106.
Etzel, B. C., & LeBlanc, J. M. (1979). The simplest treatment alternative: the law of parsimony applied to choosing appropriate instructional control and errorless-learning procedures for the difficult-to-teach child. Journal of Autism and Developmental Disorders, 9, 361–382.
Fabio, R. A., Giannatiempo, S., Antonietti, A., & Budden, S. (2009). The role of stereotypies in overselectivity process in Rett syndrome. Research in Developmental Disabilities, 30, 136–145.
Fager, S., Bardach, L., Russell, S., & Higginbotham, J. (2012). Access to augmentative and alternative communication: new technologies and clinical decision-making. Journal of Pediatric Rehabilitation Medicine, 5, 53–61.
Gast, D. L., & Ledford, J. (2014). Multiple baseline and multiple probe designs. Single Case Research Methodology: Applications in Special Education and Behavioral Sciences, 251.
Gee, K., Graham, N. G., Goetz, L. L., Oshima, G., & Yoshioka, K. (1991). Teaching students to request the continuation of routine activities by using time-delay and decreasing physical assistance in the context of chain interruption. Journal of the Association for Persons with Severe Handicaps, 16, 154–167.
Hagberg, B. (2002). Clinical manifestations and stages of Rett syndrome. Mental Retardation and Developmental Disabilities Research Reviews, 8, 61–65.
Hagberg, B., & Witt-Engerstrom, I. (1986). Rett syndrome: a suggested staging system for describing impairment profile with increasing age towards adolescence. American Journal of Medical Genetics, 24, 47–59.
Higginbotham, D. J., Shane, H., Russell, S., & Caves, K. (2007). Access to AAC: present, past, and future. Augmentative and Alternative Communication, 23, 243–257.
Julien, H. M., Parker-McGowan, Q., Byiers, B. J., & Reichle, J. (2014). Adult interpretations of communicative behavior in learners with rett syndrome. Journal of Developmental and Physical Disabilities, 1–16.
Mostert, M. P. (2001). Facilitated communication since 1995: a review of published studies. Journal of Autism and Developmental Disorders, 31, 287–313.
Reichle, J., & Brady. (2012). Teaching pragmatic skills to individuals with severe disabilities. In S. S. Johnston, J. Reichle, K. M. Feeley, & E. A. Jones (Eds.), AAC strategies for individuals with moderate to severe disabilities (pp. 3–23). Baltimore: Brookes Publishing Company.
Rett Syndrome Diagnostic Criteria Working Group. (1988). Diagnostic criteria for Rett syndrome. Annals of Neurology, 23, 425–8.
Ryan, D., McGregor, F., Akermanis, M., Southwell, K., Ramke, M., & Woodyatt, G. (2004). Facilitating communication in children with multiple disabilities: three case studies of girls with Rett syndrome. Disability & Rehabilitation, 26, 1268–1277.
Sandberg, A. D., Ehlers, S., Hagberg, B., & Gillberg, C. (2000). The Rett syndrome complex communicative functions in relation to developmental level and autistic features. Autism, 4, 249–267.
Sigafoos, J., & Couzens, D. (1995). Teaching functional use of an eye-gaze communication board to a child with multiple disabilities. The British Journal of Developmental Disabilities, XII, 114–125.
Sigafoos, J., Woodyatt, G., Tucker, M., Roberts-Pennell, D., & Pittendreigh, N. (2000). Assessment of potential communicative acts in three individuals with Rett syndrome. Journal of Developmental and Physical Disabilities, 12, 203–216.
Sigafoos, J., Green, V. A., Schlosser, R., O’eilly, M. F., Lancioni, G. E., Rispoli, M., & Lang, R. (2009). Communication intervention in Rett syndrome: a systematic review. Research in Autism Spectrum Disorders, 3, 304–318.
Sigafoos, J., Kagohara, D., van der Meer, L., Green, V. A., O’Reilly, M. F., Lancioni, G. E., & Zisimopoulos, D. (2011). Communication assessment for individuals with Rett syndrome: a systematic review. Research in Autism Spectrum Disorders, 5, 692–700.
Skinner, B. F. (1957). Verbal behavior. Englewood Cliffs: Prentice-Hall.
Stasolla, F., De Pace, C., Damiani, R., Di Leone, A., Albano, V., & Perilli, V. (2014). Comparing PECS and VOCA to promote communication opportunities and to reduce stereotyped behaviors by three girls with Rett syndrome. Research in Autism Spectrum Disorders, 8, 1269–1278.
Urbanowicz, A., Leonard, H., Girdler, S., Ciccone, N., & Downs, J. (2014). Parental perspectives on the communication abilities of their daughters with Rett syndrome. Developmental neurorehabilitation, 0, 1-9.
Van Acker, R., & Grant, S. H. (1995). An effective computer-based requesting system for persons with Rett syndrome. Journal of Childhood Communication Disorders, 16, 31–38.
Von Tetzchner, S. (1997). Communication skills among females with Rett syndrome. European Journal Child Adolescent Psychiatry, 6, 33–7.
Warren, S. F., Fey, M. E., & Yoder, P. J. (2007). Differential treatment intensity research: a missing link to creating optimally effective communication interventions. Mental Retardation and Developmental Disabilities Research Reviews, 13, 70–77.
Wetherby, A., & Prizant, B. (1989). The expression of communicative intent: assessment guidelines. In Seminars in Speech and Language, 10, 77–91.
Wetherby, A. M., & Prutting, C. A. (1984). Profiles of communicative and cognitive-social abilities in autistic children. Journal of Speech, Language, and Hearing Research, 27, 364–377.
Wolery, M., & Gast, D. L. (1984). Effective and efficient procedures for the transfer of stimulus control. Topics in Early Childhood Special Education, 4, 52–77.
Woodyatt, G., & Ozanne, A. (1992). Communication abilities and Rett syndrome. Journal of Autism and Developmental Disorders, 22, 155–173.
Woodyatt, G., & Ozanne, A. (1993). A longitudinal study of cognitive skills and communication behaviours in children with Rett syndrome. Journal of Intellectual Disability Research, 37, 419–435.
Woodyatt, G., & Ozanne, A. (1994). Intentionality and communication in four children with Rett syndrome. Australia and New Zealand Journal of Developmental Disabilities, 19, 173–183.
Woodyatt, G., & Ozanne, A. (1997). Rett syndrome (RS) and profound intellectual disability: cognitive and communicative similarities and differences. European Child & Adolescent Psychiatry, 6, 31–32.
Acknowledgments
The authors would like to acknowledge Breanne Byiers for her comments on earlier drafts of this manuscript and Julianne Bazyk and Stephanie Hammerschmidt-Snidarich for their efforts with interobserver agreement and treatment integrity data collection.
Compliance with Ethical Standards
“All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.” “Informed consent was obtained from parents or guardians for all individual participants included in the study.”
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Simacek, J., Reichle, J. & McComas, J.J. Communication Intervention to Teach Requesting Through Aided AAC for Two Learners With Rett Syndrome. J Dev Phys Disabil 28, 59–81 (2016). https://doi.org/10.1007/s10882-015-9423-7
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DOI: https://doi.org/10.1007/s10882-015-9423-7