This investigation explores medical advocacy for Rett syndrome—a rare neurological disorder causing loss of speech and hand function—through the lens of eye-tracking augmentative and alternative communication (AAC) technology. We gathered data from five individuals with Rett syndrome and their caregivers, encompassing semi-structured virtual interviews, video analyses of AAC device usage, and examination of AAC pageset screenshots. The findings reveal diverse AAC strategies employed to express discomfort or illness and highlight caregivers' pivotal role in processing medical information. Notwishstanding challenges like cost, time limitations in medical contexts, training needs, and the lack of standardized AAC symptom descriptions, eye-tracking AAC technology has the potential to enhance symptom assessment, foster patient autonomy, and facilitate personalized medical care. This study illuminates the transformative power of this AAC technology in medical communication, showcasing its promise in tackling communication challenges and underscoring its capacity to enhance quality of life for those with Rett syndrome and similar health conditions.

Analyzing the capacity of students with severe intellectual disabilities to develop reading and writing skills is a major challenge. This group is highly heterogeneous in basic skills and prerequisites, and sometimes struggle with basic capacities in attention. However, compelling and real evidence shows that individuals with severe intellectual disabilities can engage in adapted and modified shared reading activities. This literature review reports on studies on literacy assessment and instruction for individuals with severe intellectual disabilities. The first aim of this review is to highlight factors that can facilitate literacy learning within severe intellectual disabilities. The second aim is to analyze previous literacy interventions and training, with a main focus on assistive technologies. For this review, we included 24 empirical studies published between 2012 and 2022 that met our four criteria. The included studies were analyzed to determine if the current research in this field supports a comprehensive approach to the development of literacy skills for individuals with severe intellectual disabilities. These studies were systematically analyzed focusing on settings, assessment, methods of interventions, and the use of technological aids in which learning occurred. The findings indicate that current literacy instruction is not comprehensive; and the literacy instruction provided in the studies does not address recommendations from the field for individuals with severe intellectual disabilities. However, there is a growing interest in exploring innovative approaches to literacy instruction for this population, and the most powerful emerging area of research involves the use of assistive technology to support literacy learning in individuals with severe intellectual disabilities.

Aided augmentative and alternative communication (AAC) modeling is an important approach to facilitating language learning for individuals with complex communication repertoires. This study examines the implementation of this approach during COVID-19 virtual schooling. Key implementation challenges are identified, along with implications for educational practice to facilitate language learning. We conducted a qualitative case study of a 5-year-old child with Rett syndrome, a rare neurological disorder, who used an eye-tracking AAC device. We collected and triangulated data using participant observation of three one-on-one story reading sessions involving the child, her caregiver, and her teacher during virtual schooling as well as a semi-structured interview with the teacher. The study identified key steps for successful language modeling during virtual sessions. These included: ensuring access to the device, promoting attention through gestural and verbal prompts, providing modeling of AAC symbols, confirming responses, providing feedback, using visual supports, a collaborative approach, and positive reinforcement. Our findings suggest these strategies can help facilitate effective language development for children using AAC devices in online schooling contexts. The virtual context presented significant barriers to the practice of aided AAC modeling. Active participation of caregivers and teacher–caregiver collaboration is essential for effective implementation of aided AAC modeling during such schooling.

Historically, individuals with Rett syndrome, a rare neurodevelopmental disorder, have been cast as “silent angels,” “nonverbal,” and “speechless.” As a consequence, they have not been consulted in their medical care. Recently, however, augmentative and alternative communication (AAC) devices that use eye-tracking technology have facilitated communication for individuals with Rett syndrome. Yet, no prior research has investigated how such communication occurs within medical settings. Through an applied linguistics lens that centers the analysis of language use, we construct a case report capturing how Kalika, a child with Rett syndrome, offers medical information. Kalika’s device-mediated language use suggests multiple implications for applied linguistics scholars and language educators, including: broadening notions of speaking, increasing consideration of AAC, exploring more device-mediated language use, extending multimodal considerations, nuancing notions of communicative competence, presuming competence, and, last but not least, more deliberately espousing principles of linguistic justice in our field.