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The vast majority of individuals with Rett syndrome do not utilize natural speech and therefore require alternative and augmentative communication (AAC). The purpose of the current study was to investigate the use of high- and low-tech AAC modalities by three individuals with Rett syndrome given similar instruction for using both modalities. For all participants, the number of sessions to criterion and cumulative number of trials with independent requests during simultaneous or alternating instruction in the use of a high- and low-tech AAC modality were investigated. Parents conducted all sessions with remote coaching from a research assistant via telecommunication. Each participant exhibited idiosyncratic response patterns in terms of use of their high- and low-tech AAC modalities during instruction but ultimately demonstrated the ability to use both modalities to make requests. Implications for future research and practice pertaining to AAC of individuals with complex communication needs are discussed. This paper is a companion to Girtler et al. ( 2023 ).

In behavior-analytic clinical work and research, opportunities for choice can be arranged as an independent variable, and response allocation among choice options can be measured as a dependent variable (i.e., engaging in one response given two or more concurrently available options). Choice-based interventions provide behavior analysts with tools to promote their clients’ rights to autonomy and self-determination by incorporating client preference. The purpose of the current article is to systematically review the literature published from 2003 to 2020 on choice-based interventions with children. We reviewed 32 articles (38 experiments) identified through ERIC, PsycINFO, and MEDLINE/PubMed, and we summarized the participant and study characteristics arranged into two categories by procedure: (1) differential reinforcement with asymmetrical-choice options; and (2) building choice opportunities into daily contexts. We provide suggestions for clinical applications of choice to intervention procedures and future research. The reviewed literature demonstrates how practitioners working with children can use choice-based interventions to incorporate consumer choice into clinical practice while effectively addressing versatile clinical goals across populations and settings.