Before Caroline entered the Regression stage (the second of four stages of Rett Syndrome), she had about 12 words and would "point" to objects she was interested in by reaching for them. The loss of hand skills prevents Caroline from communicating the way she used to so we now rely on her eye gaze and facial expressions. When we talk to her about someone she loves or mention an activity she enjoys, she lights up and smiles at the appropriate time. If we hold a toy cow in one hand and a cat in the other hand, and ask her to point to the cow, she will look directly at the cow. We engage her in this exercise throughout the day by asking her to "point" to people she knows or objects she's familiar with.
We hope to soon find a way that will enable her to consistently communicate "no," "yes," and "I don't know/maybe" so that we can better meet her basic needs and wants. We're all working together and have a lot to learn.