Pam and Josh Harris Josh is a young adult with Rubinstein-Taybi syndrome (RTS). Like most people with RTS, he has an intellectual impairment, muscular/skeletal concerns and complex communication challenges. Josh doesn't have functional speech so he relies on augmentative and alternative communication (AAC) methods. Pam is Josh's mom, personal care attendant and advocate. Together they develop family-friendly AAC strategies and materials while organizing a variety of social and recreational opportunities for people who use AAC and their families.