Increasing instructional efficiency by presenting additional stimuli in learning trials for children with autism spectrum disorders.

The team asked: does it matter if you show the picture first or the word first when you teach new names to kids with autism?

They ran single-case trials with preschoolers. Each child got the same picture-word pairs in two orders: word-then-picture or picture-then-word.

The goal was to see which order helps kids later name the picture without any prompts.

Both orders worked the same for emergent tact control. Kids could later name the picture no matter which order they saw.

The only difference: kids said more echoics when the word came first. More immediate repeats, but no extra learning boost.

Cao et al. (2018) echo the echoic point. They showed that once preschoolers could echo Chinese sounds, full naming popped out in that language. The 2013 data say the extra echoics from word-first trials might feed that same engine.

Silva et al. (2020) used the same alternating-treatments trick. They compared adding tokens versus taking tokens away in the Good Behavior Game and, like here, found both formats worked. The message: stimulus order often matters less than we think.

Bhana et al. (2023) and Wainer et al. (2021) also boost toddler communication, but they use parent photos or telehealth RIT instead of direct clinician trials. The 2013 study shows a quick tabletop option you can slide into any of these parent programs.

You can stop worrying about picture-first versus word-first. Pick the order that keeps your learner echoing if you want extra vocal practice, then move on. This frees you to design smoother, faster teaching loops and still get the same naming gains.