Communication growth in minimally verbal children with ASD: The importance of interaction.
Back-and-forth play exchanges, with an SGD on the table, can boot-strap language in minimally verbal children with autism.
01Research in Context
What this study did
Koenen et al. (2016) ran a six-month play-and-engagement program for minimally verbal children with autism. Kids could use a speech-generating device if they wanted. The team tracked how often each child started a back-and-forth communication exchange.
Sessions looked like natural play. Therapists followed the child’s lead, waited for any signal, and responded right away. The goal was to pile up lots of short, balanced turns.
What they found
Every child started more exchanges, kept them going longer, and spoke more words. The children who also used the SGD grew the fastest. Baseline turn-taking scores predicted later spoken-language gains.
In plain words: practice chatting back and forth, with or without tech, greases the wheels for future talking.
How this fits with other research
Bishop et al. (2020) and Gevarter et al. (2016) ran smaller single-case tests that echo the same SGD-plus-vocal tactic. All three papers show positive expressive gains, giving you confidence the effect is real.
Kaneda et al. (2025) extends the idea to children who also have intellectual disability. They turned off the SGD voice output and still saw more vocal requests. It looks like the device can stay in the room even when you want the child to use their own voice.
Capio et al. (2013) ran an earlier parent-coaching RCT without any SGD. Language scores did not rise, but social interaction did. The new study adds the optional device and gets both interaction and language gains, suggesting the tech piece may tip the scale.
Why it matters
If you work with minimally verbal children, build sessions around short, balanced turns instead of correct responses. Offer an SGD but do not force it. Track how many back-and-forth cycles the child starts each day; that number predicts later spoken words. You can run this play-based format in clinic, home, or preschool with no extra table-top drills.
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02At a glance
03Original abstract
Little is known about language development in children with Autism Spectrum Disorders (ASD) who remain minimally verbal past age 5. While there is evidence that children can develop language after age 5, we lack detailed information. Studies of this population generally focus on discrete language skills without addressing broader social-communication abilities. As communication and social deficits are both inherent to ASD, an examination of not only what language skills are acquired, but how those skills are used in interactions is relevant. Research in typical development has examined how communication interchanges (unbroken back-and-forth exchanges around a unified purpose) develop, which can be used as a framework for studying minimally verbal children. This study examined the interchange use by 55 children with ASD over the course of a 6-month play and engagement-based communication intervention. Half of the children received intervention sessions that also incorporated a speech-generating device (SGD). Interchanges were coded by: frequency, length, function, and initiator (child or adult). Results indicated that children initiated a large proportion of interchanges and this proportion increased over time. The average length and number of interchanges increased over time, with children in the SGD group showing even greater growth. Finally, children's total number of interchanges at baseline was positively associated with their spoken language gains over the course of intervention. This study supports the crucial relationship between social engagement and expressive language development, and highlights the need to include sustained communication interchanges as a target for intervention with this population. Autism Res 2016, 9: 1093-1102. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.
Autism research : official journal of the International Society for Autism Research, 2016 · doi:10.1002/aur.1594