Autism & Developmental

Improving Use of Social Communicative Gestures by Children with Autism.

Barall et al. (2026) · Behavioral Sciences 2026
★ The Verdict

Prompt and praise proximal pointing and most kids with autism will start pointing to distant items on their own.

✓ Read this if BCBAs running early learner groups or home programs for preschoolers with autism.
✗ Skip if Clinicians focused only on advanced conversation or vocational skills.

01Research in Context

01

What this study did

Barall and team worked with twelve children who have autism.

They used simple prompts and praise to teach proximal pointing.

The kids had to point to things right in front of them first.

Later the team checked if the children would point to things farther away.

They tracked each child across time to see if the skill stuck.

02

What they found

Nine of the twelve children learned to point to nearby items.

Most of these kids then began to point to distant items on their own.

The new gestures were still there four weeks later.

No extra drills were needed for the jump from near to far pointing.

03

How this fits with other research

Wilkinson et al. (1998) did the same thing years earlier with only four kids.

Both studies show that prompting plus praise equals quick gesture gains.

Porter et al. (2008) went one step further and taught joint-attention bids.

They still used prompts, but added extra steps so kids would initiate looks.

Weisberg et al. (2019) also used prompts, yet each child needed tweaks.

Barall’s team kept the protocol the same for everyone and still saw success.

The difference is that Barall focused on one clear gesture: pointing.

04

Why it matters

You can teach pointing in one short block of sessions.

Start with items the child can touch, then move them farther away.

Most kids will generalize without extra planning.

Track for a month to be sure the skill stays.

If it fades, run a quick booster and check again.

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Place a preferred toy just out of reach, prompt a point, deliver praise, and slowly move the toy farther away across trials.

02At a glance

Intervention
prompting and fading
Design
multiple baseline across participants
Sample size
12
Population
autism spectrum disorder
Finding
positive

03Original abstract

Difficulties in social communication are a core characteristic of autism. Gesture use in children with autism is often delayed or atypical, with reduced frequency, diversity, and spontaneity. Pointing gestures, which typically emerge between 9 and 12 months of age, have been shown repeatedly to predict later language acquisition in both neurotypically developing children and those with autism. Thus, the deficits in proximal and distal pointing gestures observed in children with autism may impede social communication and language learning. Employing a nonconcurrent multiple baseline across participants design, this study examined the efficacy of prompting and reinforcement for teaching proximal pointing to request in 12 children with autism, aged 3 to 11 years. Results showed that 9 of the participants acquired proximal pointing and subsequently emitted distal pointing at distances of 0.61 m, 1.22 m, and 1.83 m (2, 4, and 6 feet) without additional intervention. Proximal and distal pointing was maintained at 4-week follow-up. However, not all participants acquired proximal pointing, highlighting potential variability related to individual characteristics and the need for modified procedures. These findings provide support for the use of prompting and reinforcement to teach socially communicative gestures in children with autism.

Behavioral Sciences, 2026 · doi:10.3390/bs16030401