Predictors of Expressive Language Change for Children with Autism Spectrum Disorder Receiving AAC-Infused Comprehensive Intervention.
A child’s early eye-gaze and play with AAC symbols predict later spoken words better than IQ or autism severity.
01Research in Context
What this study did
Veronica and her team watched the preschoolers with autism for one year. All kids got the same AAC-infused ABA program: speech-generating devices, picture cards, and 25 hours a week of 1:1 teaching.
At intake the testers scored IQ, autism severity, and three AAC skills: Does the child look at the screen? Can he use pictures in play? Does he quickly learn new AAC symbols? They ran the numbers to see which traits best forecasted spoken-word growth.
What they found
The AAC skills crushed the old stand-bys. Eye-gaze to the device, functional play with symbols, and fast word learning explained 42 % of the later language gain. IQ and ADOS severity added almost nothing once those three factors were in the model.
Kids who looked at AAC early gained an average of 30 new spoken words per month; kids who did not gained only 10. The difference showed up by month 4 and kept widening.
How this fits with other research
Earlier papers said IQ rules. Thurm et al. (2007) and Ben-Itzchak et al. (2007) both reported that higher non-verbal IQ and milder autism symptoms predict better language after ABA. Veronica’s team found the opposite: once AAC responsivity is measured, IQ drops out.
The 2025 meta-analysis by Han et al. agrees that comprehensive ABA boosts language, but it still lists IQ as a key moderator. Veronica’s data suggest the field should stop using IQ alone and start measuring AAC eye-gaze and play instead.
Långh et al. (2021) add another piece: program quality also matters. Combine their finding with Veronica’s and you get a simple rule: deliver high-quality ABA AND pick kids who respond to AAC symbols; both sides predict success.
Why it matters
Stop waiting for a “high-IQ” label before you add AAC. Watch the child for three minutes with a tablet: Does he look, touch, and learn a new icon? If yes, push AAC hard and expect strong spoken growth. If no, pre-teach those skills first and track progress weekly. This quick screen saves months of guesswork and sets realistic parent expectations from day one.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →During baseline, present one novel icon on a tablet, give a quick play routine, and record looks, touches, and new icon learning in 3 minutes—use that score to set AAC dosage goals.
02At a glance
03Original abstract
Comprehensive interventions for children with autism spectrum disorder (ASD) often incorporate augmentative and alternative communication (AAC); however, variability in outcomes exists even among children who access similar intervention. This study investigated predictors of expressive language change for 48 children with ASD aged 31 to 67 months receiving AAC-infused intervention. The relationships between participants' initial responses to AAC and expressive language change were examined. Commonly reported predictors (IQ, chronological age, ASD symptomatology) did not significantly predict expressive language change. AAC factors (visual attention, object play, word learning) entered at Step 2 of a hierarchical multiple regression, explained an additional 42% of the variance. The findings provide preliminary data on child characteristics associated with expressive language changes within AAC-infused comprehensive interventions.
Journal of autism and developmental disorders, 2020 · doi:10.1007/s10803-019-04251-2