Service Delivery

Multimodal Communication Outcomes for Hispanic Autistic Preschoolers Following Coached Student Clinician and Caregiver-Led NDBIs

Gevarter et al. (2025) · Behavioral Sciences 2025
★ The Verdict

Train students to coach Hispanic caregivers in NDBI and minimally verbal preschoolers quickly gain big multimodal communication jumps, in Spanish or English.

✓ Read this if BCBAs training students or serving Hispanic preschoolers with autism who use few or no words.
✗ Skip if Clinicians only serving fluent verbal school-age children or non-Hispanic families.

01Research in Context

01

What this study did

Five Hispanic preschoolers with almost no words got coached NDBI. First, student clinicians learned the moves. Then they coached each family in Spanish or English at home.

The team used a multiple-baseline design. They tracked gestures, words, and AAC use before and after coaching started.

02

What they found

Every child showed big jumps in multimodal communication. Kids used more signs, word attempts, and device hits together.

Gains were large to very large, and they held for weeks. Language of coaching—Spanish or English—did not change the outcome.

03

How this fits with other research

de Jonge et al. (2025) also gave Hispanic families parent NDBI and saw large social gains. Their study added the cultural goal of respeto, while Gevarter focused on total communication.

Capio et al. (2013) ran a 12-month parent program and saw only medium social gains with flat language scores. The new study shows very-large expressive growth in less time, suggesting coached student-clinician cascades can speed things up.

Cariveau et al. (2019) tested a short ABA package for minimally verbal girls and found large communication jumps. Gevarter’s NDBI coaching matched those gains while also training future clinicians.

04

Why it matters

You can pair student trainees with Hispanic families and get strong, lasting communication gains in either language. Use the cascade model: teach the student, then the student coaches the parent in daily routines. Track gestures, words, and AAC together to catch every communicative move.

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→ Action — try this Monday

Have your student clinician film a short parent demo in the family’s language, then set one joint-attention goal for snack time this week.

02At a glance

Intervention
natural environment teaching
Design
multiple baseline across behaviors
Sample size
5
Population
autism spectrum disorder
Finding
positive
Magnitude
very large

03Original abstract

This study examined child outcomes for five minimally verbal (or non-speaking) autistic preschoolers who participated in cascading coaching programs in which naturalistic developmental behavioral intervention (NDBI) techniques were taught to graduate student clinicians and Hispanic caregivers (three who primarily spoke English, and two who spoke Spanish). While prior studies reported on adult participant outcomes, this study analyzed child multimodal communication outcomes, using multiple baselines/probes single case experimental designs across contexts. Neurodiversity-affirming and culturally responsive principles were embedded within the intervention procedures. Following the introduction of a coached NDBI, all five children (three who received the intervention in English and two who received the intervention in Spanish) demonstrated increased use of (a) the total targeted communicative responses and (b) the targeted unprompted communicative responses, across both student clinician-led and caregiver-led play sessions. The Tau-U effect size measures revealed large-to-very large effects across all of the variables. Overall, higher rates of communication responses were observed during student clinician-led sessions than in caregiver-led sessions. Additionally, behavioral coding of the multimodal response forms (e.g., gestures, aided augmentative and alternative communication, signs, vocal words) using the Communication Matrix revealed that the children used a variety of response topographies during the intervention sessions beyond their preferred communication mode (e.g., signs for three participants). Four of the five children used symbolic communication forms consistently across both caregiver and student clinician-led sessions. Importantly, adults’ reinforcement of pre-symbolic or less advanced communication forms during the intervention did not inhibit the use of more advanced forms.

Behavioral Sciences, 2025 · doi:10.3390/bs15101425