Journal of Autism and Developmental Disorders

, Volume 44, Issue 5, pp 1244–1251 | Cite as

A Randomized Trial Comparison of the Effects of Verbal and Pictorial Naturalistic Communication Strategies on Spoken Language for Young Children with Autism

  • Laura Schreibman
  • Aubyn C. Stahmer
Brief Report


Presently there is no consensus on the specific behavioral treatment of choice for targeting language in young nonverbal children with autism. This randomized clinical trial compared the effectiveness of a verbally-based intervention, Pivotal Response Training (PRT) to a pictorially-based behavioral intervention, the Picture Exchange Communication System (PECS) on the acquisition of spoken language by young (2–4 years), nonverbal or minimally verbal (≤9 words) children with autism. Thirty-nine children were randomly assigned to either the PRT or PECS condition. Participants received on average 247 h of intervention across 23 weeks. Dependent measures included overall communication, expressive vocabulary, pictorial communication and parent satisfaction. Children in both intervention groups demonstrated increases in spoken language skills, with no significant difference between the two conditions. Seventy-eight percent of all children exited the program with more than 10 functional words. Parents were very satisfied with both programs but indicated PECS was more difficult to implement.


Autism Behavioral intervention Functional communication Vocal language intervention Pictorial communication intervention Augmentative communication 



This research was supported in part by U.S.P.H.S. Research Grants MH 39434 and MH 28210 from the National Institute of Mental Health. The authors acknowledge the ongoing support and important contributions of Drs. Andrew Bondy and Gail McGee for providing consultation and supervision to ensure appropriate program procedures. We also wish to thank Dr. Allison Jobin for her valuable contributions to the preparation of this manuscript and to Dr. Mark Appelbaum for statistical consultation.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of California, San DiegoLa JollaUSA
  2. 2.Rady Children’s HospitalSan DiegoUSA
  3. 3.Department of PsychiatryUniversity of California, San DiegoLa JollaUSA

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