Examining Social Communication Effects of a Picture Communication Board in a Child With Autism

Purpose Augmentative and alternative communication (AAC) systems have been shown to increase requesting and protesting among minimally verbal children with autism spectrum disorder (ASD). However, there is a lack of research on using AAC to address social communication in ASD. Additionally, most previous research on AAC involves expensive, difficult-to-access technology. Enhanced milieu teaching and joint attention, symbolic play, engagement, and regulation interventions have been combined to successfully improve social communication in ASD. The purpose of this study is to examine the impact of introducing a low-technology, picture-based communication board using enhanced milieu teaching with joint attention, symbolic play, engagement, and regulation on social communication. Method An A-B-A-B single-subject design was implemented with a minimally verbal boy with ASD aged 3;4 (years;months). Three baseline sessions were followed by six intervention sessions and then repeated. Outcome measures included frequency of communicative acts, percentage of communication acts using AAC, and percentage of communication acts that were social. Visual analysis in combination with Tau-U effect sizes was used to evaluate the effects of intervention. Results Clear and immediate effects on frequency of communication (Tau-U = 0.97) and adoption of the AAC system (Tau-U = 1.00) were observed. The intervention did not clearly impact social communication (Tau-U = 0.17). Conclusions This study extends previous research indicating that AAC can quickly increase communication frequency to low-technology, accessible systems. The intervention dosage may have been insufficient to affect social communication, and further research should consider whether picture communication boards can positively influence social communication in young children with ASD.