A pragmatic approach to increase expressive language skills in young autistic children.

This paper is a description of a pilot communication program for autistic children designed to increase communication skills in the context of establishing reciprocal communication exchanges. The methods involved intensive modeling of verbal responses within joint activity routines and using a reinforcement system based on fulfilling the intent of the child's communication. Five male subjects ranging in age from 36 to 68 months participated in the communication program for 6 weeks during an inpatient stay at the Iowa Autism Program, Child Psychiatry Service. Communication exchanges involving requests for actions and objects, descriptions of actions and objects, comments on existence and nonexistence, and requests for recurrence were targeted. Individual gains for each subject are outlined. Posttreatment results indicated a significant increase in the mean length of response, in the mean receptive language level, and in the mean number of semantic-grammatical rules expressed. Suggestions regarding future research are discussed.