The effect of Smart-Glove exchange-based system vs. PECS® on communication initiation in minimally verbal toddlers with autism spectrum disorder

Children with autistic spectrum disorders (ASD) show low engagement and priority of video over other activities. The Smart-Glove system is an augmentative and alternative communication tool combining video visual scene display (VVSD) with a picture exchange-based approach. This study compares the effectiveness of integrating Smart-Glove during PECS® phase 1 instructional strategy to teach independent initiation in minimally verbal toddlers with ASD. Four participants who failed to master PECS® Phase 1 over eight months at a specialized daycare were included. An alternating treatment design evaluated the relative effectiveness of Smart-Glove (VVSD and cards) versus cards only during PECS Phase 1 instruction. Percentages of independent request initiations, reaction times (RT) and social validity inventories were measured. Participants demonstrated improved independent initiations in both intervention sessions, with instances of 90 %-100 % successful independent exchanges. However, during Smart-Glove sessions, significantly higher average independent initiation, a faster learning linear trend and reduced RT reductions over time were achieved. Social validity inventories indicated satisfaction with the Smart-Glove system. Use of the Smart-Glove system improved independent request initiations, accelerated learning and increased reaction speed among minimally verbal toddlers with ASD, suggesting that integrating VVSD into PECS may be a motivational and effective instructional strategy for this subgroup.