Predictors of Communication Skills Following a Peer Partner Intervention for Young Autistic Children with Limited or No Spoken Language

Young autistic children with limited or no spoken language present with a myriad of social and communication challenges that restrict participation in school environments. Instructional approaches that include a speech-generating device (SGD) to augment speech and teaching peers to be supportive communication partners can lead to marked improvements in communication, expressive language, and social reciprocity. To inform clinical decisions and individualize approaches to meet child needs, more research is needed to identify key child-level behaviors that predict treatment response to social communication interventions. This study determined if pre-treatment levels of (1) expressive and receptive language, (2) nonverbal cognitive skills, (3) autism characteristics, and (4) peer-directed communication and reciprocity were related to child communication following an SGD intervention with peer partners. Participants included N = 56 autistic children (ages 3 to 6 years) with limited or no spoken language and N = 107 non-autistic peers (1–3 for each child). Peers learned to Stay–Play–Talk, then participated in 10 play-based intervention sessions with an autistic child implemented by trained school staff. An SGD with voice output app was provided for all children. Participants demonstrated significant increases in three social communication outcomes after intervention. Bivariate correlations were used to assess the relationship of potential predictors with these three key communication outcomes. Then, predictors with significant associations were included in multiple linear regressions to examine the contributions of child-level predictors for each outcome. All three regression models explained significant variance and had at least one significant child-level predictor (e.g., expressive language, autism characteristics, or nonverbal cognitive skills). Results provide support for identifying child characteristics that are precursors for growth in peer-directed social communication, and are thus important to teach to optimize outcomes for autistic children with significant communication challenges.