Communication Intervention for Children with Autism: A Review of Treatment Efficacy

David Icanberry, B.S.
April 30, 2018

For children with Autism, there are a variety of ways to support emerging language skills. One of these strategies is called “Total Communication.” Essentially, this is a style of communication that incorporates sign language paired with verbal language.

Review of the Literature about Total Communication

Findings from multiple studies in the meta-review completed by Howard Goldstein in 2002 showed that “total communication training resulted in quicker and more complete learning of vocabulary than speech training for many participants.” The article also discussed how this style (total communication) is best used with participants who display limited verbal communication skills (i.e. low/non-verbal), whereas children who display good verbal imitation skills often benefit more from systematic discrimination training or speech training alone.

At CSLOT, a good number of the clients we see are children on the autism spectrum. Many of these children are still developing verbal language skills. It can be helpful to identify clients who have little-to-no verbal imitation skills and utilize Total Communication with them.

Benefits of Total Communication

Using Total Communication to support the emerging expressive language skills of children gives a second medium of communication to model. Autism spectrum disorder is often comorbid with auditory processing disorders, so using sign language while speaking gives a more tangible and less transient than spoken words, and signs are much easier to prompt. In conclusion, when working with a child with autism spectrum disorder who show limited verbal imitation skills, current research supports the use of both sign language and verbal language to support language acquisition.


Goldstein, H. (2002). Communication Intervention for Children with Autism: A Review of Treatment Efficacy. Journal of Autism and Developmental Disorders, 32(5), 373-96.


Photo by David Icanberry, B.S.

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