Comparison of learning text vs. picture symbol AAC representations for young children on the autism spectrum

Children on the autism spectrum¹ with minimal speech are generally provided with augmentative and alternative communication (AAC) systems that represent vocabulary using picture symbols (i.e., color line drawings). However, there has been minimal research investigating the comparative effectiveness of picture symbols vs. other types of symbol representation (e.g., text) in supporting the communication of children on the autism spectrum. Using a single case adapted alternating treatments experimental design, the current study compared learning of picture symbol and text representations, measured by the accurate identification and functional use of novel AAC symbols by young children on the autism spectrum with minimal speech. Two participants demonstrated notable acquisition of both picture symbols and text. The remaining four children had difficulty demonstrating learning of either symbol representation type. These results suggest that different symbol representations (e.g., digital photographs), layouts (e.g., visual scene displays), and/or instructional procedures (e.g., more naturalistic methods) may have been a better fit for these four participants. Additionally, variability in performance across participants underscores the critical importance of personalization of AAC systems - including symbol representation - based on comprehensive assessment of individual strengths and needs.