**7. Conclusion**

The research base with respect to AAC used by young children with autism has grown in recent years. This research mostly consists of singe-subject-design studies and case studies, with very few controlled group studies being done. On the other hand there are some welldone meta-analyses published that compile results from singe-subject research studies. Due to the difficulties of conducting RCT studies within the field of AAC-intervention the metaanlyses are important and can be seen as the golden standard. In total 14 studies were identified

In conclusion, meta-analyses and other studies show that AAC-interventions are cost-effective and give fast results and furthermore tend to stimulate speech development [82, 84, 85, 86, 87, 91]. The best results seem to be reached when the social network surrounding a child is given support and resources, to be able to use responsive strategies and provide communication opportunities and direct training using AAC in natural daily interactions. AAC intervention should be started as soon as communication difficulties are displayed or suspected since AAC promotes communication, language and speech. AAC-intervention has also been proved to effectively decrease challenging behaviour [83]. There is today no mode of AAC that is known to be better than any other for young children with autism. Instead multimodal approaches seem to be the most effective [93]. However, graphic AAC seem to be acquired at a faster rate and also easier to generalize to other situations [90]. PECS has been proved to be an effective AAC method, specifically at early stages of communication and with respect to the first three

as focusing the use of AAC and of these 10 were reviews or meta-analyses.

phases of the method [89].

736 Recent Advances in Autism Spectrum Disorders - Volume I

**Figure 1.** Model for early communication intervention

The conclusion of this chapter is presented in the form of eight recommendations and of a model for early communication intervention answering the question that was initially formulated in this study: **"A young child with autism and severe communicative disability, living with his/her parents and being placed in a pree-school group: which intervention is most effective; indirect or direct interventions?"**


**8. The AAC-modes should be used and modelled by the child's communication part‐ ners** (aided language stimulation or modelling) to promote learning and spontaneous use of the symbols.

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These recommendations means that the child in our formulated question should be provided with intervention according to the model below.
