The role of assistive technology in enhancing communication skills in non-verbal children with autism

For a child who cannot speak, every unmet communicative need is a source of frustration, isolation, and missed developmental opportunity. Assistive technology (AT) offers one pathway out of that silence, yet the comparative effectiveness of different AT modalities for non-verbal children with autism remains poorly documented in Latin American settings. This research compared three assistive technology approaches for enhancing communication skills in non-verbal children with autism spectrum disorder (ASD) aged 3 to 9 years in Monterrey, Mexico. Eighty-seven children were assigned to one of four conditions: tablet-based augmentative and alternative communication (AAC) applications (n = 24), speech-generating devices (SGD, n = 21), the Picture Exchange Communication System (PECS, n = 23), or a control group receiving standard speech-language therapy (n = 19). The intervention lasted 18 months, with assessments at baseline and at 3-month intervals.Communication was measured using the Communication Matrix, the Peabody Picture Vocabulary Test (adapted Spanish version), and structured behavioral observation coding of communication acts during therapy sessions. All three AT groups outperformed controls, but tablet-based AAC produced the largest gains in the communication composite score (baseline: 8.2, 18 months: 43.9, p < 0.001), followed by SGD (7.9 to 37.6, p < 0.001) and PECS (8.4 to 24.8, p < 0.001). The control group showed minimal change (8.1 to 12.3, p = 0.09). Requesting behaviors emerged fastest, followed by comments, social greetings, and protests/rejections. Parent satisfaction ratings favored tablet-based AAC across ease of use, child engagement, and portability. Effect sizes (Cohen's d) for the tablet group versus controls were large across all communication domains (d = 1.74 to 2.31). These results indicate that technology-supported communication interventions, particularly tablet-based AAC, can produce substantial and sustained gains for non-verbal children with ASD, and that such tools are both effective and acceptable to families in a Mexican clinical context.