Augmentative and alternative communication (AAC) includes picture exchange (PE) and speech-generating devices (SGD), but these two systems have rarely been compared. We therefore conducted three studies comparing PE and SGD for an adolescent boy with a developmental disability. Study 1 compared acquisition of a PE-and SGD-based requesting response and monitored the effects on social interaction. For Study 2, both communication modes were made simultaneously available and the child could choose to use either PE or the SGD. For Study 3, only PE intervention continued, with the distance between the child and trainer systematically increased to prompt social interaction. The results showed equally rapid acquisition of the PE-and SGD-based requesting response, but only the distancing manipulation had any positive effect on social interaction. We conclude that PE and SGD are equally viable modes of communication, but acquisition of an initial PE-or SGD-based requesting response may not be sufficient to promote social interaction.

Obsessive-repetitive behavior is a core feature of autism and represented the presenting complaint for Robert, a 15-year-old boy with autism. Robert's constant rearrangement of objects interfered with his participation in classroom activities, and this behavior was successfully reduced by providing structured opportunities to select and use preferred leisure activities. Provision of structured leisure opportunities could be conceptualized as an antecedent intervention that includes differential reinforcement of incompatible behavior. Although the treatment was generally successful, follow-up data indicated that long-term maintenance could be lacking. This treatment can be recommended given that it appears to be efficacious for applied settings, relatively benign, and easy to implement.