This study focused on increasing expressive communication skills in children with limited verbal output to allow for communication of basic wants and needs with parents and caregivers. There were three children ages 22-34 months enrolled in the study with a diagnosis of mild-moderate, moderate, or moderate-severe expressive language delay or mixed receptive-expressive language delay who produced fewer than 10 spoken words or signs. This study was a non-concurrent multiple baseline across participants, so the sessions were allocated according to the start of their intervention, which was randomly assigned. During the baseline and follow-up sessions, the children were exposed to labeling of toys and pictures of a pre-determined vocabulary list. The intervention sessions consisted of the speech-language pathologist modeling American Sign Language (ASL) signs and spoken words from the same pre-determined vocabulary list. Two of the three participants demonstrated an increase in expressive communication skills and were able to produce 10 to 22 signs and five to ten new single words. While the other participant did not demonstrate an increase in spoken communication, she was able to produce two signs at the completion of the study. The intervention of traditional spoken English models and American Sign Language (ASL) signs proved to be an effective method of treatment and all children demonstrated and increase in both signed and spoken vocabulary. While further research is necessary to solidify the current treatment, it demonstrated a strong basis for increasing overall expressive communication skills in preverbal and nonverbal children.
