Communication development of a child with autism, the son of deaf parents, using alternative communication: a case report.

One child was studied, and the authors state themselves that this prevents generalisation of the results. No comparison group. Any change could be the therapy, the family's input, nine months of ordinary development in a 5-year-old, or a mixture. A lot changed at once: 29 sessions of an earlier picture-board approach, then two versions of the DHACA book, speech-language therapy in Portuguese, and parents prompted to continue activities at home. Nothing in the design separates the contribution of any one of these. The behaviour checklist was completed together with the parents, who were also active in the intervention, so the raters were not neutral. The child's communicative abilities were still limited at the end of follow-up: reduced vocabulary, little communicative initiative and difficulties in social interaction were still recorded at assessment.

The authors declare no financial support and nothing to declare.

Do not read this as evidence that the DHACA method, or pairing pictures with sign language, works for children with autism. It is a single child, with no comparison group, who received an earlier picture-board approach, two versions of the communication book, speech-language therapy and home practice across nine months. The paper itself says one subject prevents generalisation of the results.