Using visuals with toddlers with ASD is practically the gold standard in early intervention. Temple Grandin taught us that some people with ASD can more easily understand a picture than a sentence. However, Fitch et al. showed that toddlers with ASD can use verbal information to update their expectations of the world.
This study focused on mental representations, which is just a fancy term for pictures or concepts in our head. If a parent said to you “Jackson took three steps yesterday” you would probably form a mental representation of Jackson toddling along in his living room. If the parent then said “it happened at the park” you would update your mental representation to include the park as the setting, instead of the living room.
This seems simple for us, but it’s actually pretty complex, and typical infants can do this by their 2nd birthdays. For verbal updating to occur, the child must be able to understand that language can refer to something that is absent or that they cannot see. They must also retrieve the prior representation, comprehend the new verbal input, and then manipulate their representation to incorporate new information.
This study found that toddlers with ASD, who had significant language delays, were able to learn with solely verbal information just as well as typically developing peers. The authors suggested that verbal comprehension abilities may be underestimated using traditional language testing in toddlers. And as an SLP, I personally might interpret these results as supporting use of narration and language modeling even in the absence of visual referents with toddlers, as they may actually be listening, learning and updating their knowledge.
Side note—the authors used a really interesting eye-tracking method to measure whether infants understood verbal information, so check out the original article for more information on that!
Fitch, A., Valadez, A., Ganea, P.A., Carter, A.S., & Kaldy, Z. (2018). Toddlers with autism spectrum disorder can use language to update their expectations about the world. Journal of Autism and Developmental Disorders. Advance online publication. doi: 10.1007/s10803-018-3706-7