Interventions and Autism Spectrum Disorder Social communication skill development begins early in infancy and continues throughout childhood. During the first year of life, a child learns to deliberately communicate through social exchanges such as smiling, coordinating attention between objects and people, and using sound and gestures (Wetherby, 2006). Such early social engagement lays the foundation for more complex social interactions that emerge in early childhood, including imitation, imaginary play, and spoken language (Kohler, Anthony, Steigner, & Hoyson, 2001). Spoken language develops to fulfill communicative functions such as requesting wants and needs, labeling items, and obtaining information (Sundberg & Michael, 2001). Children with autism spectrum disorder (ASD) often struggle with early social engagement leading to further difficulties with more complex social communication, academic learning, and personal interactions (Kasari, Gulsrud, Wong, Kwon, & Locke, 2010). Research confirms that children with ASD spend more time in purposeless activity, interact less with others, and maintain greater physical distance from peers compared with typically developing peers (Goldstein, Lackey, & Schneider, 2014). Among the deficits related to a lack of social engagement is an absence of social communication, a core deficit in children with ASD (American Psychiatric Association, 2013). Early social communication skills, such as joint attention, imitation, symbolic play, and the ability to understand and express language, are skills that are often delayed or impaired in children with ASD (Ingersoll & Schreibman, 2006). In particular, spontaneous social communication is a typical behavior that children with autism often lack (Duffy & Healy, 2011). Recently, interventions combining behavioral and developmental approaches delivered in natural environments show promising results in increasing social communication behaviors in young children with ASD (Dawson 662870T ECXXX10.