Expressive Language and Communication

ELSA is a measure of expressive language and communication. The language sample obtained during an ELSA administration can provide valuable information about the child’s expressive language and communication skills. Expressive language is a significant predictor of long-term functional outcomes for individuals with Autism Spectrum Disorder (ASD). Most standardized language assessments only measure expressive language. ELSA is set apart from the other assessments because it measures expressive communication as well. This is particularly important when assessing communication in individuals with ASD as about 30% of those with ASD are minimally verbal. One important goal of any treatment program is to improve language and communication skills. ELSA is an outcome measure that can be used to measure change in language and communication. 

Natural Language Samples (NLS)

NLS are recordings of spontaneous expressive language. ELSA utilizes NLS because they can be elicited in a variety of settings (e.g. clinic, school, home) and conversational partners (e.g. parents, clinicians). Many of the ways commonly used to assess language, such as standardized tests and parent questionnaires, are not useful outcome measures. Many of these measures are time consuming and can be taxing on the child. Other measures, such as parent questionnaires, may be biased and therefore they do not give an accurate representation of a child’s abilities. NLS can provide the optimal approach for assessing communication skills. NLS do not impose test-taking challenges on the participant which can enhance the participant’s enjoyment during the assessment. NLS are developmentally sensitive and capture quantitative and qualitative changes in all aspects of language.


ELSA is comprised of 8 different activities that were designed to be fun and interactive for participants across a large age range. The activities are play based and include popular toys and activities that are motivating for the child. Each activity incorporates a variety of skills including gross motor, fine motor, turn taking, requesting, etc., in order to capture a comprehensive view of each individual’s skills. The protocol can be administered in a variety of settings and takes 15-25 minutes to administer.


The 8 activities are appropriate for participants ages 5-20 at varying developmental levels. Additionally, an adapted Toddler version of ELSA, ELSA-T, was created to address the needs of children aged 18 months- 5 years. The ELSA-T protocol provides more age appropriate toys and language prompts.  The ELSA and ELSA-T protocol is flexible to meet the individual needs of each participants and the activities are easily adapted based on cultural considerations. Additionally, the ELSA and ELSA-T manual and other materials are freely accessible on this site, allowing ELSA to be used across diverse populations.