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This article examines the form and function of spontaneous communication and outcome predictors in nonverbal children with autism following classroom-based intervention (Picture Exchange Communication System [PECS] training). 84 children from 15 schools participated in a randomized controlled trial (RCT) of PECS (P. Howlin, RK Gordon, G. Pasco, A. Wade, & T. Charman, 2007). They were aged 4–10 years (73 boys). Primary outcome measure was naturalistic observation of communication in the classroom. Multilevel Poisson regression was used to test for intervention effects and outcome predictors. Spontaneous communication using picture cards, speech, or both increased significantly following training (rate ratio [RR]= 1.90, 95% CI [1.46, 2.48], p<. 001; RR= 1.77, 95% CI [1.35, 2.32], p<. 001; RR= 3.74, 95% CI [2.19, 6.37], p<. 001, respectively). Spontaneous communication to …