Both picture exchange, a low-tech picturebased communication system, and technologybased interventions, such as the iPad™ with communication application, are emerging treatments for students with autism spectrum disorder (ASD), according to the National Autism Center (2009). Recently, investigations regarding the use of the Apple iPad™ to communicate have been conducted with mixed results. The authors used a single-subject alternating treatment design during an extended school year (ESY) program for students with disabilities to compare the independent use and effectiveness of the two approaches (low-tech picture-based versus iPad™ equivalent) for three pre-school and two elementary students with ASD and developmental delay (DD). The authors concluded that teaching low-tech picture exchange prior to introducing the iPad™ may be effective progression in teaching communication reciprocity skills for some students with ASD/DD. Limitations and strengths of both technologies are discussed.