This report discusses the outcomes of a project that examined the acquisition and use of voice output communication aids in naturally occurring routines by four young children (ages 3-5) with autism. The effects of naturalistic teaching and the use of voice output communication aids (VOCAs) on communicative behaviors of the participants as well as the communicative interactions of the teacher and aids were also examined. Finally, an evaluation of the effects of naturalistic teaching and VOCA use on other alternative communicative behaviors of the young children (e.g., gestures, vocalizations, and words) was also conducted. Results demonstrated the efficacy of a naturalistic teaching strategy to teach VOCA communication skills to young children with autism. All participants demonstrated the skills to use the VOCA to request items and respond to questions from classroom staff during the natural routines of snack and play. The majority of the VOCA communication responses for all participants were not physically guided by staff. All participants also showed some increase in other communicative behaviors, such as gestures, words, or vocalizations, when they had access to the VOCA. Appendices include graphs showing the children's progress, a guide for VOCA use, and the contextual rating survey. (Contains 63 references.) (CR)