The association between object play and intentional communication was examined in children with autism spectrum disorder (ASD). Meta-analysis of concurrent and longitudinal correlational studies revealed significant associations between object play and intentional communication in young children with ASD. One well-conducted and internally valid, randomized, controlled trial suggests a bidirectional causal relationship between object play and intentional communication. Further experiments are needed to replicate these findings and test a play-as-stronger-cause hypothesis. Findings of the review have implications for development and implementation of effective interventions for young children with ASD when communication is the target and play serves as the context for intervention strategies. One model for conceptualization of treatment is proposed. (Contains 3 tables and 4 figures.)