Abstract
Prematurity and autism spectrum disorder (ASD) are risk factors for alterations in language development. Their coexistence, frequent in twin pregnancies, may result in atypical communicative profiles that require specific interventions. This case report analyzed the linguistic, cognitive, and socioemotional development of two premature twins with ASD, relating the results to the therapeutic strategies applied. Standardized tests were applied to measure cognitive, linguistic, adaptive, and socioemotional development. The intervention combined the TEACCH, ABA, DIR/Floortime, and Hanen-More Than Words models. Both children showed significant impairments in communication, executive functions, and autonomy, with differentiated clinical profiles. Individualized interventions favored advances in functional language, emotional regulation, and routines, although challenges in language generalization and pragmatics persisted. The combination of prematurity and ASD creates complex challenges that require individualized therapeutic approaches. Early and intensive intervention, based on structured and relational approaches, is useful to promote functional and communicative development.