: Minimally verbal autistic children face significant communication challenges, often unmet by traditional therapies. Social robots, like NAO, offer predictable, structured interactions that may improve engagement and language skills. This study aimed to evaluate the effectiveness of NAO-assisted therapy in improving communication and social interaction in minimally verbal autistic children compared to standard therapeutic approaches. : In a single-blind, randomized, controlled study, 37 autistic children aged 4-12 years were assigned to either NAO-assisted therapy or standard speech therapy. Participants were assigned to either an NAO-assisted therapy group or a standard speech therapy control group. The intervention included 12 weekly 45 min sessions. Communication outcomes were measured using the Language Development Level Test (TVL) and mand request observations. : All 37 participants completed the 12 sessions without adverse events, highlighting the intervention's feasibility and safety. Children in the NAO-assisted therapy group showed greater improvements in verbal communication (on average, 159 ± 49% more children exhibited improvement across verbal aspects (range: 107-284%; < 0.001)) particularly in spontaneous communication, compared to the control group. The therapy also increased mand production (from 6.8 ± 4.3 in session 1 to 16.7 ± 7.7 in session 12; < 0.001; average gain: 0.9 per session), demonstrating steady growth in communicative initiative. These findings underscore the structured and engaging nature of NAO-assisted therapy in supporting consistent progress in communication skills. : NAO-assisted therapy is a promising, safe, and effective intervention for enhancing communication in minimally verbal autistic children, offering unique benefits in promoting spontaneous and consistent verbal engagement.