What is the first step Ms. Rooney should take to facilitate Lila's use of a picture communication board?

Determining what is most motivating to Lila and customizing the corresponding card is the appropriate first step in facilitating her use of a picture communication board because motivation is essential in enhancing communication skills, especially for individuals with Autism Spectrum Disorder (ASD). When communication aids are tailored to the individual's interests and preferences, they are more likely to engage with the board and use it effectively.

By identifying what motivates Lila—such as her favorite toys, activities, or interests—Ms. Rooney can create a personalized communication board that captures her attention and encourages her to express herself. The motivational aspects can significantly impact her willingness to use the board and interact with others, promoting communication development and overall engagement.

The other choices, while valuable parts of the process, ideally follow this initial step. Creating a set of cards based on common items or teaching Lila how to match cards to items would be more beneficial once there is a foundational understanding and interest in using the communication board. Providing cards for home practice is also effective but would be most helpful after establishing motivation.