Objective To explore the effect of speech rehabilitation training combined with simulated game training on social communication ability in children with autism. Methods A total of 116 children with autism were selected as the research subjects, and they were divided into control group or observation group according to the interventional methods, with 58 cases in each group. The control group received routine rehabilitation training, based on which the observation group implemented speech rehabilitation training combined with simulated game training. Social communication ability with respect to Autism Treatment Evaluation Checklist (ATEC) score, core symptoms of autism in terms of Autism Behavior Checklist (ABC) score, childhood autism rating scale (CARS) score, improvement of clinical symptoms before and after intervention, and satisfaction of parents of children after intervention were compared between the two groups. Results After intervention, the scores of all dimensions of ATEC, ABC and CARS of the two groups were lower than those before intervention, and the aforesaid scores of the observation group were lower than those of the control group (P<0.05). The incidence rates of gastrointestinal reactions and excitement symptoms in the observation group were lower than those in the control group (P<0.05). The total satisfaction of parents of children in the observation group was higher than that in the control group (P<0.05). Conclusion Speech rehabilitation training combined with simulated game training can effectively improve the social communication ability of children with autism, reduce the core symptoms of autism, reduce the occurrence risk of gastrointestinal reactions and excitement symptoms, and improve the satisfaction of parents of children.