Healing Thresholds Autism Therapy Topic Feed

Picture Exchange Communication System (PECS) for Children with Autism

PWSMom — Fri, 06 Nov 2009 17:35:25 +0000

What is it?

A picture exchange communication system (PECS) is a form of augmentative and alternative communication (AAC) that uses pictures instead of words to help children communicate. PECS was designed especially for children with autism who have delays in speech development.

When first learning to use PECS, the child is given a set of pictures of favorite foods or toys. When the child wants one of these items, he gives the picture to a communication partner (a parent, therapist, caregiver, or even another child). The communication partner then hands the child the food or toy. This exchange reinforces communication ^(1-4).

PECS can also be used to make comments about things seen or heard in the environment. For example, a child might see an airplane overhead, and hand a picture of an airplane to his or her parent. As the child begins to understand the usefulness of communication, the hope is that he will then begin to use natural speech ⁽⁵⁾.

What's it like?

A child can be trained in PECS by a parent, caregiver, or therapist who has learned about the method (see Resources). An applied behavior analysis (ABA) approach is used, in which prompts are given to guide the picture exchange. Further, in the early phases of PECS training, the child chooses a picture of a desired food, and receives the food in exchange for the picture. Getting the food is the positive reinforcement for using the picture to communicate.

PECS is usually taught in six phases ^{(6, 7)}:

Phase One: The communication partner makes a list of the child’s favorite items (usually beginning with foods). One of these items is selected for the first training session, and a picture of the item is made. That item can be placed under a clear container, so the child can see it, but not get it. If the child looks interested in the item, the communication partner gives the child the picture card. Then the child is prompted (usually by holding his/her hand and guiding it) to hand the picture card back to the communication partner. Once the communication partner receives the card, the request is spoken aloud (“Oh, you want the cookie! You can have it!”). At this point, the requested item (which has become the reinforcer) is given to the child.
Phase Two: The communication partner moves slightly away from the child so that the child has to move towards the communication partner to place the picture card in his/her hand.
Phase Three: The child is given more than one picture card. Now the child must choose which one represents a desired object, and then give this card to the communication partner. At this point, the child may be using a communication board or a binder in which to hold the cards.
Phase Four: The child is given a card with the phrase "I want ____" on it. This card now must be used with the picture card showing what is desired. The idea is that the child will learn how to communicate using complete sentences. Even children who cannot yet read can learn to recognize the words as symbols on the cards.
Phase Five: Before this point, the child has never been asked directly, "What do you want?" In this phase, the communication partner asks the child this direct question, and waits for the child to hand him/her a picture card. This builds the foundation for future communication when a parent needs to know the desires of his or her child.
Phase Six: Once the child can use PECS with fluency and has generalized the system to more than one communication partner, the child is taught how to comment on something s/he observes. The communication partner holds up an interesting object, asking the child, "What do you see?" at the same time pointing out the "I see ____" card. The child is then prompted to place the picture card representing the object next to the "I see ____" card. The parent then comments on the cards ("Yes! I see the airplane too"). In this way, the child learns how to communicate his or her observations and experiences to others.

What is the theory behind it?

The direct reinforcement that comes from immediately getting what you want is the key to PECS. Without having to use spoken words, a child is able to turn an inner desire into an external reward. It is thought that tangible rewards are more reinforcing to children with autism than social rewards, at least during the first steps of communication learning. However, if these rewards are too difficult to receive – that is, if it is very difficult for the child to form words – then the point of communication may, at first, be lost on these children. This can result in tantrums and other undesirable behavior, because the child cannot clearly communicate what s/he wants. However, when children with autism are trained in PECS, problem behaviors often subside as the benefits of communication become more tangible ^{(1, 4, 5)}.

PECS may also help improve social interactions in children with autism. Because the child is in charge of approaching the communication partner, the child learns how to make the first move. For children with autism, approaching another person socially can be difficult. However, in this case, the child is not expected to speak, so the initial approach may be less intimidating ^{(1, 2)}.

Does it work?

There are several well-designed research studies showing the usefulness of PECS ⁽⁸⁾. In one study of 18 preschool children with language delays, some of whom were diagnosed with autism, PECS generalized across communication partners and environments ⁽⁶⁾. These children were able to use PECS to communicate throughout their school days, not just during the training sessions. Further, almost half of these children stopped using PECS and started using natural speech within a year ⁽⁶⁾. One parent commented that "PECS turned on the light for communication" in her child ⁽⁶⁾. Similar results were found for two smaller, but still well-designed studies ^{(5, 7)}.

A larger study of school-aged children found significantly increased use of PECS when adults trained in the use of PECS were in the classroom. The study involved 6 half-days of PECS intervention per month for 5 months. While use of PECS by the children increased, there was no significant increase in verbal language use ⁽⁹⁾. The children's use of PECS diminished after classroom visits by the trained adults were stopped ⁽⁹⁾.

Recently, a comparison was made between PECS and another popular AAC technique, Responsive Education and Prelinguistic Milieu Training (RPMT). The results showed that children with autism trained in PECS were more verbal than those for whom the RPMT approach was used ⁽¹⁰⁾.

Overall, the evidence supports the use of PECS as a tool for developing natural communication in children with autism, especially when it is taught before the child is six years old ^{(3, 8)}.

Is it harmful?

There are no known negative effects of PECS. Some parents have been concerned that their child will become dependent on PECS and not move on to develop natural speech. However, this view is not supported by research studies. In fact, there is evidence that children with autism who have learned to use PECS develop speech more quickly than those who have not been trained in PECS (see Does it work?) ^{(2, 4)}.

Cost

The materials used in PECS are relatively inexpensive. A binder for storing PECS pictures can be made from a 3-ring binder. A Velcro^TM strip is attached to the front cover to hold the picture(s) currently being used. Each picture can be drawn by a parent, cut out of a magazine, or made from an actual photograph of the object glued onto a card. A Velcro^TM strip can be placed on the back of each picture to hold it in place on the front cover of the binder when it is being used. Each picture can be hole-punched for storage in the binder ⁽¹⁾.

A more expensive alternative is to purchase a PECS binder and several commonly used pictures (see Resources). However, even if you purchase these ready-to-use PECS systems, you will have to create your own pictures of preferred items that are unique to your child.

The more expensive side of PECS can be the expertise involved in PECS training. However, PECS can be covered in speech therapy under IDEA (see Resources). Also, PECS training manuals are available for $40 to $70 for parents and other caregivers (see Resources).

Resources

Healing Thresholds has partnered with Natural Learning Concepts. They have many tools that will make it easier to do PECS in your own home.

Many PECS resources, including commonly used pictures and PECS binders can be found at: http://www.pecs.org.uk/.

Several books that might be useful:

Empower! by Beth A. Soeder, M.A., SLP-CCC and Catharine M. Critz, Ph.D., CPNP, 2003. Pyramid Educational Products, Inc.

A Picture's Worth: PECS and Other Visual Communication Strategies in Autism (Topics in Autism) by Andy Bondy, Ph.D., and Lori Frost, M.S., CCC/SLP, 2001. Woodbine House.

PECS Training Manual, 2nd Edition by Lori Frost, M.S., CCC/SLP and Andy Bondy, Ph.D., 2002.

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References

What is it?

Tablet Computers as Method for Kids with Autism to Communicate

scottie — Wed, 06 Mar 2013 15:00:00 +0000

Teaser:

New research from the University of Canterbury has shown that non-verbal kids with autism can use tablet computers to request food and toys.

Body:

New research from the University of Canterbury (UC) has shown that non-verbal kids with autism can use tablet computers successfully to request food and toys. Dr. Dean Sutherland, UC researcher, explained, “This is an exciting finding that provides evidence to support the use of these devices but we have some way to go to fully complete this study.” Sixty percent of the children they studied preferred the tablet as a way to communicate as opposed to PECs or sign language. Sutherland said their next step is to determine if children learn better communication more quickly if they are using a device they are most comfortable with.

Original Article:

Young Autistic Children Like to Communicate Via Computers

Speech and Language Therapy as Early Intervention for Autism

scottie — Mon, 17 Dec 2012 15:00:00 +0000

Teaser:

This article suggests that a third of the children diagnosed with autism have communication issues.

Body:

This article suggests that a third of the children diagnosed with autism have communication issues. These issues include not talking, unintelligible sounds, speaking in a sing-song tone, and repetition. The earlier speech and language therapy starts, the better the chances are that the child’s communication skills may improve. Speech and language therapy doesn’t just involve speaking, but also helping a child use facial expressions and body language. Other options used to increase speech and language skills include electronic talking devices, sign language, typing, picture boards (PECS), and facial massage.

Original Article:

Speech & Language Therapy for Autism in Children

A Library in Wisconsin Becomes Autism-Friendly

scottie — Thu, 08 Nov 2012 15:00:00 +0000

Teaser:

Georgia Jones, a librarian at Friday Memorial Library, went to a workshop to train librarians how to make their libraries autism-friendly.

Body:

Georgia Jones, the youth librarian at Friday Memorial Library, went to a workshop designed to train librarians about autism and how to make their libraries autism-friendly. Jones began a Sensory Storytime and she focuses on “consistency, slower speaking and transition time.” The library also provides fidgets (sensory hand toys) and weighted blankets so the children will feel more comfortable. As well as the training Jones received, the library has purchased books and DVDs related to autism. They also have in place Boardmaker software for families to create PECS, flashcards, and visual schedules. The library hopes to expand into working with teens and adults with autism.

Original Article:

Friday Memorial Library Works to Become Autism-Friendly Facility

The Need for Evidence-Based Autism Therapies

scottie — Mon, 05 Nov 2012 15:00:00 +0000

Teaser:

At Healing Thresholds we have always advocated for evidence-based therapies for autism; here’s a mom who agrees.

Body:

At Healing Thresholds we have always advocated for evidence-based therapies for autism; here’s a mom who agrees. Joslyn Gray, creator of stark.raving.mad.mommy blog went searching for evidence-based therapies when her son was diagnosed with autism. She found that while there were few treatments that were evidence-based, there were no lack of heresay evidence that she said supported “just about any therapy from the completely whackjob to the seemingly sensible.” She came across a recent study, led by researcher Margaret Maglione, that rated levels of therapeutic evidence from moderate to insufficient. The lead therapies reported in the research were applied behavior analysis (ABA), integrated behavioral/developmental programs, picture exchange communication system (PECS), and various social skills interventions for Asperger’s and high-functioning autism.

Original Article:

Study: More Evidence Needed on Which Autism Therapies Really Work

What’s the Difference Between ABA and Verbal Behavior Methods?

scottie — Mon, 08 Oct 2012 23:27:40 +0000

Teaser:

This article is written in response to a question about autism therapy for a child with autism.

Body:

This article is written in response to a question about autism therapy for a child with autism. The child’s parents asked, “What is the difference between applied behavior analysis and verbal behavior methods, and which one does our child need? The referenced response from the Continuum Autism Spectrum Alliance explained that verbal behavior therapy is a type of ABA, and covers any type of communication. Verbal behavior includes sign language, speaking, picture exchange communication system (PECS), pointing, and crying. Because many times the child with autism has communication difficulties, it makes sense to include verbal behavior with ABA.

Original Article:

Applied Behavior Analysis & Verbal Behavior

A Family Shares Adventures with Their Son with Autism

scottie — Tue, 26 Jun 2012 14:51:31 +0000

Teaser:

This article speaks to how creative a family can be when they have a child with autism.

Body:

This article speaks to how creative a family can be when they have a child with autism. Because the Lettieri’s son, Jordan, cannot speak and uses picture symbols to communicate, they were worried about his safety in the neighborhood. The town of North Tonawanda made a traffic sign for their town, Wheatfield, to warn drivers that a child with autism lived in the area. The Lettieri’s also reported that their son is doing well in the BOCES program at school; he’s good with jigsaw puzzles, and he loves to swim and jump on the trampoline. Knowing that Jordan has trouble with new people, places, and things, they were hesitant about the Autism on the Seas cruise they recently took. They were amazed at the caring staff and their immediate connection with Jordan – the wait staff knew just what he liked to eat, and the respite staff were his good friends so his parents could get away on their own. His dad explained, “He’s just a good, fun-loving kid. You’d have to meet him or be around him to know that he’s just a sweet kid.”

Original Article:

Working on Behalf of Son with Autism

Dragons as Behavior Rewards for Child with Autism

scottie — Fri, 05 Aug 2011 17:15:28 +0000

Teaser:

This article highlights cooperation between teachers, family members, and school peers to help a youngster with autism.

Body:

This article highlights cooperation between teachers, family members, and school peers to help a youngster with autism change some behaviors. Eli, who thrived in a special class for kids with autism, learned to speak after using picture exchange communication systems (PECS), and even began to read with the help of augmentative and alternative communication (AAC). All of a sudden, he began to regress, and the rewards that family and teachers had used in the past were no longer working. First the teachers discovered that Eli’s mom had started working since he had been doing so well in school. Then they figured out that newer younger children in the classroom were getting more attention than Eli was used to. Eli loved dragons and since the Disney movie, How to Train your Dragon, had been used as a reward so often, the staff began looking for dragon toys. Using the toys as a reward began to work for Eli, at school and at home. The added benefit was that other students helped him with his behavior, because they got an extra trip to the toy box.

Original Article:

Dragon Slays One Bad Habit for Child with Autism

School District in South Carolina Receives Grants to Improve Schools for Children with Autism and Other Disabilities

scottie — Wed, 08 Sep 2010 16:42:14 +0000

Teaser:

The Berkeley School District in South Carolina received grant money from the South Carolina School for Exceptional Children specifically to upgrade programs for students with autism.

Body:

The Berkeley School District in South Carolina received grant money from the South Carolina School for Exceptional Children specifically to upgrade programs for students with autism. Uses for the money include training for teachers in the Picture Exchange Communication System (PECS), transition services for children moving from elementary school into middle school, and a job awareness and community connection program for older students with mild to moderate mental disabilities. Dr. Karen Whitley, Chief Academic Officer for the school district said, “Special educators will receive training on 11 effective treatment practices and data collection procedures for children with ASD’s. . . . In addition, parents of Berkeley County youth with autism can receive training on facilitating effective home and school partnerships.”

Original Article:

School District Awarded $196,000 in Grants

Picture Exchange Communication (PECS) Training for Young Children: Does Training Transfer at School to Home?

scottie — Tue, 13 Jul 2010 15:00:00 +0000

Title	Picture Exchange Communication (PECS) Training for Young Children: Does Training Transfer at School to Home?
Publication Type	Journal Article
Authors	Carre AJM, Le Grice B, Blampied NM, Walker D
Journal Title	Behavior Change
Year of Publication	2009
Volume	26
Issue	1
Pages	54-65
URL for Abstract	http://www.atypon-link.com/AAP/doi/abs/10.1375/bech.26.1.54
Teaser	Picture Exchange Communication (PECS) may be easily taught to children with autism, but it may be hard to teach the children to generalize PECS requests outside of therapy sessions and into school and home.
Full Text	Picture Exchange Communication (PECS) may be easily taught to children with autism, but it may be hard to teach the children to generalize PECS requests outside of therapy sessions and into school and home. This study focused on the extent to which PECS training transfers to the classroom and home. The three children in the study (5-6 years old) learned PECS quickly. The children did not make many PECS requests outside of the therapy session. The child who had the most PECS training was also the child who made the most PECS requests in school. The authors suggest that it may be important to have trained PECS communication partners in the school and home in order to get the child to use PECS in different settings.

Healing Thresholds Autism Therapy Topic Feed

Picture Exchange Communication System (PECS) for Children with Autism

What is it?

What's it like?

What is the theory behind it?

Does it work?

Is it harmful?

Cost

Resources

References

What is it?

Table of Contents

Tablet Computers as Method for Kids with Autism to Communicate

Speech and Language Therapy as Early Intervention for Autism

A Library in Wisconsin Becomes Autism-Friendly

The Need for Evidence-Based Autism Therapies

What’s the Difference Between ABA and Verbal Behavior Methods?

A Family Shares Adventures with Their Son with Autism

Dragons as Behavior Rewards for Child with Autism

School District in South Carolina Receives Grants to Improve Schools for Children with Autism and Other Disabilities

Picture Exchange Communication (PECS) Training for Young Children: Does Training Transfer at School to Home?