Healing Thresholds Autism Therapy Topic Feed

Picture Exchange Communication System (PECS) for Children with Autism

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

Body:

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.

back to top

References

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.

Read original article: Dragon Slays One Bad Habit for Child with Autism

Responding to picture exchange communication system (PECS)

Tue, 26 Jul 2011 04:35:21 +0000

PECS is amazing! At first i was hesitant to try it, thinking if its really even gonna work. I'm so glad we did! My son started on PECS at the age of 4, and had no words in his vocabuary. Now I'm so thankful to say At the age of 5 he is a pro at his PECS book he says I WANT... what ever item he is asking for, he can now say every word in his book up to 40! he is now starting to ask for thing without the book! The PECS book helped so much with tantrum because he is able to express to us what he wants!!!!!

Responding to picture exchange communication system (PECS)

Mon, 06 Jun 2011 15:07:18 +0000

Very interesting and useful information that I could work with.

Responding to picture exchange communication system (PECS)

Fri, 20 May 2011 15:15:07 +0000

My daughter who has ASD was taught using the PECS SYSTEM at her school and I also used the same method at home using my homemade pictures to communicate with my daughter when she was about 4 rs old. She's now thirteen and I can't get her to stop talking. I thought my daughter would never talk again. I think the PECS SYSTEM should be used for Early Intervention for children with delayed speech with Autism.

Ms Trauma F Newell

Responding to picture exchange communication system (PECS)

Fri, 20 May 2011 15:13:24 +0000

Ms Trauma F Newell

Responding to picture exchange communication system (PECS)

Fri, 17 Sep 2010 14:41:06 +0000

This is a great description of PECS, overall. One of the key tenets of the PECS protocol, though, is that the PECS user learns to initiate the communicative exchange. This means that Phase I must involve a 2-person prompting procedure. That is, there is a communicative partner who has what the learner wants, and a physical prompter who assists the learner to complete the picture exchange. If the assistance comes from the communicative partner, the lesson is confusing for the learner and the prompts are harder to eliminate.

Responding to picture exchange communication system (PECS)

Fri, 17 Sep 2010 14:39:57 +0000

This is a great description of PECS, overall. One of the key tenets of the PECS protocol, though, is that the PECS user learns to initiate the communciative exchange. This means that Phase I must involve a 2-person prompting procedure. That is, there is a communciative partner who has what the learner wants, and a physical prompter who assists the learner to complete the picture exchange. If the assistance comes from the communciative partner, the lesson is confusing for the learner and the prompts are harder to eliminate.

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.”

Read 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.