Pecs exchange communication system for students with autism spectrum disorder by Kelly Jean Sullivan

 Pecs exchange communication system

  

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     Pecs the picture exchange communicating system is a type of augmentative alternative communication.  The people who made this is a company called Pyramid Educational Consultants Inc.  This system can be used with both children with learning disabilities in preschool and children with autism. 

 (Charlop-Christy, M. H., Carpenter, M., Le, L., LeBlanc, L. A., & Kellet, K. 2002).

     Pecs was created by Lori Frost and Andrew Bondi in the mid-eighties at the dew aware autism program when Lori and Andy looked at the type of communication systems that were being used they saw that even the speech and sign language and even the child pointing systems all did one thing.  These systems all relied on the shoulders of the teacher to start the interaction. None of them focused on teaching the students the skills they need to imitate interaction and hence, be independent.  This for Lori and Andrew was the inspiration to create the pecs system

     What Lori and Andrew did was to create something to fill the gap.  They pecs system they developed was focused on how to teach the child functional communication skill and spontaneous child communication.

   (Frost, L. A. & Bondy, A. 1998).

     The pecs system is for nonverbal children or those children who only have a few words.

What is terrific is that pecs are not expensive to make, and the materials that can be used are not very expensive.  What pecs uses is a system of visual. What it boils down to is that pecs are a strategy or a method to teach students with disabilities especially autism how to communicate in a social context.

      One of the first things the teacher needs to determine is if the child is an intentional communicator.  What this would mean is that the child with autism is aware of the need to communicate their message to someone. 

     The next most important thing is that the child has preferences just like we assessed for possible selves the teacher needs to get to know the child and what motivates them once this is dome the teacher can be sure that the child is a good choice for that pecs.

 the research shows that it is helpful with the preschoolers who have communication impairments.  The research has shown that these students begin to speak. The research also shows that is it very effective for autism.Pecs is an EBP that is effective in communication.

      There is very little research, only five trials and smaller studies that had nineteen case studies that had three that have looked at the use of PECS for children with autism.

     This research did show that PECS may be an effective way to increase the social communication skills of some small children on the autism spectrum that were non-verbal or that had limited functional speech. 

    There is now  evidence to decide if PECS was able to show any benefits in reducing the challenging behavior to small children with autism. .

     PECS is a positive, cheap, and not time-consuming for the teacher to use. There is a debate on if the person using the Pecs needs training for it to be effective.  

(VIKER, B. 2002.)

 

   

     The teacher needs to go through the training on how to use the pecs system or the principals of applied behavior analysis, which is what this class is we are in now.  The program has a goal that the child with the communication impairment can spontaneous and can use functional communication.  The interesting thing is that verbal prompts are not used in the beginning. PECS produces immediate initiation, and it avoids the child's dependency on the prompting. 

     When the teacher uses pecs, they begin with teaching the child with the disability how to exchange a picture card of the item they want with the teacher or whoever they are trying to communicate with and then the teacher gives the child the object.  Then the child will then go to the next step and on their own request for the item.  The next step is 

  Teaching the child to construct sentences, and then the child is taught how to give their own response to a question or a request. One of the most exciting thing about PECS for me this that the students will learn to describe by size, and color

 . This procedure will be very helpful for the art teacher.

  In the art room especially

 For art history and critiques of their own artwork,

There are 6 phases of this program

     The first thing the teacher needs to do is to do an interest assessment

 of the student so that the cards and pictures that the teacher prints and makes are of interest to the student since this is a lot of work to print laminate and cut the teacher can save time by doing a lot of the work up front by narrowing down the child's interests.

       The kids of visuals that the teacher can use with this program are photos, black and white or colored simple line drawings or even symbols.  The square sizes I printed, and laminated were 2x2, but the teacher can make this bigger or smaller depending on the need of the child. The teacher can get a lot of the pictures already made off the pecs website or take photos themselves or if artistic draw their own.  The actual product form pecs are pricy.

     PECS begins with three people in the training situation, the child who will be sending a message, the person who receives the message-parent or teacher, and the adult who deliberately assists the message sender in making the targeted response. 

Phase 1-how to communicate with the child in this phase the spontaneous requesting and the two-person prompting procedure is used. the child will use the pickup and reach and then release procedure.  The objective is to have approximately 80 exchanges during the course of the day. 

Phase 2- getting distance and good perspective-the child here goes to or walks to the person they want to communicate with and takes or carries the PECS material or book with them.  The child keeps at it no matter what the obstacle. The PECS user is to be responsible for carrying his or her own communication book.

 

Phase3-using symbols- the child next will use the simple discrimination which is the one half of a second rule.it is in phase two that the four-step error correction procedure is used

In phase 3 the child also uses the conditional discrimination. here we use the correspondence check and also the four-step correction procedure the child is also capable of finding visual or pictures in the book on their own

Phase 4-using word phrases for sentence structures-here the child uses the sentence strips and constructs and exchanges sentence strips to communicate. The error correction procedure is used here. most important is that the teacher used the time delay to encourage speech form the child now.

Attributes /vocabulary that is descriptive. here the child requests specific items the child can use action words, descriptive words, For size the color or even the shape.

Phase 5- answering a question/"what do you want?"

Here the child maintains the spontaneous requesting, and the teacher uses the time delay. 

Phase6-commenting back-the child here will use responding commenting.

This commenting is different from the requesting. 

Frost &Bondy 2002

The commenting is spontaneous from the child.

The company has a set of steps to use with their pecs manufactured program.

          The program may take several months or several years to complete.

 The truth about those who say they are using PECS is that they may or may not be running the program as it was designed to be used.

      Teachers may start off using the strategy picture exchange and then not do the PECS procedures and phases. Something to watch to for it that the teacher tries to run the program without using a facilitator in the beginning.   I spoke to a represented of the PECs company on the phone I was told that following the first three stages and then moving to another intervention program such as video modeling would be ok to do.   (Frost, L.A., & Bondy, A.S. 2002).

 (Howlin, P., Gordon, R. K., Pasco, G., Wade, A., & Charman, T. 2007).

    There is evidence that pecs work best environment for it to work is in the general classroom. 

It is Important for the teacher to know that the research shows that the children who worked with pecs in one setting rather than many had a bigger number of on their own requests.  I could not believe this when I researched it. 

     In 2009 the national standards reported listed pecs as a new treatment but that there was not yet enough evidence to make evidence-based.  This is important for the teacher to know.

     The first question I was to ask was why.  I decided to call the company and see if I could get an answer. During the phone conversation, I was told that there was an initial concern that the pecs program may be a barrier to the child's speech growth.  The peer-reviewed article state that there is no evidence that stated that it helped.

      The problem can sometimes be with the person who is using the pecs and how they reinforce the child. The research also showed that in the beginning, the pecs did make big short time improvements in how the child could recognize words but that this did not continue in the long run. (Vicker.B.,2002)

       The company also told me that the biggest results were those that were in their preschoolers, which is what we learned in our autism class that early intervention is best.  The problem seems to be in that the long term results do not stick because it doesn't teach how to ask questions.  This then would be a great dove tail with other things we have learned to use and can help the child communicate when it's socially acceptable.  This would work great with the video modeling 

     Pecs is not evidence-based.

 PECS is a communication system that teachers can use that is very helpful with preschoolers with autism.  This system uses visuals to help nonverbal children with a low tech picture exchange system to learn functional communication skills. 

     Even though this is not evidence-based, this system has evidence from Studies that show that the use of the system did have a positive impact on the nonverbal children in increasing their functional communications skills.it is a good strategy to use with video modeling or other evidence-based strategies.  PECS is individualized and can be made cheaply. It would be the team's decision on how to use this or not to use this with a child with autism but should be considered when working with children who are no verbal.

   

References 

Beukelman, D. & Miranda, P. (1998). Augmentative and alternative communication: Management of severe communication disorders in children and adults (2nd Ed.). Baltimore, MD: Paul H. Brookes Publishing Company.

Charlop-Christy, M. H., Carpenter, M., Le, L., LeBlanc, L. A., & Kellet, K. (2002). Using the picture exchange communication system (PECS) with children with autism: assessment of PECS's acquisition, speech, social-communicative behavior, and problem behavior. Journal of Applied Behavior Analysis, 35(3), 213-231.

Flippin, M. Reszka, S. & Watson, L.R. (2009). Effectiveness of the Picture Exchange

Communication System (PECS) on communication and speech for children with autism

Spectrum disorders: a meta-analysis. American Journal of Speech-Language Pathology,

19, 178-195.

Frost, L. A. & Bondy, A. (1998). An introduction to PECS: The Picture Exchange Communication System. [Video recording]. Newark, DE: Pyramid Educational Consultants. 

Frost, L. A. & Bondy, A. (1994). PECS: The Picture Exchange Communication System. Cherry Hill, NJ: Pyramid Educational Consultants. 

Frost, L. A., & Bondy, A. S. (2002). The Picture exchange communication system training

Manual (2nd Ed.). Newark, DE: Pyramid Educational Products, Inc.

Howlin, P., Gordon, R. K., Pasco, G., Wade, A., & Charman, T. (2007). The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: A pragmatic, group randomized controlled trial. Journal of Child Psychology and Psychiatry, 48(5,473-481.

Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. §1400 et Esq.

(2004).

Kravitz, R. R., Kamps, D. M., & Kemmerer, K. (2002). Brief report: Increasing communication skills for an elementary-aged learner with autism using the picture exchange communication system. Journal of Autism and Developmental Disorders, 32(3), 225-230

McLean, J., McLean, L., Brady, N., & Etter, R. (1991). Communication profiles of two types of gestures using nonverbal persons with severe to profound mental retardation. Journal of Speech and Hearing Research. 34(2), 294-308.

Preston, D., & Carter, M. (2009). A review of the efficacy of the picture exchange

Communication system intervention. Journal of Autism and Developmental Disorders,

Reichle, J., York, J., & Eynon, D. (1989). Influence of indicating preferences for initiating, maintaining, and terminating interactions. In F. Brown and D. Lehr (Eds.), Persons with profound disabilities: Issues and practices (pp. 191-211). Baltimore, MD: Paul H. Brookes Publishing.

Vicker, B., (2002). What is the Picture Exchange Communication System or PECS? The Reporter, 7(2), 1-4, 11.

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