PECS

• What does pecs stand for?

  Picture exchange communication system.
• What is PECS?

  Developed by Bondy & Frost in 1985.

  It is an alternative communication system.

  It enables people with ASD to improve their functional communication.
• Pre-programme preparation

  Determine what the child likes and what is rewarding to them.

  Reinforcer assessment is carried out where the child is observed.

  Child’s caregivers asked about the child’s preferences.

  Eg place toys on the table and observe which ones the child plays with.

  Once determined what the child likes, these things are placed in a hierarchy. Child given choices between different items.

  Assess how much effort the child puts into obtaining what is being offered.
• What are the stages of PECS

  Initiating communication

  Expanding the use of pictures

  Choosing the message within PECS

  Introducing sentence structure within PECS

  Teaching answering simple questions

  Teaching commenting
• Initiating communication

  One person plays the ‘communicative partner‘ and the other plays the ‘physical prompter’.

  The child is shown an item they want.

  As the child reaches for the item, the physical prompter guides the child to pick up the picture and place it in the open hand of the other adult.

  The child is given the item as the adult says the items name.

  This is repeated.

  Role of physical prompter is to reduce the need for assistance as quickly as possible.
• Expanding the use of pictures

  During the first session, an adult and picture is placed in front of the child. The child has to reach out to grab the picture. As the sessions progress the adult & picture get further away, increasing persistence of the child.

  Communicative folder introduced. Folder filled with laminated picture cards. Front has velcro fixed to its middle for picture to be placed on.
• Choosing the message within PECS

  Range of pictures used in the child’s folder increased.

  Child learns how to select specific messages. Learns to discriminate between the pictures.

  Only one other adult as the child doesn’t need physical assistance.

  At first the second picture will be a neutral or disliked item to teach the child to be selective. They are given the item of the picture they choose.
• Introducing sentence structure

  Child starts to build sentences by creating sentence strips.

  ’I want’ or ‘I see’ icons placed alongside pictures.

  Child encouraged to touch each picture as the trainer reads out the sentence.
• Teaching answering simple questions

  At this stage, the child should be requesting spontaneously using sentence structure.

  Child asked ‘what do you want?’ prior to being presented with something they desire.

  Over time, presenting the items desired is eliminated. Child asked ‘what do you want?’ Whilst pointing to the ‘I want’ picture.

  In time, the child will respond without the trainer pointing to the picture.
• Teaching commenting

  Child taught to reply to other simple questions such as ‘what do you hear?’ and ‘what do you have?’

  Item taken out of box. Trainer says ‘oh! What do you see?’ Or ‘look! What is it?’ Whilst the questions is asked the trainer points to the ‘I see’ picture on the communication folder.

  The child picks up the picture & item.

  Trainer reads sentence back to child & praises them.

  Question gradually eliminated to promote spontaneous commenting.
• After completion

  Children who have completed each step should be able to:

  Request wanted & needed items spontaneously & in response to questions.

  Comment spontaneously on aspects of the world.

  Promote asking for help over eg getting frustrated and having a tantrum.
• Charlop-Christy et al (2002)

  Investigated the effects of a PECS programme on the development of speech in 3 boys with ASD.

  All had been through speech training programmes that had been ineffective.

  All had virtually non-existent spontaneous speech.

  Found all made significantly more spontaneous speech utterances after PECS. Maintained after 12 months.

  Eye contact improved & reduction in problem behaviours.
• Strengths of PECS

  Supporting evidence.

  Ease of use.

  Can be used informally

  Boost child‘s self-esteem.

  Increases successful communication in the family.

  Positive reinforcement.
• Weaknesses of PECS

  Lack of reliable evidence

  In some cases speech negatively effected by PECS

  Will communication continue without reward?

  Costs money - seeks profit.