Picture Exchange Communication System
Pre-Assessment
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Pre-Assessment
What makes PECS unique from other graphic augmentative alternative communication (AAC) systems of communication?
Select an answer for question 204
Before beginning training with PECS, it is important to assess the learner's . . .
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Verbal prompts are allowed in any phase of teaching PECS.
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During Phase 3 of PECS training, the learner is taught to make a request from more than one picture or symbol. What is this called?
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When conducting pre-PECS teaching reinforcement sampling, how are preferred items confirmed? By...
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PECS has been shown to increase what abilities in children with whom it has been implemented long-term?
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Overview
A key characteristic of autism spectrum disorders (ASD) is that many individuals have difficulty developing and using verbal speech to communicate with others. The Picture Exchange Communication System (PECS) has been used to help children and youth with ASD develop a system for communicating with teachers, parents, and peers. PECS was initially developed at the Delaware Autistic Program (Bondy & Frost, 1994) as an alternative communication system and has since been demonstrated in the research literature to promote speech development and production (Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002). An updated version of the original procedures is now available (Frost & Bondy, 2002).
This module will define PECS, outline the steps to effectively implement it, and provide specific examples for its use across settings and age groups. It is not intended, however, to take the place of training and resources on PECS provided by Pyramid Educational Consultants, Inc., (www.pyramidproducts.com). Further, the strategies described in this resource should be implemented under the supervision of a trained professional. PECS can be used across age ranges, starting in preschool, to help individuals with ASD communicate with others.
What is PECS?
PECS falls into the category of augmentative and alternative communication (AAC) systems and is considered an aided technique (Mirenda, 2003). AAC systems are included in a larger grouping of systems and methods that are used to help individuals who do not have typical verbal skills to communicate with others. Examples of commonly used AAC systems include sign language and picture boards. PECS is another type of AAC system that was designed to teach children with limited functional communication skills to initiate communicative exchanges and interactions within a social context.
According to the developers of PECS, it is a behaviorally-based intervention that teaches the learner to use visual-graphic symbols to communicate with others (Bondy & Frost, 1994; Frost & Bondy, 2002). With PECS, learners are taught to give a picture or graphic symbol of a desired item to a communicative partner in exchange for the actual item. PECS is the system of communication, not to be confused with how PECS is taught and used (e.g., behavioral principles).
There are six phases of PECS instruction, each building on the last. The phases include the following:
o teaching the physically assisted exchange
o expanding spontaneity
o simultaneous discrimination of pictures
o building sentence structure
o responding to "What do you want?"
o commenting (initially in response to a question and later spontaneously)
Unlike other graphic systems of communication, the individual using PECS hands the symbol depicting a desired item to the communicative partner. After learners understand that PECS can be used to make requests (e.g., demands), it can be extended to other communicative functions (e.g., labeling, questioning) and to other contexts (e.g., home, community).
Each of the phases will be explained more in depth throughout the module. It is essential that the phases are taught sequentially.
Why Use PECS?
Children and youth with ASD may not use words the way most typically developing children do. In fact, impairment of communication skills is a core feature of autism spectrum disorders (American Psychiatric Association, 2000). Some children with ASD do not use or have limited use of eye contact, vocalizations of any type, or gestures to communicate with others. Instead, children and youth with ASD sometimes learn and use other means (at times inappropriately) to gain the attention of others and to obtain desired objects/outcomes.
Early intervention is a well-established and supported practice (Thompson, 2007) and is critical for helping children and youth with ASD develop communication skills as early as possible. For children who do not develop typical verbal and nonverbal communication skills, learning to express wants and needs can be challenging. Delays in developing these skills can cause frustration for both the child and the caregiver and may lead to behavioral challenges. AAC systems such as PECS can be highly effective tools in helping to decrease challenging behaviors and increase the use of appropriate functional communication.
Who can use PECS and where can it be used?
While any professional, parent, or caregiver may use PECS procedures, it is recommended that those interested in doing so receive professional training. Training is available from the individuals who developed and market the PECS system through Pyramid Educational Consultants, Inc. (For more information, see www.pyramidproducts.com). The information in this module is intended to provide a detailed overview of how PECS may be successfully implemented and to supplement training for parents and paraprofessionals working with a child or youth with ASD in a variety of educational and community-based settings. PECS can be implemented anywhere communication is desired or needed and across a variety of home, school, and community settings (see evidence-base reference list in the Resources section).
With what ages is PECS most effective?
Research has shown that PECS is effective with preschool and elementary children across a variety of home, school, and community settings (e.g., Howlin, Gordon, Pasco, Wade, & Charman, 2007; Yoder & Stone, 2006). For more information about the evidence base for PECS, see the reference list in the Resources section. While most of the research in this area has been completed with younger children, there is some evidence that it also works with students in middle school (Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002). Additional research supports the effectiveness of PECS with adult learners (Chambers & Rehfeldt, 2003; Rehfeldt & Root, 2005; Stoner et al., 2006).
What assessments should be conducted prior to using PECS?
If you are considering using PECS for a student with ASD, some assessments probably have been completed already. These assessments often include formal intelligence tests and tests of adaptive behavior/functioning, including social interactions and communication skills. However, teachers should conduct two additional assessments prior to implementing PECS training. First, a checklist should be completed to determine the student's current communication skills. For example, it would be helpful to know whether the student is currently requesting, what kinds of directions are needed to complete a task (e.g., visual, oral), and how the student transitions between activities. Such information can help teachers determine target skills for PECS training (e.g., requesting, initiating interactions) as well as the types of prompts that can be used to facilitate communicative exchanges (Frost & Bondy, 2002).
In addition to the communication assessment, a reinforcer sampling should be conducted. A "reinforcer sampling" is an informal inventory of items and activities that are of particular interest to the learner. There are a number of options for completing reinforcer sampling; however, for children and youth with limited communication skills, the following steps are suggested (Fisher et al., 1992):
1. Gather a selection of items that may be favorable to the individual. These items can be identified by asking caregivers and observing the individual.
2. Present the learner with pairs of choices, being sure to match each item at least once with the other items being sampled (this is to determine relative preference). Also, vary left and right presentation throughout to minimize the effects of a side preference on the part of the learner.
3. Document the items chosen most often, least often, or that produce a notable response (e.g., learner tastes something and spits it out, learner throws item after choosing it).
From this informal assessment, a selection of favorite items to be used during PECS training is created. These reinforcing items will help to increase student motivation as well as promote acquisition of effective communication skills.
Implementing PECS
Once an adequate number of desired reinforcers has been identified and gathered, picture/symbol cards are created. The number of reinforcers and picture cards will vary for each individual; however, the goal is to provide enough choices to keep the learner engaged and motivated. Cards can be created by using simple drawings or pictures taken with a digital camera. The decision to use photos versus pictures or line drawings is based on the skills of the individual with whom you are using them. Resources are also available for creating cards at no cost. Please see the Document section of RESOURCES for more information.
Other factors to address prior to beginning PECS instruction include the following:
o Training Environment. One important goal of PECS is that it should be used across all natural environments. In the early phases of teaching, the setting for training remains structured and consistent (described in each phase of training). As the student becomes more proficient at using PECS, the learning environment is more relaxed to promote generalization of skills.
o Teachers/Adults. Initially, two adults are involved in training: one is identified as the "helper" and the other as the "communicative partner." These two adults can trade roles throughout PECS. Finally, PECS should be used across all natural settings to assist in creating a functional communication system that children and youth with ASD can use to communicate with a variety of communication partners including same-age peers.
Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com)
o Communication Pictures/Symbols and Book. In the early phases of instruction, only a few pictures/symbols are used. It is important to have a designated communication book in which commonly used pictures/symbols are stored. Frost and Bondy (2002) recommend using small three-ring binders with Velcro strips placed on the cover and inside the book and attaching pictures organized by theme, making it as functional as possible. Many teachers organize books by vocabulary categories such as food, toys, places, people. Others organize by activities of the day (e.g., snack time, library time, play time). Additional pages can be added as needed. As the learner begins to use PECS across settings and with varying communication partners, a second copy of the book as well as extra pictures/symbols should be created for use in the home setting. One common practice is to create a CD with a PDF file of pictures that can be quickly printed out for replacement pictures. See the Resources section for more detailed information about how to create and set up communication systems for individual children.
o Monitoring Individual Student Progress. In each phase of the training process it is essential that individual student progress is monitored so that teachers and other professionals can make informed decisions about when to fade prompts as well as when to move on to the next phase. Frost and Bondy (2002), the developers of PECS, recommend multiple communication training opportunities spread across the day, with training continuing within each phase until the child has reached 80% or greater proficiency for a minimum of three days before moving on to the next phase. Throughout this module, the methods that can be used to monitor student progress in all of the phases will be discussed. To access existing progress monitoring forms and checklists, you will need to purchase the Picture Exchange Communication System Training Manual (Frost & Bondy 2002) at http://www.pyramidproducts.com.
Once the key players (e.g., learner, helper, partner), reinforcers, and initial materials have been identified and developed, PECS training can begin. The six phases of instruction are outlined below.
Phase 1: Teaching the Physically Assisted Exchange
The outcome of Phase 1 is for the learner to look at, reach for, pick up, and hand the picture/symbol to his/her communication partner. These are the basic skills needed to effectively communicate using PECS (Frost & Bondy, 2002). To achieve this, the following factors must be taken into account:
o training environment
o communicative exchange
o reinforcers
o teaching strategies
o progress monitoring
o Training Environment
o The training environment includes opportunities for both structured and unstructured learning (Frost & Bondy, 2002). In the structured training environment, the student with ASD may be seated across from the communication partner, with a helper seated behind or beside him or her to assist in developing the desired actions (e.g., reaching, picking up). It is not necessary for the learner to be seated. Some learners with ASD may find learning PECS easier if they are allowed to move about the room. At the beginning of the training session, one of the highly preferred items identified through the reinforcer sampling is on the table and out of reach of the learner. The picture or symbol of that item is on the table between the learner and the item.
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o Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com)
o PECS training also can occur during more unstructured learning activities such as during free play or on the playground. Teachers and other classroom staff must be vigilant to ensure that PECS training takes place across daily routines and activities. For example, if a student on the playground seems interested in swinging with peers, the teacher and helper should stop what they are doing, grab the communication book with a picture of a swing, and help the child request a turn from a peer. This learning opportunity will help the child generalize the use of newly acquired skills across settings, activities, and people (Frost & Bondy, 2002).