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 . . .
Select an answer for question 205
Verbal prompts are allowed in any phase of teaching PECS.
Select an answer for question 206
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?
Select an answer for question 207
When conducting pre-PECS teaching reinforcement sampling, how are preferred items confirmed? By...
Select an answer for question 208
PECS has been shown to increase what abilities in children with whom it has been implemented long-term?
Select an answer for question 209
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
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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.
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 o o o o teaching the physically assisted exchange expanding spontaneity simultaneous discrimination of pictures building sentence structure responding to "What do you want?"
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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.
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.
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
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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).
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).
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
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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.
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
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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
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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.
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 o o training environment communicative exchange reinforcers teaching strategies o o o progress monitoring
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 o 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 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).
o o Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com) o The physically assisted communicative exchange is prompted by physically interrupting the learner's reach toward the actual, desired item, and redirecting the learner to pick up the picture/symbol instead. It is important at this stage to use NO VERBAL PROMPTS, as this helps the student become more independent and less reliant upon others during communicative exchanges.
Once the learner grasps the picture/symbol, the assistant helps him to place it in the open hand of the communication partner. Once the picture/symbol is in the hand of the communication partner, s/he responds by saying the name of the item/activity.
If the learner does not indicate an interest in the available reinforcer (e.g., does not reach for the item), the communication partner presents the reinforcing item again while maintaining silence (i.e., NO VERBAL PROMPTS). To gain the attention/interest of the learner, the communication partner may use other cues such as showing the object or playing with the object in front of the child. It is imperative that neither the helper nor the
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communication partner says anything until the picture has been received from the learner and is in the communication partner's hand.
Two teaching strategies are used during Phase 1 and are critical in helping students with ASD acquire the basic communicative exchange skills. They include (a) fading physical assistance and (b) fading open-hand prompt.
Fading Physical Assistance
Initially, total physical assistance (i.e., hand-over-hand) is used to help the learner navigate and practice successful exchanges; however, this must be gradually reduced so that the child can initiate and complete an exchange with few or no prompts.
Backward chaining is a common strategy that can be used to fade and eliminate the physical prompts used by the helper. With backward chaining, the helper assists through to the final step of the exchange and then gradually fades assistance as the student becomes more independent. Sometimes it is helpful to move from the full physical assist (i.e., hand-over-hand) to a touch or gesture prompt as fading begins. It is important to note, however, that the communication partner continues to show an open hand whenever the child reaches for the picture while the helper's prompts are faded.
While the goal of PECS is independent communication, some learners may not reach complete independence. The level of independence may vary according to student needs and abilities. This should not discourage you from using PECS with learners having physical or other limitations (Frost & Bondy, 2002).
Fading Open-Hand Prompt
As physical assistance is decreased and as students become more independent during communicative exchanges, the communication partner can begin to fade the open-hand prompt. Some learners may continue to need some physical guidance (e.g., mild touch, gesture prompts) while others may need no prompt assistance to participate in exchanges. The goal is for the learner to initiate the handing of the picture/symbol before the communication partner opens his/her hand to receive the item.
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Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com)
In Phase 1, progress monitoring focuses on student participation in the training process.
Specifically, teachers and other professionals collect data on the skills used during the communicative exchange (i.e., picking up, reaching, releasing). Teachers also record what types of prompts were needed to complete the communicative exchange (e.g., full physical, partial physical). This information will help teachers and other professionals make decisions about when to move on to Phase 2 (Frost & Bondy, 2002).
Phase 1 data collection forms may be found on pages 370-371 of the PECS Manual
(Frost & Bondy, 2002).
Phase 2 can begin as soon as students have acquired the basic skills outlined in Phase
1 (e.g., reaching for the high-interest item, picking up the picture/symbol of the item, handing the picture/symbol to the communication partner, acquiring the high interest item). There will continue to be many opportunities for the learner to practice these skills in a variety of settings with highly desirable reinforcers.
o o o
The outcome of Phase 1 is for the learner to look at, reach for, pick up, and hand the picture/symbol to the communication partner as independently as possible.
During Phase 1, two individuals (i.e., helper, communication partner) are required to assist the learner.
Verbal prompts (e.g., "What do you want?") should not be used. The goal is for the desired item to serve as a visual cue by being placed slightly out of reach.
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o o o o o o o o
At the beginning of Phase 1, the helper fully assists (i.e., hand-over-hand) the physical exchanges (e.g., pick up, reach, release).
Physical assistance is faded by moving to touch and gesture prompts, before fading out physical prompts completely.
Immediate access to the requested item is provided with each successful exchange.
"Open-hand" cues are faded only after the helper's assistance has been faded.
Each successful exchange is reinforced by using items known to be highly motivating to the student.
Many opportunities are provided for practice and exchanges should be fun for the student.
The communication partner and helper include a variety of individuals to prevent the learner from becoming "stimulus dependent" on any one person.
For learners who are echolalic (e.g., repeat what is said to them), the phrase, "I want ______," may be used instead of "You want _______" when acknowledging and reinforcing the exchange. However, it may be simpler to just say the name of the requested object.
The outcome of this phase is to increase the learner's spontaneity and generalization of the picture exchange. That is, adults create opportunities for students to increase their ability to initiate the communicative interaction, including gaining the attention of the communication partner and being persistent in seeking the desired outcome. Much of the routine remains the same as in Phase 1 with the most critical aspect being the exchange sequence of the learner picking up the picture/symbol for the desired item, handing it to the communication partner, and receiving the desired object with the verbal confirmation of the name of the item. While the helper has faded the prompts, s/he remains available to assist as necessary. As in Phase 1, no verbal prompts are used, and only one picture/symbol is used at a time.
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In Phase 2, the number and variety of reinforcer items is increased. A balance of food, activities, and tangible items should be available for the learner to request through the exchange process. As with any teaching program that uses reinforcing consequences, there is always a danger of reinforcer satiation (i.e., the learner growing tired of the reinforcer), which can hamper the effectiveness of the training. Therefore, it is essential that multiple items are used during communicative exchanges to maintain student motivation.
During Phase 2, the learner must have many opportunities to engage in picture exchanges with a variety of communication partners. Partners are chosen from individuals with whom the child interacts on a regular basis, including parents, siblings, family members, classroom or building staff, peers, and therapists. While verbal prompts should be avoided, it is sometimes helpful for the communication partner to interact with the preferred item in front of the learner, which will encourage him or her to request the item. For example, the partner may be eating a preferred food item or interacting with a favorite toy or object as the learner enters the teaching setting. The purpose of this activity is to motivate the student to engage in a communicative exchange.
In order to promote generalization of the learned communicative exchange using the
PECS system, instruction should take place in a variety of natural environments (e.g., home, school, community) and should occur during natural events and activities that take place throughout the course of a typical day (e.g., meals, snacks, play time, teaching time, playground opportunities). By mixing it up, the learner begins to experience the immediacy of the reward for communicating and learns that the same exchange system is effective across people, places, and activities.
Traveling is an important component of Phase 2 because it requires the student to seek out the communication book in order to request items or activities from a partner. Two types of traveling activities are used to expand the spontaneity of communicative
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exchanges (a) increasing the distance to the communication partner and (b) increasing the distance from the communication book.
Increase Distance to the Communication Partner
In Phase 1 the partner was readily available (e.g., within arm's reach, across the table) to the learner and waited expectantly for the exchange to occur. In Phase 2, the partner gradually increases distance and positioning from the learner so that the student learns to access the picture/symbol, move within proximity of the desired communication partner, and gain the partner's attention before making the request. When transitioning from Phase 1 to Phase 2, the helper is available to provide nonverbal prompts or assistance when students begin to navigate the steps and the distance. The "expectant look" often is used to facilitate student initiations. For example, the communication partner raises his/her eyebrows while also hunching shoulders and raising arms to convey the message, "What do you want?" This often is enough to elicit a communicative exchange between student and partner. As before, prompting, including the expectant look, is faded as quickly as possible (Frost & Bondy, 2002).
Increase Distance From the Communication Book
As the learner accomplishes the steps required in traveling from a point of origin to make a request of a communication partner, the distance is increased between the learner and the pictures/symbols on the communication book. This increase in distance is gradual and encourages the learner to actively seek the specific picture/symbol needed for the communicative exchange (Frost & Bondy, 2002).
Phase 2 progress monitoring focuses on the traveling process. For example, teachers record whether the student traveled to the communication partner and/or
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communication book as well as the distance traveled. It is also noted whether prompting was necessary during the communicative exchange.
Phase 2 data collection forms may be found on pages 372-374 in the PECS Manual
(Frost & Bondy, 2002).
Phase 3 training can begin once students are independently traveling to and from the book to a communication partner to initiate an exchange on a consistent basis and requesting at least four different items (Frost & Bondy, 2002).
o o o o o o o o o
The outcome of Phase 2 is for the learner to engage in communicative exchanges that involve increasing distances between the learner and the communication book, as well as between the learner and the communication partner to promote generalization and persistence.
Both the communication partner and the helper still are necessary to provide assistance if needed.
The learner travels to and from the communication book during communicative exchanges.
The learner travels to gain the attention of communication partners.
Physical prompts and subtle visual cues are faded.
No verbal prompts are provided throughout Phase 2.
Highly preferred items are used to encourage communicative exchanges.
The pool of reinforcers is increased and varied to increase communicative competence.
Many opportunities per day (20-30) are provided across a variety of settings, partners, and activities.
In this phase, the learner is ready to choose from more than one picture during communicative exchanges. At this stage, the learner must closely attend to the pictures/symbols in order to be able to discriminate between them (Frost & Bondy,
2002). The following components should be included in Phase 3 training: (a) discriminating between two pictures, (b) teaching discrimination through correction
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procedure, (c) increasing pictures in the display, (d) conducting a correspondence check, and (e) monitoring student progress.
Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com)
In early discrimination training, the communication book includes only two pictures/symbols. One picture is a known, highly reinforcing item or an item appropriate to the situation, and the other is a non-preferred or unrelated item. For example, if the learner is being read to and the communication partner stops reading, the learner would reach for and give the picture for a book to the partner. If the learner gives the picture of an unrelated item (e.g., shirt), the communication partner gives the learner the shirt without any social reaction (Frost & Bondy, 2002). If the learner persists, note his or her reaction to receiving the unrelated item. Then continue teaching with an alternate scenario using other preferred items and pictures/symbols. A critical feature of discrimination training is to reinforce the selection of the correct picture as soon as it happens (i.e., as soon as the learner's hand touches the picture). This may be done with verbal praise such as "Yes," "That's right," "Uh-huh," or "Good choice."
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Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com)
Some individuals easily learn to discriminate between pictures and make the connection between the items pictured and the actual items/activities. Others do not learn this skill as readily and will need specific instruction. Steps for implementing this procedure are included below (reprinted from The PECS Training Manual, 2nd edition, 2002, pp.127-
128 with the authors' permission).
Alternative strategies that increase the contrast between the picture/symbol being taught and other pictures include the following: o o o o o o
Make the picture of the relevant object larger than the picture of the non-preferred object
Use color pictures of relevant/desired objects to contrast with black-and-white pictures of non-preferred/irrelevant objects
Highlight the desired picture by outlining it with a magic marker
Use a blank card as the other picture in the display
Make the desired picture 3-dimensional by attaching it to a poker chip or block
Place the desired picture closer to where you are holding the desired object
Successful use of these or any strategies for discrimination training depends upon correct use of error-correction procedures. Furthermore, once the learner is able to discriminate among pictures, enhanced features (e.g., using large pictures or highlighting certain aspects) should be gradually eliminated.
Note that the official PECS distributors and trainers have developed several DVDs on discrimination training: PECS Discrimination Training Alternatives DVD, Modules 1, 2, and 3; they are available at www.pyramidproducts.com
.
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As the learner becomes more competent at discriminating between two pictures, additional pictures/symbols are introduced so s/he can begin to request from numerous options. Initially, both highly and less preferred items are included. As training progresses, symbols of equally desirable items are added. Ample opportunities for the learner to practice discriminating among pictures/symbols are provided. This is accomplished by slowly increasing the number of new pictures. If the learner appears to be confused or loses the ability to discriminate, decrease the number of pictures to the last known success point. Provide the learner with an opportunity to practice at that level before the number of pictures is increased again.
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Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com)
As the learner reliably demonstrates the ability to discriminate between a picture of a highly preferred item and the picture of a contextually inappropriate or undesired item, the next step is to teach discrimination between two items that are both appropriate and desirable to the learner. This is done with correspondence checks to ensure that the learner is requesting and taking the item for which he or she is asking. A simple way to do this is to present two preferred items and have pictures of both available on the communication book. When the learner presents the communication partner with one picture, do not give the item and do not name the item. Offer both items and say, "Go ahead," "Show me," "Here," or something similar. If the learner takes the item that corresponds with the picture presented, allow access, provide praise, and name the item. If the learner reaches for the other item, block access and begin an errorcorrection sequence for the picture that corresponds to the item reached for by the learner.
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The goal of progress monitoring in Phase 3 is to determine whether the learner can accurately discriminate between three or more pictures. Data are collected throughout the discrimination process. Once a learner is discriminating between 12 to 20 pictures independently and can travel to and from the communication book to initiate an exchange, Phase 4 instruction can begin.
Once a learner is discriminating between 12 to 20 pictures independently and can travel to and from the communication book to initiate an exchange, Phase 4 instruction can begin.
o o o
The outcome of Phase 3 is for the learner to (a) select the picture associated with the object s/he wants from a display of pictures, (b) approach a communication partner, and (c) give the communication partner the picture to access the object desired.
During discrimination training, the placement of pictures in the communication book/board should be varied. Please see photo in PECS Manual (Frost & Bondy,
2002) on page 131.
No verbal prompts are used during this phase.
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o o o
Ample exchange opportunities are offered throughout the day and across settings/people/activities.
Helpers and communication partners avoid saying "No" when the child makes a mistake during discrimination training. Instead, respond by giving the child what he has requested even if you know it is not the desired item (i.e., natural consequences).
Ongoing documentation of items used as reinforcers as well as those that have lost reinforcing value is an important part of the PECS training.
In this phase, the learner is taught to place an "I want" symbol with one of the pictures already successfully used onto a sentence strip and then use it during the communicative exchange. Sentence structure is taught for two specific reasons. First, a framework is established for teaching other communicative functions in the future by visually defining requesting with the "I want" symbol. Second, the use of the sentence strip may provide the structure to elicit spoken words. The outcome of Phase 4 is for the learner to spontaneously request using simple sentence structure (Frost & Bondy,
2002). Other factors involved in Phase 4 include: (a) introducing sentence structure, (b) promoting verbalization, and (c) monitoring student progress.
When introducing the use of the sentence strips, the "I want" symbol is placed on the left side of the sentence strip. When the learner begins to take a picture off the board, the helper immediately guides the learner to (a) place the picture next to the "I want" symbol on the sentence strip, (b) take the entire strip off the book, and (c) give it to the communicative partner. The communication partner then reads the sentence ("I want
____.") as s/he points to the symbols on the strip while also giving the learner the item requested. The helper or the communication partner places the sentence strip and symbols back on the communication book (or assists the learner to do so). The helper gradually fades physical guidance until the learner is able to place the symbol next to the "I want" symbol on the sentence strip by using the backward chaining strategy outlined in Phase I and gives it to the communication partner with minimal assistance.
Once the sentence strip has been introduced, the learner uses it for all requests throughout the day.
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Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com)
The next step is to have the learner place the "I want" symbol before placing the picture/symbol of the desired item. In doing so, the "I want" symbol is placed in the upper left-hand corner of the cover of the communication book. When the learner puts the picture of the desired item on the sentence strip, the helper physically prompts him or her to put the "I want" symbol in front of it on the strip. As in previous phases, these physical prompts are quickly faded as the learner independently places all symbols on the sentence strip. At this point, the helper begins to prompt the learner to point to the symbols on the strip as the communication partner reads it. Although eye contact is not directly taught in PECS, it is often a positive outcome of many successful communicative exchanges using the system. It is helpful for the adult partner to hold the sentence strip near his or her face while reading the sentence. If the learner is not directing his gaze to or making eye contact with the communication partner, a return to the two-person training system may help the child become more persistent in getting his partner's attention (i.e., face-gazing/eye contact). The communication partner should not automatically look at the child when he approaches with his sentence strip, but rather put his head down. The prompter can help the child tap the partner's shoulder to get his attention. The communication partner should then look up and respond ("Oh, it's learner's name") and respond to the request. After repeated trials, physical assistance is faded.
Once the learner is able to point to the symbols as the communication partner reads the words "I want _____," it is appropriate to promote vocalization of the word for the desired object. To do this, the communication partner adds a pause after reading "I want" and before naming the requested item. Individuals who are able to vocalize may begin to complete the sentence with a vocalization, a word, or a word, approximation.
Any attempt to vocalize during this pause should be immediately reinforced with the learner obtaining the requested item, even if he is unable to properly say the word. Even if the learner cannot vocalize, it is important to honor the request.
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In Phase 4, progress monitoring focuses on the use of the "I want" symbol as well as the prompting that is needed to complete the communicative exchange. Teachers also should conduct correspondence checks once the student is able to point to the pictures on the sentence strip independently (Frost & Bondy, 2002).
Phase 4 progress monitoring forms may be found on pages 377-378 of the PECS
Manual (Frost & Bondy, 2002).
o o o o o o o
Physical prompts are used initially and quickly faded.
Verbal prompts are not used at any time during Phase 4.
Frequent requesting is maintained in a variety of environments.
It is easiest to begin sentence structure training in a one-to-one session with the communication book and a communication partner in close proximity.
Once the sentence strip is introduced, it is used for all requests.
Requesting vocabulary continues to be expanded.
Correspondence checks are continued.
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o o o o
When reading the sentence strip, continue to provide opportunities for vocal/verbal requesting by pausing.
During initial training, pictures of items are placed on the front cover of the book.
As the learner becomes accustomed to using the sentence strip, the pictures are kept on the inside pages according to the category to which they belong.
Both at home and at school, the communication book is kept in a designated place that is accessible to the learner.
By this time, most learners are spontaneously requesting a variety of objects or activities. Phase 5 instruction encourages initiation and teaches the learner to answer the question, "What do you want?" Using the strategies presented in previous phases, the question "What do you want?" is introduced by using a delay method, followed by fading the prompt cue (Frost & Bondy, 2002). This can be implemented using the strategies of zero-second delay, increasing delay interval, fading pointing cue, and monitoring student progress, as outlined below.
The communication partner begins by simultaneously pointing to the "I want" card and asking "What do you want?" (i.e., zero-second delay). The goal is for the learner to complete the sentence strip with the "I want" picture and follow through with the exchange (Frost & Bondy, 2002).
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In Phase 5, teachers and other staff collect progress monitoring data that focus on the delay interval used and whether or not the student "beat" the prompt. Correspondence checks also are conducted as students progress to determine students' understanding of the phrase "I want" (Frost & Bondy, 2002).
Phase 5 progress monitoring forms may be found starting on page 379 in the PECS
Manual (Frost & Bondy, 2002).
As the learner demonstrates the ability to complete the sentence strip and the exchange, the communication partner increases the time interval, encouraging the learner to complete the exchange prior to the point prompt (Frost & Bondy, 2002).
Once the learner demonstrates that s/he is able to beat the prompt, the opportunities for spontaneous requesting and responding to "What do you want?" are varied. The goal is for the child to both request and respond without prompting.
o o o o
This is one of the easiest steps of PECS!
The outcome of Phase 5 is for the child to answer the question, "What do you want?" and spontaneously request a variety of items.
Spontaneous requesting should be alternated with responding to the verbal request
"What do you want?"
Numerous opportunities continue to be provided each day for the learner to request during functional, meaningful activities across settings and with a variety of communication partners.
PECS training to this point has focused on the communicative function of requesting, i.e., asking for and getting what you want. The purpose of Phase 6 is to teach a new communicative function: labeling or naming things. This initially involves listening and responding to another person's request for information (Frost & Bondy, 2002). This is an important step in the development of communication skills and is often difficult for children and youth with ASD. The later part of this phase aims to eliminate the question so that the learner can begin to use spontaneous comments. Important components of
Phase 6 include (a) preparation, (b) introducing commenting in response to a question,
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(c) teaching differentiated responses to questions, (d) teaching spontaneous commenting, and (e) monitoring student progress.
A number of items the learner already has in his or her requesting vocabulary are gathered along with the pictures associated with the items and a new symbol to represent the concept "I see." These items should be familiar to the learner but should not be the most highly desired objects. The "I see" symbol is placed on the cover of the learner's communication book.
The adult holds one of the training items, then places the "I see" symbol, the picture representing the item, and the sentence strip on the communication book. The adult holds up the item and asks "What do you see?" and points to the "I see" symbol on the book. If the learner does not pick up the "I see" symbol, the adult physically guides him/her to pick it up and place it on the sentence strip. The adult then waits for five seconds to see if the learner will pick up the picture of the item s/he is holding and place it on the sentence strip. If the learner assembles the sentence strip and gives it to the adult, the adult responds with "Yes, you see a "___," and gives the learner a reinforcer unrelated to the item she is holding. If the learner does not assemble the strip, the adult guides him to do so and responds as above. The adult then holds up another item (having placed the corresponding picture on the book) and again asks, "What do you see?" using the same procedure. The adult fades cues as quickly as possible until the learner is able to assemble and use the "I see" symbol to respond to the question. It is very important that the item being commented on is NOT used as the reinforcer when teaching a response to "What do you see?" This is to help the learner to distinguish between the labeling function being taught and the previously taught requesting function.
Gradually increase the pictures and items so that the learner must discriminate among pictures, assemble the sentence strip, and respond to "What do you see?" New vocabulary items may be added and taught in this manner. Training in responding to
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"What do you see?" should take place during defined training sessions until the learner is able to respond reliably with a variety of symbols. After that, the process may be used across settings, activities, and communication partners (Frost & Bondy, 2002).
Graphic courtesy of Pyramid Educational Consultants, Inc. (www.pyramidproducts.com)
Once the learner is able to respond reliably to "What do you see?," the adult begins to intermix the question "What do you see?" with "What do you want?" in order to teach differentiated responses. At this point the "I see" symbol is placed below the "I want" symbol in the upper left-hand corner of the communication book. The adult gives the learner the requested item when s/he uses "I want ___," and verbally acknowledges this while providing alternative reinforcement when s/he uses "I see ___." If possible, progress from tangible to social reinforcement for the learner's correct responses to
"What do you see?" That is, verbal reinforcement for identifying the correct item is gradually provided without offering another tangible or edible reinforcer. Responses to these questions should be generalized to a variety of communication partners and environments (Frost & Bondy, 2002).
The outcome of Phase 6 is for the learner to appropriately answer randomly asked questions, including "What do you want?" "What do you see?" "What do you hear?"
"What do you have?" and even spontaneously comment without being asked a question.
As the learner demonstrates commenting in response to a question, the goal is to promote commenting independent of questioning. In order to do that it is important to continue to create interesting environmental events and eliminate any questions. A
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chart on page 230 of the PECS Training Manual (Frost & Bondy, 2002) illustrates how to remove the question.
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Teachers and other professionals gather data on learners' use of spontaneous commenting. For example, progress monitoring data are collected during structured training sessions and during daily routines and activities to determine whether learners spontaneously comment about meaningful objects, people, and events (Frost & Bondy,
2002).
Phase 6 data collection forms may be found starting on page 380 in the PECS Manual
(Frost & Bondy, 2002).
In Phase 6, you begin to teach commenting through labeling, a new communicative function. o o o o
Teaching responses to a question begins with familiar, but not highly desired items.
The item you are asking the learner to label should not be used as the reinforcer for a correct response. This may confuse the learner in terms of the function of what he is learning to do.
Responses to a question are taught and practiced during a training session, then generalized to other environments.
Materials that are interesting to learners should be used when teaching them to comment on what they see. Examples include: o o o o o o making different stuffed animals appear from behind a screen using lift-the-flap books (e.g., the Spot series) where the pictures are hidden under flaps in the book putting familiar objects in sealed, clear containers and then putting them inside a cloth bag pulling a container out of the bag, showing it to the learners, and asking, "What do you see?" hanging objects of interest from the ceiling going on a walk and asking learners what they see in the school hallway or outdoors
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Once learners have progressed through all six phases of PECS training, they are fairly proficient in seeking their communication book, discriminating among pictures, constructing sentence strips, finding a communication partner, and completing the exchange. Logical next steps for post-PECS instruction include: o o o o o o o continuing to add new pictures to the learner's communication book. developing multiple copies of the learner's communication book for use across settings (e.g., home, community). continuing to provide multiple and varied opportunities for communicative exchanges across settings, people, times, and items. introducing others with whom the learner may interact to PECS (e.g., store and community workers, extended family, peers). providing opportunities without questions to promote spontaneous commenting. introducing attributes and modifiers to provide the learner with specificity in requests (e.g., "I want the blue blocks," "I'd like a large piece of cake"). This is an important aspect of language development and should not be overlooked, particularly with learners who respond to and learn PECS quickly. The full PECS training includes details on how to fully incorporate this into regular PECS use. applying the picture symbol system to a voice output device if the learner is not showing progress in vocalizations.
Alex (short for Alexandra) is a 5-year-old girl with ASD enrolled in an inclusive kindergarten classroom. Alex's teachers and parents have been working with her to develop behavioral, communication, and social skills that will enable her to succeed in first grade without one-on-one instructional support. It has become evident to everyone that Alex needs a way to initiate her wants and needs. Alex is mostly nonverbal. To this point, she has utilized a combination of gestures, vocalizations, and idiosyncratic signs to indicate her desires. Most often, Alex waits for others to interact with her before attempting to communicate. Her educational support team has decided to implement
PECS as a means of teaching her some consistent communication skills, with an emphasis on initiating. Alex's parents are hopeful that PECS training will encourage her to begin to use verbal language.
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After talking to Alex's parents and observing her in the classroom, her teacher, Ms. M, gathers some of Alex's favorite toys, books, and snacks along with some new items.
She spends a few minutes sitting with Alex and offering her items, two at a time, being sure to switch between left and right presentation across trials. After repeating this process on another day, Ms. M feels that she has identified enough desired items to begin PECS training.
Ms. M prepares for Alex's PECS training by taking digital pictures of the items identified as highly motivating from the reinforcer sampling. She prints out multiple copies of the pictures on her computer, organizing two sets and backup copies into two binders. One binder will be used as Alex's at-school communication book. The other will be sent home for Alex's parents to use there. Because Ms. M knows that Alex has a younger brother who is very active, she includes a CD with copies of the pictures with the book.
This allows Alex's parents to print out new pictures if the old ones are lost or destroyed.
After going over the PECS procedures with Alex's current one-on-one educational assistant, identifying times throughout the school day during which PECS trials can be implemented, and setting up a table in the corner of the room at which to begin the training, Ms. M is ready to begin training.
Alex makes excellent progress learning the communication exchange taught in PECS.
She quickly learns the advantage of handing the picture to her teacher or educational assistant to have a book read to her or to get a taste of a favorite snack food. Alex also enjoys the extra attention she is receiving with the two-person training. Alex's classmates also are intrigued by the PECS training. Soon, they are asking if they can be involved. Ms. M thanks them for their interest and tells them that they will be able to communicate with Alex this way in the near future.
Ms. M is pleased with how quickly Alex learned the physically assisted exchange in
Phase 1. They have been able to quickly fade the physical assist and open-hand prompt. Alex's parents report that while they have had some success in using the PECS system at home, it is difficult to find the time to do it as Mom and Dad are rarely home and unoccupied at the same time. They also comment on how independent Alex is at
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accessing the things she wants or needs in their home. Alex's parents agree to keep trying to implement PECS and Ms. M assures that Alex is making excellent progress on the system at school. From Phase 1, Alex transitioned smoothly to picking up the pictures herself. During Phase 2, Ms. M and the educational assistant move the communication book with pictures to a bookshelf near the table where they have been teaching Alex. During the training trials, Ms. M will now move from the table to her desk or to another area of the room so that Alex will have to walk over to her to give her the picture. Everyone is delighted when Alex begins to go through the communication book to find pictures of items she wants. This means that Ms. M does not have to teach her to discriminate from a variety of pictures. Occasionally, Alex will be in a hurry to get an item and will not look carefully at the pictures. This is sometimes the case with pictures of favorite story books. However, when Ms. M takes the picture and verbally confirms,
"You want name of book," Alex will make the correction if it is the wrong book by pointing to the correct book or going to get the correct picture of the book and switching it for the wrong picture.
Much to everyone's surprise, Alex has not only led the way to adding new pictures to her book (e.g., bringing an item to the teacher, pointing to the book indicating that she would like it in the book), she has also initiated bringing new people into the training scenario. Like her classmates, Alex wants other children to be involved. Ms. M has responded to this request by having Alex's peers participate in the training trials across the day. For example, during story time, when it is Alex's turn to choose a book, Ms. M invites a classmate to interact with Alex to determine which book she would like read.
This has been so successful that Alex's school friends are now volunteering to take the communication book to inclusive classes like art and music, as well as to the lunchroom and playground. This is all timely, as during Phase 3, one of the goals is to increase opportunities for requesting. Also, throughout the PECS training, it is important to generalize across stimuli, settings, and people.
During Phase 4, Ms. M is working with Alex to use sentence strips by placing an "I want" picture on the left side of the strip and an already learned picture request card to the right. Initially, Ms. M and the educational assistant do this training with Alex. Ms. M is concerned that if too many people are involved, Alex may become confused. As Alex
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has repeated practice and learns to place the "I want" symbol without help, other helpers are added. This is also an excellent opportunity for other students in the classroom to practice their reading skills. While Alex progresses rapidly in this phase, her parents are disappointed to learn that she is not initiating verbalizations during Step
9 of Phase 4. (i.e., Communicative partner pauses after reading, "I want" from the sentence strip, before saying the name of the pictured item). Ms. M tries to encourage
Alex's parents by telling them that Alex may pick up the verbalizations in time. She also comments on how anxious, and sometimes impatient, Alex is to complete the exchange. In time, perhaps she will learn that if she says the word she will get the item faster.
Ms. M decides to make a game out of Phase 5 (i.e., responding to "What do you want?") and has a small group of students sit around a circular table with a pile of pictures in the middle. She goes around the table, asking, "What do you want?" The students have the option of finding a picture with the desired item on it and using a sentence strip like Alex or of answering verbally. When it is Alex's turn, Ms. M uses the sentence strip and points to the "I want" card, asking "What do you want, Alex?" Alex uses the picture cards on the table to complete the sentence and receive the desired item. All of the children enjoy this activity and frequently ask if they can do it. Ms. M incorporates it into snack time and free time on a regular basis.
During this phase of instruction, Ms. M is working toward teaching Alex to answer questions and label. This is difficult for Alex because she wants to receive each item she labels, and it is important for her to learn the difference between answering a question and asking for something. Initially, some exchanges end in tantrums when Ms.
M does not give Alex the item that she labels after being asked, "What do you see?" Ms
M talks to Alex's mom, and together they identify some activity reinforcers that will make
Alex happy and help to prevent a tantrum. These activities include Alex going for a short walk to say hi to another teacher in the building, listening to music on headphones for a minute, taking a drink of a preferred juice, and looking briefly at a picture of Mom and
Dad. These are all preceded by Ms. M praising Alex for her work (e.g., "Nice job, Alex, that is a ______. Let's go say hi' to Ms. K.") In a short while, Alex is able to use the sentence strip on her communication book to answer the question, "What do you see?" with the "I see" symbol and a picture. Now Ms. M feels comfortable alternating these questions with request for items. Alex's tantrums have subsided during the labeling
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questions, and to everyone's delight, in general. She clearly understands the difference between labeling and requesting.
For Alex, PECS training has been a huge success. In just a little over a month, she has learned to answer labeling questions and to initiate when she wants something. She is ready for first grade with a solid start on a systematic means of communicating with adults and peers. While Alex still needs a significant amount of one-on-one educational support, she will be able to work independently for short periods of time and to interact with peers without much assistance. An important next step for Alex is to continue to build her vocabulary with pictures in her book. Another next step might be to begin to incorporate some symbol pictures (e.g., simple line drawings) into the collection of photographs. Being able to use symbols, rather than photos, might broaden Alex's vocabulary and help her generalize newly acquired skills to other objects, people, and settings. Finally, teachers should continue to build the expectant pause into reading sentence strips, "You want [pause] __________" because Alex's parents still would like her to develop verbal skills. As Alex continues to use PECS to communicate with sameage, nondisabled peers, she may learn to verbalize her wants and needs.
Joe is a sixth-grade student with ASD who attends an inclusive middle school. Joe has limited verbal abilities (i.e., he frequently vocalizes); however, it is very difficult to understand him unless the person with whom he is speaking knows him well and is able to use a communication book with a limited number of symbols. While Joe is not easy to understand when he does attempt to vocalize, it has been noted that he is somewhat echolalic in his speech. Joe participated in PECS training as a young child, but it was discontinued when his family moved to another school district. Historically, Joe has been very passive in terms of communicating with others. Though he will respond (with limited choices) to a question from another individual, rarely will Joe begin the interaction or seek out a communication partner. Joe's IEP team has set a goal for him to learn how to initiate communicative interactions with a greater number of people.
They feel that a return to PECS may equip Joe with the initiation skills he needs, while broadening his vocabulary and helping him gain confidence in interacting with people he does not know well.
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Mr. L is Joe's case manager and also acts as the transition coordinator for the school district that Joe attends. Prior to beginning PECS training, Mr. L observes Joe across the school day and talks with his mom and brother, Lee, who is three years older, and with whom Joe is very close. Lee enjoys the kinds of things that Joe likes to do, wear, eat, listen to and watch. From this information Mr. L constructs a list of possible reinforcers, adding to the list other options that come to mind. He then conducts a reinforcer sampling, being sure to alternate left and right presentation and pairing old known reinforcers with new ones. From the notes he takes during the sampling, Mr. L identifies 10 items that can be used during the PECS training.
Mr. L prepares for PECS training by gathering symbols of the reinforcing items identified through a reinforcer sampling. Because Joe already uses some symbols, Mr. L decides to use symbols rather than photographs. He prints out multiple copies of the symbols on his classroom computer, organizing two sets and backup copies into two binders. One binder will be used as Joe's at-school communication book. The other will be sent home for Joe's mom and brother to use. Because Mr. L knows that Joe spends time at his grandparents' house, he gives his mom a CD with copies of the symbols. This way,
Joe's family can print out new pictures if the old ones are lost or left at his grandparents' house. After going over the PECS procedures with the two educational assistants who are available to help Joe during the school day, identifying times throughout the school day during which PECS trials can be implemented, and setting up a table in the school library, Mr. L is ready to begin training.
Because Joe already uses a communication book with three to five symbols by pointing to indicate a choice, Mr. L is careful about teaching the physically assisted exchange.
He explains to Joe that with the symbols, Joe must hand the card to Mr. L rather than point. The educational assistant provides a hand-over-hand (i.e., full physical) prompt to begin. During this part of the PECS training, the use of Joe's communication book is stopped, to avoid confusing Joe. Initially, Joe does not like the physical assist. Once he understands that he is to pick up the card rather than point to it, it is easy to fade out the physical prompt. The teacher has no trouble fading the open-handed prompt either.
Because Joe does at times echo words that are spoken to him, Mr. L says, "I want
________" rather than "You want _____" during the communicative exchange. Soon
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Joe is readily exchanging symbol cards for desired items. The challenge with Joe is that the teacher and educational assistants have to refresh the reinforcer pool on a regular basis because Joe is easily bored with his choices. They suspect this is because his grandparents spoil him on the afternoons he stays with them.
Joe enjoys coming to the library for the PECS training, so Mr. L continues training there for the time being. To promote Joe's use of the communication book and to expand his ability to persist in seeking to communicate, Mr. L works with the school librarian to develop an in-school job for Joe. Joe helps the librarian to re-shelve books during study hall. The goal is for Joe to use his communication book to initiate interactions with the librarian to indicate that he is ready for another book and to ask for a break (which he does frequently). In order to do this, Joe must go to the table where his book is kept, find the symbol he wants, and take it to the librarian for the exchange. Over time, Joe learns to do this quite well and naturally begins to take his communication book with him from place to place in the library. Other training that still involves two people (i.e., Mr. L, an educational assistant) occurs during home room and across the classes Joe attends throughout the day.
Because of Joe's limited use of the communication book, Mr. L had anticipated that Joe would have trouble learning to discriminate among three or more symbols. Mr. L does repeated trials using the discrimination correction procedure. This gives Joe practice in matching the desired symbol with the appropriate item. Within the PECS instruction, Mr.
L. incorporates some symbols of non-desired items that are in black and white rather than color. This is done to help Joe further discriminate among a variety of symbol options. Finally, just to be certain that Joe knows what he is asking for, Mr. L conducts a periodic correspondence check. To do this, he accepts the symbol that Joe offers and responds with, "You want ______, go ahead and take it." Mr. L makes a note of whether or not Joe takes the item that matches the symbol he presented. After Joe reaches 80% accuracy during this phase of training and maintains it for four days, Mr. L proceeds to
Phase 4.
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Mr. L introduces Joe to the sentence strip, fashioning it after Joe's old communication book. Joe learns to place the "I want" symbol on the strip with only a touch prompt because he did not like the full physical prompt; however, this is quickly faded. After he learns to also place the picture of the desired item, Joe intently watches as Mr. L reads the strip to him, "I want [expectant pause] ______." Because Joe occasionally verbalizes, Mr. L accurately predicted that Joe would say the name of the item he wanted before Mr. L. Mr. L is quick to reinforce him with the presentation of the requested item and with verbal praise for talking. However, because of Joe's unintelligibility when speaking, it is not a goal for him to rely fully on speech for communicating with others.
This phase of training is easy for Joe because he has used a communication book to respond to questions in the past. During the early trials of being asked, "What do you want?," Joe has to be reminded to use the sentence strip to construct "I want" with a symbol of a desired object rather than simply pointing to what he wants or to its symbol.
Over time, Joe gets in the habit of using the sentence strip to answer as well as initiate.
Again, because of his experience with a communication book, Joe quickly advances through labeling items in response to the question, "What do you see?" Once Joe is able to consistently use "I see ____," he gets to engage in a favorite activity (e.g., listening to his headphones, playing his finger drum, having a TicTac), but not experience the item just labeled. Joe has come to enjoy the interactions and treats it like a game. Sometimes he turns the tables on Mr. L and hands him the sentence strip and a symbol card to put together. When Mr. L labels the item verbally, Joe allows him to listen to his headphones or tap out a drum beat on his finger drum. Rarely does he offer to share his candy though. Mr. L is careful to use the first person so that if Joe does echo, he imitates saying "I" instead of "You." After several weeks of labeling practice,
Mr. L reintroduces the "What do you want?" question and provides many opportunities for Joe to practice this skill throughout the day and across school and community settings. Joe has really warmed up to the PECS training and seems to be increasingly comfortable with initiating communicative interactions as well as responding to them.
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The biggest accomplishment for Joe during the PECS training is that he is much more likely to initiate interactions with others. This is important because he soon will transition to high school and adult life. Also, as he moves from class to class in a larger school setting, he will need to communicate with others independently. A valuable next step is to arrange for an assessment to determine the need for an electronic communication device such as a "TuffTalker Plus," "Hand Held Voice," or a "Say It Sam." With an AAC device such as these, Joe will be able to use the skills learned through PECS to both initiate and respond to others. The sky will be the limit with his ability to quickly learn new symbols!
o o o o o o
Deficits in communicative ability are a defining feature of ASD.
Deficits in communication can sometimes lead to or contribute to behavioral difficulties.
PECS can be effectively used to increase communicative initiations of individuals with ASD.
PECS has the potential to increase vocalizations of individuals with ASD.
PECS can be used across settings and with a variety of communication partners.
Effective implementation of PECS involves careful preparation of training materials, identification of multiple reinforcers, involvement of others to act as helpers and communication partners, many opportunities for communication exchanges, and monitoring of learner progress across the six phases. o
o NOTE: First five questions from the Interactive Collaborative Autism Network website (ICAN, retrieved Jan. 24, 2008, from Picture Exchange Communication
System: FAQs) o o o
Question.
Why can't I ask, "What do you want?" when teaching a child to use PECS?
Answer.
One of the unique aspects of PECS is that from the very beginning the child is taught to initiate communication. If the child were to give the picture to his partner after the partner said "What do you want?," he would be responding to the question. When the child puts the picture in his partner's hand, he is, in a
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o o o o sense, the first one to "talk." This is called initiating a request and is very different from responding to a question. Another reason for not asking the child what he wants is that the question often becomes a verbal cue. It is common for children and youth with ASD to become dependent on cues used by teachers and parents to teach them things. Prompts are a very useful teaching strategy and, when used effectively, often speed up the learning process significantly. It is important when using prompts to fade them as quickly as possible so the learner does not develop dependence. You will know a learner has developed a prompt dependency if he tends to sit and wait until either told or given some other cue before doing something. In PECS, physical prompts (guiding the child's hand to pick up a picture) or visual prompts (pointing to a picture in the child's communication book) are used rather than verbal prompts (verbally telling the child what to do) because verbal prompts are much more difficult to fade. It is much easier to go from totally guiding the child's hand, to giving the arm an initiating nudge to no physical contact than it is to go from telling the child "What do you want, pick up the picture, give it to me" to silence.
Question. What is the difference between pictures and symbols? Can you use both?
Answer.
Pictures are just what you would expect--they may be photographs or drawings of objects. They leave no question as to what is being requested.
Symbols are more representational; individuals must be able to look at a symbol, interpret what it means, and then generalize and apply it to an actual situation. It is important to individualize according to the child's learning style. Some begin training with photos because they are so specific, then move on to more general symbols when they learn how to use descriptors. Also, some individuals respond better to color pictures while others respond more readily to black-and-white line drawing symbols. Computer programs are available that provide photos and symbols to print out for use with PECS books. Pictures and symbols can be used together. Professionals who are trained in the system regularly evaluate and make changes to promote success.
Question.
What size pictures or symbols should I use for the learner I am working with?
Answer.
It depends on the child. During the initial stages of PECS it is very important that the child is able to pick up the picture or symbol as easily as possible so you may want to begin with pictures that are 2-3 inches square. The child's fine-motor abilities are a factor as are visual discrimination skills. As the
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o o o o learner develops a vocabulary of 25-30 symbols and becomes proficient in manipulating the symbols, it may be a good idea to reduce the size of the symbols to 1-inch square. Reducing the size of the symbols makes it easier for the learner to find the symbol she is looking for, as the small size allows for fewer pages in the book and/or more space between the symbols on a page.
Question.
My child doesn't want to use PECS. He just goes and gets what he wants. What do I do?
Answer.
Children with ASD who do not have a communication system are often very determined and persistent in getting what they want by themselves. Their parents and caregivers often learn to "read the signs" of the child's behavior and know what the child wants without the child actually communicating anything. By introducing PECS, you are basically changing the rules, and that can be very uncomfortable in the beginning. It takes effort on the part of parents and teachers to make sure that a few highly desired items are available to the child only during
PECS training to make this initial learning as quick and easy as possible. Once the child learns how quickly he can go tell the important people in his life what he wants, it becomes much easier to use the system.
Question.
Won't my child become dependent on using symbols? Will my child ever learn to talk?
Answer.
There are many factors involved in learning to use spoken language and functional communication. One major factor is a child's ability to produce a variety of vocalizations even if she is not using words. Another factor is the child's understanding that her vocalizations can have meaning to another person. A third factor is the child's cognitive abilities. One or all of these may be significantly affected in young children with ASD. It is impossible to predict the rate of progress in any of these factors when a child is very young. What is known, however, is that the earlier a communication system is taught to the child, the more practice she will get in successfully communicating with and learning from others. Many children who began to communicate using PECS start to say words and begin talking. These children tend to gradually use their communication books less and less and become more skilled in communicating with spoken language. A few children never develop the verbal skills needed for spoken language. For these children PECS continues to be an effective way to communicate. There is no evidence that use of PECS prevents children from developing spoken language.
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o o o o o o o o
Question.
The learner I am working with is continually losing his PECS symbols when he is not at school. How can I expect his family to use the system when they are unable to keep track of his symbols and book?
Answer.
Keeping track of symbols and communication books at home can be a challenge for some families, especially if they have young children. One strategy that you can use to support PECS use at home is to provide the family with a CD of the child's symbols in PDF format. Assuming they have a computer and printer
(preferably color), they can easily and affordably replace symbols as needed.
Question.
The young girl that I am working with has done quite well with
PECS until recently. Now she no longer seems interested in participating in the training sessions. She often gets up and walks away. What can we do?
Answer.
The first thing to check is your supply of reinforcing items. She may simply be bored (i.e., satiated) with the limited number of items you are using for the exchange. It pays to continually update your supply of reinforcers and to regularly rotate their use.
Question.
Is it okay to use reinforcing items that are known self-stimulation objects (e.g., a playing card that is used for flapping)?
Answer.
This is a question best answered by those who know the individual the best. For some individuals, access to a stimulation item will deter further progress in the training for that session. For others, the highly motivating object will support faster learning and use of the exchange system. Consideration should also be given to behavior support plans that may be in place to minimize self-stimulating behavior.
Question.
When implementing the four-step discrimination training procedure, why, in Step 3, do I not give the learner the object shown in the picture? I find this step a bit confusing and don't see how it is relevant to the training.
Answer.
This step is necessary as the goal of the discrimination training is to confirm that the learner understands the association between the picture and the object and that he can choose the picture of the desired object from more than one picture. By acknowledging what the picture represents and then "distracting" the learner with a simple, non-related request, you can be confident that the next time he hands you the picture, he knows what he is asking for.
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o Post-Assessment o o
What makes PECS unique from other graphic augmentative alternative communication (AAC) systems of communication?
Select an answer for question 210 o o
Before beginning training with PECS, it is important to assess the learner's. . . .
Select an answer for question 211 o Verbal prompts are allowed in any phase of teaching PECS. o o
Select an answer for question 212
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? o o o
Select an answer for question 213
When conducting pre-PECS teaching reinforcement sampling, how are preferred items confirmed? By...
Select an answer for question 214 o o
PECS has been shown to increase what abilities in children with whom it has been implemented long-term?
Select an answer for question 215
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