Picture Exchange Communication System

"PECS" redirects here. For the ESA "Plan for European Cooperating State" charters, see Enlargement of the European Space Agency. For other uses, see Pecs (disambiguation).

The Picture Exchange Communication System (PECS) is a form of augmentative and alternative communication produced by Pyramid Educational Consultants, Inc.[1] While the system is commonly used as a communication aid for children with autism spectrum disorder (ASD), it has been used with a wide variety of learners, from preschoolers to adults, who have various communicative, cognitive, and physical impairments, including cerebral palsy, blindness, and deafness.[2] PECS has been the subject of much academic research,[3] with currently over 85 PECS-related publications.[2]

PECS was developed in 1985 at the Delaware Autism Program by Lori Frost and Andy Bondy.[2] They noted that traditional communication techniques, including speech imitation, sign language, and picture point systems, relied on the teacher to initiate social interactions and none focused on teaching students to initiate interactions. Based on these observations, Frost and Bondy created a functional means of communication for individuals with a variety of communication challenges.[2]

Overview

PECS is designed to teach functional communication skills with an initial focus on spontaneous communication. It has been and continues to be implemented in a variety of settings and contexts (home, school, community) so users have the skills to communicate their wants and needs. PECS does not require complex or expensive materials since it uses picture symbols as the modality. PECS is a method to teach young children or any individual with a communication impairment a way to communicate within a social context. Research has shown that many preschoolers using PECS also begin developing speech.[4] Based on the current evidence base, PECS has been described as an emerging treatment shown to increase communication skills for individuals with ASD.[5]

Philosophy

The training protocol is based on the principles of applied behavior analysis.[4] The goal of PECS is spontaneous and functional communication.[4] Verbal prompts are not used during the early phases, thus building immediate initiation and avoiding prompt dependency. PECS begins with teaching a student to exchange a picture of a desired item with a teacher/communicative partner, who immediately honors the request. After the student learns to spontaneously request for a desired item, the system goes on to teach discrimination among symbols and then how to construct a simple sentence. In the most advanced phases, individuals are taught to respond to questions and to comment. Additionally, descriptive language concepts such as size, shape, color, number, etc. are also taught so the student can make their message more specific. For example, I want big yellow ball.

PECS Protocol

After a preparation, the PECS Protocol occurs in six phases:

Depending on the age and cognitive level of the user, the time to master PECS will vary. One study found that it takes an average of 246 trials for users to master all six phases of PECS.[9]

Effectiveness

There is evidence that PECS is easily learned by most students, with its primary benefit being a means of communication for children and adults who have limited or no speech due to autism or other communication disorders. With regard to the intervention setting for AAC training, there is evidence that PECS is most readily learned when instruction takes place in a general education setting.[10] Evidence also indicated that learners initiate a higher number of picture exchanges when PECS is taught in a single setting versus multiple settings.[11]

The consensus among most researchers is that "PECS is recommended as an evidence-based intervention for enhancing functional communication skills of individuals with ASD."[12] On the other hand, the 2009 National Standards Report from the National Autism Center lists PECs among emerging treatments that not (yet) have sufficient evidence of effectiveness.[13]

An initial concern was that PECS might delay or inhibit speech development. However, a recent review of several peer-reviewed studies found that "there is no evidence within the reviewed studies to suggest that PECS inhibited speech; to the contrary, if any effect was observed, it was facilitative rather than inhibitory."[14] When difficulties do arise, it is often due to a lack of powerful reinforcers and/or trainer error.[15] A systematic review of interventions for children with autism spectrum disorder reported that use of PECS resulted in short-term improvement in word acquisition, but the effects were not maintained over time.[16]

However, evidence from meta-analyses indicate that PECS does not result in equal communicative outcomes for all children with ASD. PECS training appears to have the most beneficial effects for younger learners.[17] In addition, evidence of maintenance and generalization effects of functional communication gains achieved through PECs training has been mixed.[18] Research indicates that "PECS is probably best used as an initial intervention to teach manding and the basic elements of what is a communicative exchange," and is not the best selection "for a long-term intervention as it does not address question asking and may be better implemented as part of a multimodal system for when picture communications are more socially appropriate." [19]

Additional applications

There is emerging research that suggests adults with developmental disabilities and severe communication deficits may benefit from the implementation of PECS as well.[20] Others tried to combine PECS training with video modeling.[21]

References

  1. ↑ "Welcome to Pyramid Educational Consultants, Inc.!". Pyramid Educational Consultants, Inc. Retrieved 26 December 2013.
  2. 1 2 3 4 5 6 7 8 9 Overcash, A., & Horton, C. (2010). The picture exchange communication system: Helping individuals gain functional communication. Autism Advocate, 3, 21-24
  3. ↑ PECS Related Publications
  4. 1 2 3 4 5 6 7 8 9 10 11 12 13 Bondy AS, Frost LA (1994). The Picture Exchange Communication System. Focus on Autism and Other Developmental Disabilities, Vol. 9, No. 3, 1-19 (1994)
  5. ↑ National Autism Center. (2009). National Standards Report, 1-161.
  6. ↑ Bondy, A.S., and L. Frost. 2001. "The Picture Exchange Communication System." Behav Modif. 25(5):725-744.
  7. 1 2 http://www.corwin.com/upm-data/2675_10bmod01.pdf#page=58
  8. ↑ Frost, L., & Bondy, A.(2002) The Picture Exchange Communication System training manual, 2nd ed. Pyramid Educational Consultants, Inc.
  9. ↑ Charlop-Christy, M.H., Carpenter, M., et al. (2002). Using the picture exchange communication system (PECS) with children with autism: assessment of PECS acquisition, speech, social-communicative behavior, and problem behavior. Journal of Applied Behavioral Analysis, 35(3): 213-231.
  10. ↑ Ganz et al. (2013) Moderation of effects of AAC based on setting and types of aided AAC on outcome variables: An aggregate study of single-case research with individuals with ASD.
  11. ↑ Tincani, M., & Devis, K. (2011). Quantitative Synthesis and Component Analysis of Single-Participant Studies on the Picture Exchange Communication System. Remedial & Special Education, 32(6), 458-470.
  12. ↑ Tien, K-C. (2008). Effectiveness of the Picture Exchange Communication System as a functional communication intervention for individuals with Autism Spectrum Disorders: A practice-based research synthesis. Education and Training in Developmental Disabilities, 43, 61-76.
  13. ↑ National Autism Center. (2009).National Standards Report page 76.
  14. ↑ Tincani, M. & Devis, K. (2010). Quantitative synthesis and component analysis of single-participant studies on the Picture Exchange Communication System. Remediation and Special Education (Online First), 1-13.
  15. ↑ Horton, C., Matteo, J. A., Waegenaere, J., & Frost, L. (2008). Pecs: Fact and fiction. Presentation delivered at the 2008 ASHA Convention. Retrieved from www.asha.org/Events/convention/handouts/2008/1528_Frost_Lori/
  16. ↑ Warren, Z., Veenstra-VanderWeele, J., et al. (2011). Therapies for Children With Autism Spectrum Disorders. Comparative Effectiveness Review No. 26. Agency for Healthcare Research and Quality (AHRQ) Publication No. 11-EHC029-EF.
  17. ↑ Ganz, J. B., Davis, J. L., et al. (2012). Meta-Analysis of PECS with Individuals with ASD: Investigation of Targeted Versus Non-Targeted Outcomes, Participant Characteristics, and Implementation Phase. Research in Developmental Disabilities, 33(2), 406-418.
  18. ↑ Flippin, M., Reszka, S., et al. (2010). Effectiveness of the Picture Exchange Communication Systems (PECS) on Communication and Speech for Children with Autism Spectrum Disorders: A Meta-Analysis. American Journal of Speech-Language-Pathology, 19, 178-195.
  19. ↑ Ostryn, C., Wolfe, P. S., et al. (2008). A Review and Analysis of the Picture Exchange Communication System (PECS) for Individuals with Autism Spectrum Disorders Using a Paradigm of Communication Competence. Research & Practice for Persons with Severe Disabilities, 33(1-2), 13-24.
  20. ↑ Conklin, C. G. (2011-03-01). Effects of implementing the picture exchange communication system (PECS) with adults with developmental disabilities and severe communication deficits.(Report). Remedial and special education, 32(2), 155-166.
  21. ↑ Cihak, David; Smith, C. C.; Cornett, A.; Coleman, M. B. (12 March 2012). "The Use of Video Modeling With the Picture Exchange Communication System to Increase Independent Communicative Initiations in Preschoolers with Autism and Developmental Delays". Focus on Autism and Other Developmental Disabilities 27 (3): 3–10. doi:10.1177/1088357611428426. Check date values in: |access-date= (help);

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External links

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