Fwd: An Analysis of PECS (Picture Exchange Communication System)

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An Analysis of PECS (Picture Exchange Communication

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* PECS was designed for people with communication disorders, specifically

those with an Autism Spectrum Disorder. The aim of PECS is to " teach

spontaneous social-communication skills by means of pictures or symbols. "

Purpose of the Picture Exchange Communication System (PECS)

PECS was designed for people with communication disorders, specifically

those with an Autism Spectrum Disorder. The aim of PECS is to “teach

spontaneous social-communication skills by means of pictures or symbols”

(Howlin et al., 2007 pg. 473). Through using this program, people with

autism are taught how to initiate conversation. The person does this by

picking up a symbol card, for example a picture of a lolly, and exchanging

it with someone else for an actual lolly. The act of exchanging a card for a

desired item is a “communicative act that requires social interaction, which

is…highly sought after when working with children with autism and related

developmental disabilities” (Sigafoos, 2005 pg. 605). Verbal prompts are not

used in order to encourage spontaneity and avoid prompt dependency (Bondy &

Frost, n.d.) however verbal communication can develop through the use of

this program.

The program is particularly successful when “appropriately combined with

elements of behaviour analysis” (Bondy & Frost, n.d.). This means that

elements of behaviour analysis as developed by B.F. Skinner, including

using reinforcers, fading prompts and other issues, should be used with the

PECS system to ensure optimum achievement by the student in learning to

initiate conversation. For example, if a person uses PECS to request a

drink, they should be given the drink immediately as a positive reinforcer,

to encourage them to use the system more frequently. Only when a person has

begun to master the concept of exchanging a card for a desired item can they

then be denied the item if requested at an inappropriate time.

The Creators of PECS

The creators of PECS are Bondy, a clinical psychologist, and Lori

Frost, a speech and language therapist. Both of the creators have many

credentials, good reputations amongst professionals in the education field,

and a wealth of experience in the area of communication disorders.

Bondy has an master’s degree in arts, as well as a PhD, and has written many

research papers. For fourteen years he was in charge of a statewide public

school system in the US. Frost has a master’s degree in science, and much

experience in functional communication training. Both are skilled in applied

behaviour analysis.

Both creators are highly respected and regarded in their field, and their

credentials show that they indeed are knowledgeable and skilled, suggesting

that the PECS is a credible and worthwhile tool to use with people with

communication disorders.

Target Students

As already mentioned, PECS was originally designed for children with autism.

Children with autism are often visual learners. Visual learners are defined

as “children that process and retain information better if it is presented

in a format where it is written down and can be seen, as opposed to

information that is primarily heard” (Tissot & , 2003 pg. 426). Hence

PECS is a suitable tool to be used with students with autism who are

primarily visual learners, because it allows them to “gain communications

skills by channelling instruction through visual means” (Tissot & ,

2003 pg. 430). Also, studies suggest that people with autism are able to

remember non-verbal material better than verbal material (Tissot & ,

2003 pg. 427).

Studies have been completed looking at some specific case studies where PECS

has been used. One recent study looked at the effectiveness of PECS when

used with a child with autism who also had a hearing impairment. This study

found that after the intervention, the child “achieved a much higher

communication level, which was completely functional in social contexts”

(Malandraki & Okalidou, 2007).

Another study looked at the effectiveness of PECS when used with adults who

were non-verbal, and who also had an intellectual disability. Three out of

the five participants “developed functional skills that they were able to

display in home and community settings” (Stoner et al., 2006 pg. 154).

Whilst this study cannot be generalised to an entire population, it suggests

that PECS may be less effective with people with intellectual disabilities.

Analysis of Research Base

Most of the research analysing PECS is positive, but also points out

situations where PECS is not the most useful system available.

There are several reports that suggest a great number of children who were

having difficulty with verbal communication did begin to develop spoken

language after learning to use PECS (Charlop-Christy et al., 2002 pg. 214).

However this was only the case with children who had some initial

spontaneous communication, and no gains in spoken language were made by

children without any spontaneous communication (Bondy & Frost, 1994 in

Charlop-Christy et al., 2002). Ganz and Simpson (2004) also found that as

PECS was mastered by the participants in the study, “word utterances

increased in number of words and complexity of grammar” (pg. 395).

One of the main benefits of PECS is that there is often a noticeable

reduction in the problem behaviours displayed by children experiencing

difficulty in communicating. A study conducted by Dooley et al., (2001)

found that when functional communication was addressed in the behaviour plan

of students displaying problem behaviours, and PECS was introduced, there

was “a dramatic decrease in aggression and increase in cooperative behavior

in the classroom” (pg. 57). This study also found that there was an increase

in compliance amongst the participants. PECS is also lauded as a valuable

tool because it uses “basic behavioral principles and techniques, such as

shaping, differential reinforcement, and transfer of stimulus control via

delay” (Charlop-Christy et al., 2002 pg. 213-214). Charlop-Christy et al.

(2002) summarise the other benefits of PECS detailed in the literature,

including the fact it requires few complex motor skills, “does not require

the listener to be familiar with an additional language such as sign

language” (Bondy & Frost, 1994, in Charlop-Christy et al., 2002 pg. 214), is

relatively cheap and portable, and finally that the system can be taught

quickly.

Some studies, whilst noting the value of PECS, have had results suggesting

that in some cases, some interventions actually produce better results than

PECS. A study by Tincani (2004) found that sign language training for

children with communication difficulties produced a higher percentage of

vocalisations during training, compared to PECS. However this study only had

two participants, and whilst it is a valuable study, it is not a reliable

one. If the study were to be repeated, the results could vary considerably,

depending on the participants.

Tissot and (2006) briefly note that there is some debate amongst

members of the community regarding the positive reinforcers used by PECS. It

is argued that by giving the child everything they request in the initial

stages of training can lead to children developing into, to use a colloquial

expression, “spoilt brats.” There is no literature that seems to support

this notion however, and other literature states that the benefits of PECS

far outweigh any negatives.

From looking at these various studies, it can be seen that different

interventions work for different children. However PECS is a valuable tool

that can result in great improvement in a child’s communicative ability, and

most researchers agree it is an intervention that should be used with

children with autism.

Introducing PECS to Students

PECS has 7 phases. Phase 1 concerns the introduction of the strategy to the

student. Bondy and Frost (1994) explain that “it is imperative the

communication training begin with functional acts that bring the child into

contact with reinforcers.” The trainer needs to ensure he or she is aware of

what items are the most motivating and reinforcing for the student. This can

be done by presenting the student with two items, and allowing him or her to

choose an object. The object chosen is the one that the student values the

highest, and hence should be used as the reinforcer during Phase 1 of PECS.

When the training is ready to be implemented, it is important that no verbal

prompting is used whatsoever. This is to avoid prompt-dependent learning

(Bondy & Frost, 1994).

Two trainers are needed for Phase 1. The student sits in front of a table

with the reinforcer clearly visible. One trainer sits opposite the student

across the table, and the other trainer is behind the student. When the

student reaches for the item, Trainer 2 puts his or her hand over the

student’s hand, and guides it to a card with a picture of the item on it.

Continuing with full physical prompting, the trainer guides the student’s

hand holding the card to the hand of Trainer 1. As soon as the card is

received, Trainer 1 exchanges the card for the desired item. This process

continues with fading of the full physical prompting.

Phase 1 can be illustrated using the following example. is a young

student with autism who loves grapes. is seated at a table with a bowl

of grapes, with Trainer 1 sitting opposite her, and Trainer 2 sitting behind

her. Also on the table is a card with a picture of grapes on it. As soon as

reaches for the grapes, Trainer 2 guides her hand to the grapes card,

and helps her pick it up. Trainer 2 then guides ’s hand, holding the

card, to Trainer 1. Trainer 1 then takes the card and immediately exchanges

it for one grape. Multiple exchanges then continue to occur, with Trainer 2

gradually using less and less prompting. Verbal prompting is still not used

at any time.

Using PECS with Students

Once the student is independently picking up the single picture and

exchanging it with a trainer for the reinforcer, the next phases can then be

implemented. It is important that during these early stages the trainer

varies so that the student can generalise the process and use it was a

variety of people.

A brief overview of the remaining Phases is summarised here:

*Phase 2:* During this Phase the trainer gradually moves further away from

the student, so that the student actively needs to seek the trainer in order

to make an exchange. It is also important that the trainer ensures the

reinforcing items are not easily obtained by the student without needing to

make an exchange. The picture card is also moved away from the student so

that he or she learns he or she needs to find the card, and then give it to

the trainer, before the exchange can occur.

*Phase 3:* “During this phase the student is taught to discriminate between

two or more pictures on a communication board” (Bondy & Frost, 1994). The

following example describes how this phase is implemented.

sits opposite a trainer, who has a bowl of grapes. On ’s

communication board is a picture of grapes, and a picture of a house. If

gives her trainer the picture of the grapes, she gets a grape. If she

chooses the picture of the house, the trainer can say something like, “no,

we don’t have any of those” and then gesture to the correct card. Once

uses the correct card she immediately exchanges it with the trainer for a

grape.

*Phase 4:* This phase begins to look at sentence structure, and the child

begins to use an “I want____” card. The student is taught to use a sentence

strip, which is a cardboard strip with Velcro. The “I want____” card is

placed at the beginning of the strip, and the student is then guided to

place the picture card (e.g. showing grapes) next to the “I want____” card.

The exchange is made and the student receives the reinforcer.

*Phase 5:* It is during this phase that the student is taught to respond to

verbal prompts. Continuing with our example, the trainer asks , “What

do you want?” whilst simultaneously pointing to the “I want____” card.

Generally, the student will place the “I want____” card on the sentence

strip followed by the picture card. The time between the trainer asking

“what do you want?” and pointing to the “I want____” card is gradually

increased.

*Phase 6:* The object of this phase is to “teach a new communicative

function” (Bondy & Frost, 1994), for example naming or labelling. The

student may be taught to describe the things he or she sees, for example " I

see dog. "

*Phase 7 and beyond:* The goal is to increase the vocabulary of the student,

increasing the functional communication of the student, and introducing

“yes” and “no”.

Evaluating PECS for Success

PECS has been implemented successfully when the student starts to use the

picture cards to request his or her wants. The more functional communication

the student develops, the more successful PECS has been for him or her.

To begin with, an instructional objective needs to be developed by the

trainer. An example may be: *When shown grapes and given access to a card

showing grapes, will independently exchange the card for a grape

independently five times in a row.* A simple monitoring tool can be designed

to record the student’s progress throughout the training process, and

determine whether the instructional objective chosen by the trainer has been

achieved. The date is filled in at the top of each column. For each trial,

the trainer records what prompting was required, if any. If the exchange was

completed independently, the letter I is recorded in the appropriate box.

Once the letter I has been recorded five times in a row, the trainer is

aware is ready to move to the next phase of PECS.

Reference List

Bondy, A.S., & Frost, L. (n.d.). *Pyramid Educational Consultants*.

Retrieved August 18, 2007 from http://www.pecs.com/index.php

Bondy, A.S., & Frost, L. (1994). The Picture Exchange Communication System.

*Focus on Autistic Behaviour 9*(3). Retrieved August 22, 2007 from Academic

Search Elite.

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

(2002). Using the Picture Exchange Communication System (PECS) with children

with autism: Assessment of PECS acquisition, speech, social-communicative

behavior, and problem behavior. *Journal of Applied Behavior Analysis 35*(3)

213-231. Retrieved August 21, 2007 from Free E-Journals.

Dooley, P., Wilczenski, F.L., & Torem, Ch., (2001). Using an activity

schedule to smooth school transitions. *Journal of Positive Behavior

Interventions 3*(1) 57-61. Retrieved August 22, 2007 from Academic Search

Elite.

Ganz, J.B., & Simpson, R.L. (2004). Effects on communicative requesting and

speech development of the Picture Exchange Communication System in children

with characteristics of autism. *Journal of Autism and Developmental

Disorders 34*(4) 395-409. Retrieved August 22, 2007 from Academic Search

Elite.

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

effectiveness of Picture Exchange Communication System (PECS) training for

teachers of children with autism: A pragmatic, group randomised controlled

trial. *Journal of Child Psychology and Psychiatry 48*(5) 473-481. Retrieved

August 20, 2007 from Blackwell Synergy.

Malandraki, G.A., & Okalidou, A., (2007). The application of PECS in a deaf

child with autism: A case study. *Focus on Autism and Other Developmental

Disabilities 22*(1) 23-32. Retrieved August 20, 2007 from Academic Search

Elite.

Sigafoos, J., (2005). From Premack to PECS: 25 years of progress in

communication intervention for individuals with developmental disabilities.

*Educational Psychology 25*(6) 601-607. Retrieved August 22, 2007 from

Academic Search Elite.

Stoner, J.B., Beck, A.R., Bock, S.J., Hickey, K., Kosuwan, K., & ,

J.R. (2006). The effectiveness of the Picture Exchange Communication System

with nonspeaking adults. *Remedial and Special Education 27*(3) 154-165.

Retrieved August 21, 2007 from Academic Search Elite.

Tissot, C., & , R., (2006). Visual teaching strategies for children

with autism. *Early Child **Development and Care 173*(4) 425-433. Retrieved

August 21, 2007 from Academic Search Elite.