PECS

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PECS

• Amy Baumer

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What is PECS

• Picture Exchange Communication System
• PECS was developed by Lori Frost, a certified
  Speech-Language Pathologist, and Andrew Bondy,
  PhD., at the Delaware Autistic Program. 
• Using the PECS, the student learns to
  spontaneously initiate communicative exchanges.
  People using PECS are taught to approach and give
  a picture of a desired item to a communicative
  partner in exchange for that item. Using PECS,
  students learn to gain the attention of the
  communication partner in order to make a request.
  

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What is PECS

• Pyramid approach
• Start with basic communication and work your way
  up! Words first, and then sentences.
• Strongly correlated to Skinners behavioral
  theory (operant conditioning) involving an object
  and reinforcement
• Population served PECS can be used with children
  or adults who are not yet initiating requests,
  comments, etc.

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What is Communication

• Behavior (defined in form by the community)
  directed to another person who in turn provides
  related direct or social rewards.
• PECS relates communication to Skinners work,
  emphasizing the importance of why and when
  communication takes place.
• Bondy, A., Frost, L., (2002). The picture
  exchange communication system training
  manual. Newark, Delaware Pyramid
  Educational Products, Inc.

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Preparing for PECS

• Participants
• Student
• Communication Partner
• Physical Prompter
• Reinforcers
• How to determine items of interest
• Variability
• Supplies (http//www.pyramidproducts.com/)
• Reinforcers
• Book with velcro
• Pictures with velcro (Boardmaker)

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Phases of PECS

• Follows the pyramid format on one stage building
  upon another.
• Stages 1-6
• Each stage has objectives and specific procedural
  guidelines

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Phase 1 How to Communicate

• Terminal Objective Upon seeing a highly
  preferred Item, the student will pick up the
  picture of the item, reach toward the
  communication partner, and release the picture
  into the partners hand

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Phase 1

• No verbal prompting
• One picture at a time
• Two trainers required to teach initiation
• Allow for 30-40 request opportunities per day
• Pictures can be any size as long as they match
  student motor skills

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Phase 1

• Procedure
• Communicative partner sits facing student
• Picture is placed between student and trainer
• First one is free!
• Student is enticed by desired item
• Student reaches for desired item
• Hand-over-hand to assist student in giving the
  picture to the trainers open hand
• Trainer says I want.
• Trainer gives desired object within ½ second
• Trainer puts the picture back in place
• If objects is a toy, trainer takes back the
  object to initiate another cycle of requesting
• Pointing to pictures is discouraged as pointing
  does not require interaction with a person.

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Phase 1

• Fading
• Fade physical assistance
• Fade open-hand cue
• Move to phase 2 if goal is met

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Phase 1 Practical Application

• Communicative Partners Responsibilities
• Jill
• Entice the student
• Reinforce the students Exchange (with the item)
• Pair social praise with tangible reinforcement
• Time the open hand appropriately

• Physical Prompters Responsibilities
• Gina
• Wait for the students initiation
• Physically prompt the student to exchange the
  picture
• Systematically fade prompts

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Phase 2 Distance and Persistence

• Terminal Objective The student goes to his/her
  communication board/book, pulls the picture off,
  go to the communication partner, and release the
  picture into the partners hand.

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Phase 2 Introducing Variables

• Listener factors
• Distance to communicative partner
• Variety of communicative partners
• Expectant look
• Enticement style
• Eye contact
• Body orientation
• Taking picture from room to room to find
  communication partner

• Environmental Factors
• Distance to book
• Variety of rooms
• Variety of reinforcers
• Variety of activities (lessons)
• Sitting vs. standing vs. on the move
• Furniture

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Phase 2

• This stage may last a long time.
• No verbal prompting
• Use a variety of communication partners
• Get the student to travel.
• Allow for spontaneous requesting throughout the
  day
• Use a communication book to attach the picture to.

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Phase 2 Practical Application

• Communicative Partners Responsibilities
• Darcie
• Plans for student to have a communication book
• Arranges and positions trainers and environment
• Entices appropriately
• Gradually increases distance between student and
  communication book
• Teaches student to cross room to reach
  communication book
• Reinforces appropriately
• Turns away from student without body cues
• Teaches student to travel room to room
• Does not insist on speech

• Physical Prompters Responsibilities
• Kristen
• Waits for initiation
• Prompts removal of picture from book if necessary
• Physically guides student to trainer if necessary
• Physically guides student to communication book
  if necessary
• Does not interact socially with the student
• Uses backstepping if necessary

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Phase 3 Picture Discrimination

• Terminal Objective The student requests desired
  items by going to a communication book, selecting
  the appropriate picture from an array, going to a
  communication partner, and giving the picture.

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Phase 3

• By stage 3, student should be socially using
  pictures to harness the power of communication
• No verbal prompts
• Use a variety of trainers
• Create opportunities for functional communication
  throughout the day
• Vary positions of 2 pictures on the board/book
  until discrimination is mastered
• Highly preferred vs. non-preferred
• Highly preferred vs. highly preferred
• Provide vocal feedback to student the instant
  they touch the correct picture (Yes! Thats
  right!) or wrong picture (No. Hmmm.)

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Phase 3

• If trouble discriminating
• Vary sizes of different pictures to contrast
  eachother
• Place pictures further apart
• Make both pictures larger
• Make a blank picture card to compare with one
  with a picture
• Arrange pictures to correspond with actual
  objects
• Place pictures onto actual items
• By the end of stage 3, student should have a book
  of items that they can discriminate

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Phase 3 Practical ApplicationHigh vs.
Distracter discrimination

• Communicative Partners Responsibilities
• Kim
• Arranges effective training environment
• Entices with both items
• Socially reinforces as soon as student touches
  correct picture
• Appropriate reinforcement with requested item
• Uses a variety of distracter items anda variety
  of target pictures
• Conducts error correction
• Moves pictures around on book
• No insistence on speech

• Physical Prompters Responsibilities
• Kim
• Blocks student from taking items
• May assist in some hand-over-hand if student
  becomes frustrated

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Phase 3 Practical ApplicationMultiple Preferred
discrimination

• Communicative Partners Responsibilities
• Kim
• Arranges effective training environment
• Entices with both items
• Conducts error correction
• Moves pictures around on book (diagonal,
  vertical, horizontal)
• Teaches 3, 4, 5-way discrimination
• Uses a variety of target pictures in the 2-, 3-,
  4-, or 5-way mix
• Teaches looking inside book
• No insistence on speech

• Physical Prompters Responsibilities
• Kim
• Blocks student from taking items
• May assist in some hand-over-hand if student
  becomes frustrated

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Phase 4 Sentence Structure

• Terminal Objective The student requests present
  and non-present items using a multi-word phrase
  by going to the book, picking up a picture/symbol
  of I want, putting it on a sentence strip,
  picking out the picture of what is wanted,
  putting it on the sentence strip, removing the
  strip from the communication board, approaching
  the communicative partner, and giving the
  sentence strip to him. By the end of this phase
  the student typically has twenty or more pictures
  on the communication board and is communicating
  with a variety of partners.

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Phase 4

• The student must be able to request AND comment
• The sequence to teach
• Get book
• Remove I Want icon from book
• Put I want icon on sentence strip
• Remove reinforcer picture from book
• Put reinforcer picture on sentence strip
• Remove sentence strip
• Give sentence strip to communicative partner
• (Use time-delay strategy while reading sentence
  strip to encourage students speech. 3-5 seconds)
• (Student can eventually request multiple items)

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Phase 4 Practical Application

• Communicative Partners Responsibilities
• Alaina
• Begins with I want already on sentence strip
• Waits for initiation
• Physically guides student to put picture on strip
  and exchange
• Fades physical guidance to put picture on strip
  and exchange
• Verbal praise and turns strip around and reads
  sentence
• Use backward chaining to teach the sentence strip
  (work through the seven steps backwards)
• Reinforces new behavior within ½ second
• Reinforces with tangible item
• Uses physical assistance to teach student to
  point while strip is being read
• Uses delay (3-5 seconds) in reading strip
• Reinforces if student speaks
• Avoids verbal prompting
• Conducts error correction for incorrect picture
  sequence
• Organizes communication book appropriately
• Does not insist on speech imitation/drill during
  PECS
• Create opportunities throughout the day for
  spontaneous requesting
• Simplify some aspects of the lesson while
  teaching new behaviors, then reincorporate

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After Phase 4

• At the same time, add more vocabulary and
  progress to Phase 5.
• Attributes are excellent to incorporate into a
  students vocabulary. They can be included in
  the sentence strip.

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Phase 5 Responding to, What do you want?

• Terminal Objective The student spontaneously
  requests a variety of items and answers the
  question, What do you want?

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Phase 5

• Continue to verbally and tangibly reinforce each
  correct response
• Use delayed prompting during this phase
• Create opportunities to answer What do you want
  and to spontaneously request
• Continue creating multiple communicative
  opportunities throughout the day.

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Phase 5 Practical Application

• Communicative Partners Responsibilities
• Jill
• Uses delayed prompting to teach What do you
  want?
• Uses differential reinforcement if student
  beats the second prompt
• Reinforces new behavior within ½ second
• Creates multiple opportunities for spontaneously
  requesting AND answering, What do you want?
  within the same lesson.

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Phase 6 Commenting

• Terminal Objective The student answers What do
  you want? What do you see? What do you have?
  What do you hear? and What is it? and
  spontaneously requests and comments.

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Phase 6

• Reinforce each communicative act appropriately
• Use delayed prompting to train responses to each
  new question during this phase
• Use discrimination training to teach
  discrimination between sentence-starter icons
• Create at least 30 opportunities per day for the
  student to request or comment during functional
  activities

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Phase 6 Practical Application

• Communicative Partners Responsibilities
• Dr. Lapine
• Facilitate communication
• Think of some activities that can involve special
  sets of PECS pictures
• Make use of PECS as natural as possible
• Any suggestions?

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Research Article

• Compared effects of Responsive Education and
  Prelinguistic Mileau Technology (RPMT) and PECS
  on spoken communication
• 36 Preschoolers with ASD
• Study was 6 months long, with a 6-month
  follow-up.
• Yoder Stone (2006)

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Research Article

• PECS was more successful than RPMY in increasing
  the number of nonimitative spoken communicative
  acts and the number of different nonimitative
  words used at the post-treatment period.
• Growth rate of the number of nonimitative words
  was faster in the PECS group than the RPMT group
  for children with high object exploration.
• Growth rate was faster in the RPMT group for
  children with low object exploration.
• Yoder Stone (2006)

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Learn more about PECS

• Find a training workshop at http//www.pecs.com/
• (1.3 ASHA CEUs, 425.00)
• Detroit
• Two-Day PECS Training Workshop April 30 - 1,
  2007
• Grand Rapids
• Two-Day PECS Training Workshop March 29 - 30,
  2007
• Advanced PECS Course April 19 - 20, 2007

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References

• Bondy, A. Frost, L. (2002). The picture
  exchange communication system training manual.
  Newark, Delaware Pyramid Educational Products,
  Inc.
• Yoder, P. Stone, W.L. (2006). A randomized
  comparison of the effect of two prelinguistic
  communication interventions on the acquisition of
  spoken communication in preschoolers with ASD.
  Journal of Speech, Language, and Hearing
  Research, 49, 698-711.

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Websites

• Bloorview Macmillan Centre http//www.bbbautism.c
  om/pecs_contents.htm
• PECS
• (Workshops)
• http//www.pecs.com
• Pyramid Educational Products, Inc.
• (Materials)
• http//www.pyramidproducts.com/
• PECS Australia
• http//www.pecsaustralia.com/Brochures/pecs_myths
  .pdf

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Question 1

• What population is the Picture Exchange
• Communication System (PECS) typically
• used for?
• Hearing impaired
• Autism Spectrum disorder
• Downs Syndrome
• Angelmans Syndrome

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Question 2

• Which phase of PECS is most advanced?
• 2
• 4
• 6
• 8

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Question 3

• Is PECS an advanced system designed to replace
  speech?

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Question 4

• Is PECS meant to be used solely for
• children?

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Question 5

• In how many weeks is an individual
• expected to progress through phase 2?

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Question 6

• Why is the first one free?

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Question 7

• Is PECS meant to be used outside of
• speech therapy before the sequence of
• phases is completed?

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Question 8

• What makes PECS more than just basic
• picture use?

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Question 9

• What are 2 advantages of PECS over an
• augmentative/alternative communication
• device?

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Question 10

• What are 2 disadvantages of PECS
• compared to an augmentative/alternative
• communication device?