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Picture Exchange Communication System (PECS)

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Picture Exchange Communication System (PECS)

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PECS is a low-tech augmentative and alternate communication system. "People using PECS are taught to approach another person and give them a picture of a desired item in exchange for that item(National Autism Resources, 2021)." By utilizing visual symbols to teach particularly those with autism, a way to communicate their needs or wants, it allows for reduction of frustration in being unable to express their needs and or wants. The goal is to teach students who are unable to communicate a quick, self-initiating way of communicating. When beginning to implement this system you would begin with simple icons. A student may be crying but the teacher doesn't understand that they are crying because they are hungry. PECS allows the student to notify the teacher of their need without becoming upset.

There are six phases to implementing this communication system.

1. Exchange single pictures

2. Teach them to use the pictures in different settings and with different people, not just the original teacher.

3. Child learns to choose between two or more pictures to get the desired item. These are usually stored with pictures that are secured with velcro and are easily accessed.

4. The child learns to construct simple sentences for instance "I want ___".

5. Responding to questions asked like What do you want? By choosing the picture.

6. The child begins to learn to comment in response to questions asked. For example, what do you smell? and the child would reply with "I smell _____"

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Core boards are low-tech systems of communication. These can be picture, symbol or alphabet boards. These are simple non-electronic materials like paper or pictures. These boards are meant to be meaningful to the student. They can range from just a few pictures to many organized in categories. Core boards allow for a large symbol vocabulary that allow students that cannot verbally express themselves the ability to still communicate a wide range of ideas. "Essentially a core board is a colorful board with symbols that are fixed in place. (Brydon & Pretorius, 2021) Core words are the words we use most frequently when communicating. Approximately 80% of what we say when speaking is made up of less than 500 words. Core words are the parts of sentences that we would see most.

Teachers may have a large blown up copy of a core board at the front of their classroom to model communication for students. The most important part of a core board is that the pictures stay in a fixed position. Only allowing a few symbols at a time to be shown when learning is important. Having too many symbols in the beginning can be overwhelming. Most importantly in implementing this system is adult support in modeling and practice.

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SGD are usually tablet like devices that allow a person to generate a computer voice to speak for them. In the past it was thought that students need a certain set of skills to go to using these but that isn't always found to be true. These devices tend to be highly personalized to an individual's needs. SGD are known to help users communicate by improving language skills, adding to social interactions and helping reduce the frustration that is met when being unable to effectively communicate.

To implement this system, you will need to do the following:

1. Choose the right device. Taking into consideration a persons needs, cognitive and physical abilities, and the overall goal for their communication needs.

2. Training- If a person isn't trained properly on how to use something, the effectiveness of it's intent can decrease dramatically. Just as when we explain any new concept, we must train step by step.

3. Fostering an environment that encourages communication. Keeping the device handy, modeling it's usage, being patient and supportive when they are learning as well as using peer tutoring can all foster positive communication habits.

(Center for Medicare Advocacy, n.d.)

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Push Button Recording Devices (Big Mack)

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Push Button Recording Devices (Big Mack)

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These come in many different levels. This is a mid-tech device, since it only requires being able to push the button. These devices often speak a message out loud for the person after they push a button, but they don’t have fancy touch screens that can change with each button push.  One of those is the Big Mack. The Big Mack allows teachers to record multistep directions where a student can push the button and hear the directions as many times as they need. They can also enhance social communication by recording some of the appropriate greetings or responses during play.

Implementing this device can feel more natural and using it independently in turn taking can be helpful. This is a great first minimal electronic type of AAC that can be used whenever the teacher is ready to use it. It does happen to be one of my favorites for recording routines. (SLPCarrie, 2017)

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SLPCarrie. (2017, February 24). AAC and Autism: Using Communication Devices for Non-Verbal Children - Speech And Language Kids. Speech and Language Kids. https://www.speechandlanguagekids.com/giving-voice-non-verbal-children-autism-aac-autism/

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Sign language is a low-tech communication system that can be taught to young children. These signs have been proven to be beneficial for all children, even those without speech or language impairments or delays. Young children can become frustrated as well not being able to communicate a need. Basic sign language can help alleviate that frustration. Since this system is appropriate for all levels and ages, it is easily implemented by beginning with modeling the signs and then saying what the sign means. Even with young children beginning with the word "more" can be used in any activity like eating or playing with toys. There is no wrong way to use these, and it is the simplest to implement. (SLPCarrie, 2013)

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Visual schedules are systems of support that are useful for all students with autism. There are many different kinds that can be adapted to the ability of the child. As children age and mature the visual schedules can be upgraded to match their maturity. Visual schedules allow students to have a predictable routine, know what is coming next and allows them to reduce anxieties of the unknown. To implement this system you would need to take note of each activity the student will transition to during the day then create a picture for each. The schedule should also coincide with times and places. Students should then check off or move the picture to all done when the activity is complete. They will then see the next to do item on the list and be mentally and emotionally prepared to transition with less frustration than transitioning to the unknown.

"Visual activity schedules include visuals to support language and task order, explicit task steps or activity locations to support successful transitions, and embedded behavioral strategies to make learning more explicit (e.g., places where choices are possible; clear ends to activities resulting in reinforcement or preferred items/people/activities)"(Tuck et al., 2024).

When a student is able to independently use their visual schedule that is when you know that they have mastered the system. Fading support should always be used during teaching the system.

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Tuck, K. N., Chow, J. C., Kim, G. Y., Malone, E. J., & Smith, K. H. (2024). Implementing Visual Activity Schedules to Support Elementary Student Engagement. Beyond Behavior, 33(3). https://doi.org/10.1177/10742956241287093                                                           Resource Links: https://www.challengingbehavior.org/docs/Routine_cards_home.pdf

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Discrete trial training (DTT) or discrete trial instruction is an evidence-based practice.

The three essential components of DTT, are the instructor presenting an instruction (i.e., the discriminative stimulus; the instructor says, “Point to the picture of a dog”), waiting for the learner to respond (i.e., the behavioral response; the child points to the picture of a dog), and the instructor providing a consequence (i.e., reinforcing stimulus; the instructor says, “Great job pointing to the picture!”) (Fingerhut & Moeyaert, 2022).

DTT breaks down a concept into steps that can each be taught then when put together forms the whole concept.

One of the major things that is required with DTT is making sure the learner's attention is secured on the task at hand. If a learner is not paying attention, then fidelity cannot be met.

When analyzing the efficacy of DTT the scoring that is kept throughout the sessions can be given a grade and you can visually see the percentage correct with independence.

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Fingerhut, J., & Moeyaert, M. (2022). Training Individuals to Implement Discrete Trials with Fidelity: A Meta-Analysis. Focus on Autism and Other Developmental Disabilities, 108835762210810. https://doi.org/10.1177/10883576221081076                                                  Resource Link: https://www.autismspeaks.org/expert-opinion/what-discrete-trial-training

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Applied Behavior Analysis (ABA) is a type of therapy frequently applied to children with autism and other developmental disorders that focuses on imparting skills in specific domains of functioning, such as social skills, communication, academic and learning skills, motor dexterity, hygiene and grooming, and more (Applied Behavior Analysis, 2016). The unique part of ABA therapy is that it is specifically designed for each child's needs. ABA therapy begins with taking Antecedent, Behavior, Consequence data to analyze what the function of the behavior is. Once the function is established then a plan is worked out on how to mold the undesirable behavior into desired behaviors. Data is then kept on the frequency or duration of the behaviors and graphed out to see if it is working or if it needs to be changed. This is important to note because the data drives the therapy. When the therapy is affective and the behavior reduces to an appropriate level or disappears, then we need to make sure the behavior is maintained, or if there is another undesired behavior then we begin to target that. This is beneficial to students of all functioning levels, but is best suited for those with extreme behaviors in an academic setting. ABA therapy is available outside of schools and can be done in a clinical setting where parents also learn and take that knowledge home with them to transfer the environment.

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Social Stories are usually short, simple and have defined criteria to make them “Social Stories”. These stories are personalized and use illustrations to visually show a student what is expected. These stories can be used for any subject matter. There are even programs out there to help you write your own as well as websites with pre-made stories of subject matters that are typical for students with ASD.

Measuring effectiveness can be done by keeping data on the desired outcome of the story. For instance, a story about keeping your clothes on at school would be read daily to the student have the unwanted behavior. Keeping a frequency of how often the student removes their clothing would assist in knowing how well the story is helping with understanding the concept.

A social story must:

1. Have a goal

2. Include a two-step discovery process

3. Contain a title and introduction that identify the topic, a body that adds detail, and a conclusion that reinforces and summarizes the information

4. Has a format that is tailored to the individual abilities, learning style, talented, interests, and attention span of the audience

5. Have a patient and supportive voice along with vocabulary that:

Has exclusive use of first- and/or third-person perspective statements (no second-person “you”)

Contains past, present, or future tense

Has a positive, patient tone

Is literally accurate

Has an accurate meaning

6. Answers questions about where, when, who, what, how, and why

7. Contains descriptive and coaching sentences (sentences that guide behavior)

8. Has language that describes more than it directs

9. Is constantly revised

10. Has a plan for editing and implementation

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Pierce, R. (2020). How To Write A Social Story (A Step-By-Step Guide) | Life Skills Advocate. Lifeskillsadvocate.com. https://lifeskillsadvocate.com/blog/how-to-write-a-social-story/                   Resource Link:   https://abaresources.com/social-stories/                   

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Pivotal Response Treatment, or PRT, is a behavioral treatment for autism.

PRT targets areas of a child’s development instead of working on one specific behavior.

Pivotal areas include:

Motivation

Response

Self-management

Initiation of Social opportunities

Examples:

1. Transitioning.

2. Chores.

3. Routines.

4. Meals.

This type of therapy uses natural motivations to promote social behaviors.

Data should be kept on how effective the behaviors are being changed. Data can be graphed over time to show a trend in effectiveness. This type of system does take time. Since PRT promotes social interactions, it helps both receptive and expressive language areas, as input and output is both needed.