Ask Amanda - PECS system

Hi Amanda - I thought I'd get in early with a question for you - I am exploring the idea of adapting a PECS system to help Hannah cope in an inclusive classroom. Can you suggest some ways to introduce her to this, also how would it work in a classroom? ( Is it really that easy for a teacher to and child to use? it is the one I am considering because my experience is that teachers rarely ahve the time to learn signing and then use it consistently) Also - what should I include in it eg are there categories that are commonly going to be useful in kindy? Anecdotally I have heard parents say that using this system has helped their children increase utterance length due to the sentence strip. I have access to the 2008 pecs cd - if I find it is working I will probably consider buying an updated version - next year. Thanks a lot. Shelley of Mainstream Musings(using Kit's private blog address cos I am not very technologically able - sorry!

What is PECS?

First, for those who aren’t familiar with the term PECS, it stands for Picture Exchange Communication System. The most common picture system used in schools is Boardmaker, with more and more schools actually purchasing the CD for use in their inclusive classrooms. See Spectronics for more information.

However, for families this system is not always affordable. There are other picture systems that have been developed, but if you want some free downloads you can visit Visual aids for learning, Sparklebox and do2learn. Both of these sites have free, downloadable pictures of commonly used concepts at home and at school.

How are PECS used?

The idea behind PECS is that by using concrete objects (pictures), the child can communicate without having skills such as eye contact and shared attention (paying attention to the same thing as the person they are communicating with, and taking turns in conversation) (Charlop-Christy, Carpenter, Lee, LeBlanc, & Kellet, 2002). These abstract skills can be taught in a very concrete, hands-on way using the pictures.

For example, if you are finding it difficult to get your child to pay attention to what your are saying, giving them a picture can help focus their attention. If the child is trying to communicate something, but is struggling to engage in the give-and-take of conversation, exchanging pictures can be like using a “talking stick”. In this way, they are getting your attention, and you are able to respond to their needs.

Pictures can be used instead of speech, but are usually used to supplement speech. PECS has been shown to be effective in helping children develop increased vocabulary and functional communication (Charlop-Christy et al., 2002). That is, children develop the ability to communicate their needs, wants and feelings in a way that helps them participate throughout the day with fewer “meltdowns” due to the frustration of not being able to communicate.

PECS is used for children with a wide variety of difficulties, including children with Down Syndrome and Autism.

How do you teach young children to use PECS?

Applied behaviour analysis and incidental teaching are usually used to teach PECS (Wolery, 2000). Here are some ideas:

a) Put things out of reach so that the child has to request the object:
Make sure you have the picture card readily available. Do this as a game, and be prepared with extrinsic rewards such as stickers if necessary so that it does not become distressing for both the child and yourself. But the aim is to arrive at a place where getting what they want or need, and a hug or a smile is enough to make the activity rewarding for your child.

For example, if you want to teach your child to request to use the toilet (an important skill for school participation), first shut the toilet door. Assuming your child can’t open the door for themselves, that is. Then, blu-tack the picture representing the toilet to the door, making sure it is within easy reach of your child. Praise your child and immediately open the door when they point to, touch or pull the picture off the door and give it to you.

(picture from do2learn)

b) Modelling
Continuing with the above example, have everyone in the house use the same technique. When you want to go to the toilet, give your child the picture of the toilet before you open the door. This means that she will learn to apply the “word” to others, not just herself. And whenever you use the card, say the phrase, “I need to go to the toilet.”

c) Repetition
Don’t vary this routine, right down to what you say. Get her to try to say exactly the same thing every time she uses the picture as well. If you repeat the same phrase, it will become familiar. Your child will also be able to practice and develop an “imprint” of that phrase in their memory – this it will help the shaping of the sounds with their mouth, their hearing of the sounds and their understanding.

d) Prompt and wait
You may also need to have a phrase and a gesture that will help prompt her to use the picture and/or language. Again, this phrase should remain the same … and pass this on to the teacher of her inclusive classroom. Make it something simple, like pointing to the picture and saying, “What do you say?” Then give your child a minute or so to process what you have said, and have a go. If she is getting distracted, use the same gesture and phrase again. Repetition and familiarity with the prompt are important, though at first you may need to use more physical prompts like guiding her hand to touch the picture. But gradually, try and reduce the prompts you give.

How is it used in the classroom?

PECS, especially boardmaker, is used in a number of ways in schools.

Individual communication booklets:
This is where the child carries around a little booklet of key pictures in their pocket, or on a key ring clipped to their waistband. Here is an example from http://www.autismshopper.com/page8.html.

At school the communication booklet usually has pictures of key people, such as their teacher; self-help words, such as “toilet” and “hungry”; and emotions, such as happy or sad. They may also have pictures that represent key timetable features such as lunch, class and playground time.

Timetables and transitions:
Becoming more common are velcro timetables. This is where pictures representing the different activities of the school day are stuck to a strip of velcroe either to the board at the front of the room, or to the child’s desk. Each time a task is finished, the picture is taken of the strip. Therefore the child can keep track of what is going on. This benefits all children in the classroom.

PECS can also be used to break up and teach the steps in specific activities. See an example on the Spectronics website.

Rules:
The differing social demands of school can be quite challenging for the child. Therefore, PECS are often used to communicate the teacher’s expectations. For example, when sitting on the floor in front of the teacher the expectation is to sit quietly and keep your hands to your self. The teacher may stick the appropriate picture reflecting this on the board. They may also give a smaller version of the picture to the child to gain the child’s attention, then give a verbal prompt (shhh) and gesture (finger to lips). This really helps with the transitions and interactions that are an essential part of the school day. See and example here.

Social stories:
The example in the link above is also a demonstration of how PECS can be used also to develop social stories which will teach children skills to cope with the different social challenges of the school day. I discussed this in a previous post.

In sum, the most commonly used categories at school are:

Self-care, including words such as toilet, food, drink, hurt

Timetabling and transitions: desk work, circle time, craft, sport and so on.

Social skills, including greetings, key emotions (happy, sad), rules (sharing, sitting still and quiet, putting hand up)

PECS may also be used during literacy activities to develop story strips, as seen on the right. These are Boardmaker symbols.

Just a note about sign language: Makaton

Makaton sign language (they have a PECS too) is becoming more common within inclusive classrooms as it is based on natural gestures rather than finger spelling. For example, the natural good-bye wave is used for “good-bye”. The “T” that we use in a “time-out” gesture for basketball is used to signify the need for a toilet break.

Check with your school – you might find that these simple gestures can be used for some key phrases. They can be taught in the same ways as your would teach PECS.

Find out about the difference between Makaton and AUSLAN here.

References:

Charlop-Christy, M.H., Carpenter, M., Lee, 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 behaviour and problem behaviour. Journal of applied behaviour analysis, 35(3), pp213-231.

Wolery, M. (2000). Behavioural and educational approaches to early intervention. In J.P. Shonkoff & S.J. Meisels (Eds) Handbook of early childhood intervention (2nd Ed), pp179-203. Cambridge: Cambridge University Press.