PECS Overview: A Picture the and Benefits - Schedschd.ws/hosted_files/2015everychildcountssymposiuma/ff/PECS... · PECS Overview: A Clear Picture ... children with characteristics

PECS Overview: A Clear Picture Understanding the

Use and BenefitsDeveloped by: Andy Bondy, Ph.D. and

Lori Frost, MS, CCC/SLPPresented by: Donna Banzhof, M.Ed, BCBA

2014 Copyright Pyramid Educational Consultants. May not be reproduced.

1 2014 Copyright Pyramid Educational Consultants. May not be reproduced.

Objectives

• Introduction to Pyramid Educational Consultants• Overview of the Pyramid Approach to Education• Understand the 6 Phases of the PECS protocol• Discuss criteria for modality transitioning• Analyze some common “Myths and Misconceptions” associated with PECS

• Review researched benefits of PECS

2014 Copyright Pyramid Educational Consultants. May not be reproduce.

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Pyramid Educational Consultants

• Founded in 1992 by Lori Frost and Andy Bondy – To provide training to professionals and families of children with Autism Spectrum Disorders

– To ensure high‐fidelity implementation of PECS

• Exclusive home of PECS® (Picture Exchange Communication System®) and the Pyramid Approach to Education®


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Pyramid Educational Consultants• Currently has 14 offices around the world

– US, UK, France, Greece, Canada, Japan, Spain, Germany, Poland, Romania, Australia, Brazil, Korea, Portugal

• Internationally acclaimed workshops and consulting services

• Provide training to teams (professionals and parents)– Designing educational and vocational programs– PECS

• Provide on‐site and distance consultation – private and public schools– to families in homes and the community– agencies


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Brief history of PECS

• Began in DE 1985• First started with children on the spectrum• Protocol is based on B.F. Skinner’s Verbal Behavior (1957)

• Has been researched for the past 20 years• Today PECS is implemented worldwide across ages and diagnostic categories


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How widespread is PECS?

• 135 published articles to date on various topics about PECS– E.g Speech, Adults, SGD

• At least 70 data based or case studies, 12 descriptive articles, 6 literature reviews

• Articles generated in 13 countries • Research is ongoing!


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What is PECS• A methodology for teaching learners “how” to communicate by exchanging pictures

• It is an AAC (Alternative and Augmentative Communication System)

• Uses the principles of broad spectrum ABA• Parallels typical language development• Implements teaching strategies that encourages speech

• Is an evidence based practice2014 Copyright Pyramid Educational Consultants.

May not be reproduce.

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What does the evidence say?

"The most widely used intervention was PECS, with almost all of the participants mentioning it, even those who did not use any other intervention in their program."

Stahmer, A., Collings, N. & Palinkas, L. (2005). Early Intervention Practices for Children With Autism: Descriptions From Community Providers. Focus on Autism and Other Developmental Studies, 20, 66-79.

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The “why” of behaviour:The science of learning

The Pyramid Approach to Education

The “how” of teaching

Collecting and Analyzing Data

Functional Activities

Functional Communication

The “what” of teaching


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The Base ElementThe “why” of behavior: The science of learning

Functional Activities

• Purposeful activities and real materials: focus skills leading to independence.

• Provides opportunities to have something to communicate about.

Powerful Reinforcers

• Powerful motivation that drives learning. • Requesting a reinforcer is the 1st lesson in PECS

and the only prerequisite to begin.

Functional Communication

• Communication must be between at least two people.

• PECS begins exchanging a message to a person.

Contextually Inappropriate Behavior (CIB)

• Focus on finding the function and teaching functionally equivalent alternative behaviors (FEAB).

• Communication skills can be FEAB’s.2014 Copyright Pyramid Educational Consultants.


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The Top ElementsThe “how” of teaching

Generalization • Skills generalized from the beginning• Variety of people, places, activities

Effective Lesson Types

• Sequential, discrete, incidental

Specific Teaching Strategies

• Goal is to eliminate prompts• PECS is systematically taught

Minimizing and Correcting Errors

• Opportunities to teach – not just fixing mistakes

Collecting and Analyzing Data

• Determines the effectiveness of a lesson and changes to make


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What is communication?

• Not all behaviors are communicative

• Must occur between two people

• “Speaker” directs behavior to “listener”

• “Listener” mediatesaccess to reinforcer


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Understanding under what conditions communication occurs


Deprivation or environmental events

Question or prompt

Model

Spontaneous/self-initiated

Responsive

Imitative

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Pyramid Principles for Teaching Functional Communication


DecisionsModalityCommunicative function to teach firstApproach to spontaneity

PECSPicturesRequesting

From beginning

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Why and How of PECS?

WHY?• Teaches HOW to communicate

• Focuses on students initiation• First skill = spontaneous requesting

• Expands to teach discrimination, sentence structure, answering various questions and expanding language

• Develops communication/“verbal behavior” controlled by the presence of the audience


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Why and How of PECS

HOW?• Begin with learner’s favorite reinforcing item or activity

• Start implementing across the day during the natural routines in their day

• Use the picture symbol set that is most readily available


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Getting ready for implementation

• Set time for staff training • Purchase materials and supplies• Complete a reinforcer assessment• Make pictures• Identify communication opportunities across the day

Activity Goal Expressive Communication

Receptive Communication


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The Phases of PECSPhase Objective of each phase

Phase I How to communicate

Phase II Distance and persistence

Phase III Discrimination training

Phase IV Sentence Structure

Expanding Vocabulary

Attributes, action words, asking questions

Phase V Answering “What do you want?”

Phase VI Commenting


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Phase I: How to Communicate

• Goal: Approach people to initiate communication–To teach initiation, use 2‐person prompting procedure

• Teach 3‐step sequence–Pick up, reach, release

• One picture at a time – no discrimination 2014 Copyright Pyramid Educational Consultants.


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Communicative Partner

Physical Prompter

Entice Wait for initiation/reach

Physically prompt pick up, reach, release

Reinforce within ½ sec (label item)2014 Copyright Pyramid Educational Consultants. May not be reproduce.

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PP waits for the initiation, then …

prompts the pick‐up, reach,

and release. CP delivers R+ within ½ second,

labels item and praises student


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Phase II: Distance and Persistence

• Distance: travel–Adult moves away from learner, learner travels to find communicative partner

– Learner locates communication book– Learner carries communication book

• Persistence ‐Eliminate subtle prompts


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Phase II: Distance and Persistence

• Each learner has their own communication book

• Picture gets placed on communication book– one picture– no discrimination required

• Variety of people, activities, locations, and reinforcers

• Phase II never ends!2014 Copyright Pyramid Educational Consultants.


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IIIA: Simple Discrimination• Motivation to use correct picture = getting desired item & avoiding undesired item

• Remember to reinforce at 1st indication of choice!• 4 Step Error Correction Procedure for mistakes


versus

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1. Model/Show 2. Practice

3. Switch 4. Repeat


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Phase IIIB Conditional Discrimination

• Discrimination between equally reinforcing– Conduct Correspondence Checks– Use 4‐step Error Correction Procedure following mistakes


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Phase IV: Building Sentences

“I want” + picture placed on sentence strip

Whole sentence handed to adult


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Phase IV: Summary


1. The student places the reinforcer symbol on the strip and exchanges.

2. The student puts the ‘I want’ and the reinforcer symbol on the strip and exchanges.

3. The student taps the symbols.

4. The teacher inserts a 3‐5 second time delay before naming the reinforcer item.

3‐5 second delay

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Attributes

• Teach students to request very specific reinforcers

• Increase sentence length through attribute combinations

• Receptive mastery not a prerequisite!


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Phase VAnswering “What do you want?”

• Answering “What do you want?”– Expand to responding to other questions such as “what to you want to play with”

• Leads to Commenting– Use same teaching strategy for Phases V and VI

• Maintain Spontaneity– Have opportunities for requesting and responding to questions.


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Phase VICommenting

• Answering “comment” questions– “What do you see?”– “What is it?”– “What do you have/hear/feel?”

• Discriminating between “What do you see?” and “What do you want?”

• Have opportunities for both spontaneous commenting and requesting


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Expanding Language

• Teaches to request multiple items

• Teaches adverbs, prepositions• Teaches subject verb combinations• Verb tenses• Asking questions


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Modality Transitioning• Successful transitions from any modality to any other modality (e.g. PECS to SGD) include:–New modality vocabulary = current vocabulary– Rate of initiation is equal – Length of utterance is equal–New modality is at least 80% intelligible to unfamiliar listener

– Speed of interaction is equal

•Taking away skills is unethical!!2014 Copyright Pyramid Educational Consultants. May not be reproduce.

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PECS and SGD“The authors recommended that PECS® phases I –III be mastered before the iPad™ is introduced, to ensure the students master these prerequisite skills since they are more difficult to scaffold (break into smaller units for teaching and thenbuild additional skills) using the iPad™.”

Adams Hill, Doris and Flores, Margaret M. (2014). Comparing the Picture Exchange Communication System and the iPad™ for Communication of Students with Autism Spectrum Disorder and Developmental Delay. TechTrends, May/June, vol 58, no.3


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PECS Myths and MisconceptionsMyth FactIf we’re using pictures of any kind, we’re using PECS.

PECS is a specific protocol for teaching expressive use of pictures for an individual to communicate.

EvidenceFrost, L. and Bondy, A. (2002). The PECS Training Manual, 2nd ed. If the basic protocol has not been implemented then it is not PECS!


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PECS Myths and MisconceptionsMyth FactWe’re using a visual schedule, so we’re using PECS.

PECS is an expressive communication system.

Visual schedules are about receptive understanding. Sequence of pictures that gives information about the day.

The Pyramid Approach makes use of visual schedules, but users do not exchange the pictures in a communicative fashion.

Bondy, A (2012). The unusual suspects: Myths and Misconceptions associated with PECS. The Psychological Record, 62, 789‐816.


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PECS Myths and MisconceptionsMyth FactPECS is only for people who don’t speak at all.

PECS can be an alternative communication system for those who don’t speak or an augmentative communication system for those who do.

EvidenceGanz, J & Simpson R (2004). Effects on communication requesting and speech development of The Picture Exchange Communication System in children with characteristics of autism. Journal of Autism and Developmental Disabilities, 34, 395‐409. The results showed participants (3 children) master rapidly the phases taught (Ph I‐IV) and the word utterances increased in number and complexity of grammar.


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PECS Myths and MisconceptionsMyth FactPECS is only for young children.

PECS has been effectively used around the world with people aged from 14 months to 85 years.

Evidence:Conklin, C. & Mayer, G.R. (2010). Effects of implementing the Picture Exchange Communication System (PECS) with adults with developmental disabilities and severe communication deficits. Remedial and Special Education (Online First) 2011 32 155‐166The results of this study suggest that participants (3 adults) taught via PECS increased their initiation of requests, thereby increasing their independence and choice making, which also appears to have collateral effects on problem behaviors.


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PECS Myths and MisconceptionsMyth FactPECS just teaches people to request.

PECS’s final phase focuses on teaching commenting (e.g. I see, I hear, I smell).

PECS is not only about a person getting his/her needs and desires met, but about commenting with other people in his/her world.

EvidenceFrost, L. and Bondy, A. (2002). The PECS Training Manual, 2nd ed. PECS is designed to teach both functions of communication, requesting and commenting.


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PECS Myths and MisconceptionsMyth FactIf we use PECS, the person using the system won’t learn to speak.

As with any other alternative communication system, the use of PECS will increase the likelihood that a person will become a verbal communicator.

EvidenceThere are 16 research articles that show PECS increases vocal speech for preschool age children. www.pecs.com/research


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Number of Pictures and Spoken Words Acquired After PECS Training

020406080

100120140160180

0 1 3 5 7 9 11 13 15 17 20

N um ber of M onths After PEC S

Pictures

W ords

Age at Start = 3 years 0 months

First Spoken Word

(61)

(91)

Andy Bondy and Lori Frost, 19942014 Copyright Pyramid Educational Consultants. May not be reproduce.

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PECS Myths and MisconceptionsMyth FactPECS is only for people with autism.

What has been discovered over the 20 years since the inception of PECS is that it can serve as an effective communication system for a range of individuals with communication impairment.

PECS is being used with individuals with Down syndrome, Cerebral Palsy, Cri-du-Chat, developmental verbal dyspraxia, language disorder, head injury and the list goes on.


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Research‐based benefits using PECS

• Facilitates acquisition of speech• Increases social approach during play• Reduces Behavior Management Targets rates (even when not specifically addressed)

• Is easily understood in community and by peers


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ConclusionPECS

• A teaching system that focuses on initiation • Easy to get started• Evidence based• Has been shown to have a positive impact

– increase communication skills– increase vocal speech – decrease unwanted behaviors

PECS provides power to communicate!


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Where and how to contact us

13 Garfield WayNewark, DE 19713888.732.7462

www.pecsusa.com

for PECS related research publicationsPlease visit

http://www.pecsusa.com/Research.php

2014 Copyright Pyramid Educational Consultants. May be reproduce.

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Documents

PECS Overview: A Picture the and Benefits - Schedschd.ws/hosted_files/2015everychildcountssymposiuma/ff/PECS... · PECS Overview: A Clear Picture ... children with characteristics