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Picture Exchange Communication System (PECS). Hannah Coles Speech and Language Therapist Camden Language and Communication Service (CLCS) Camden ASD Provisions. What is PECS?. A visual communication system It is a form of Augmentative & Alternative Communication (AAC)
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Picture Exchange Communication System (PECS) Hannah Coles Speech and Language Therapist Camden Language and Communication Service (CLCS) Camden ASD Provisions
What is PECS? • A visual communication system • It is a form of Augmentative & Alternative Communication (AAC) • Uses object cards to express/communicate desires • A picture of the desired object is given to a communication partner in exchange for that item
What does PECS aim to achieve? • It enables non-verbal children with autism and other communication deficits to initiate communication with others. • PECS focuses on the initiation of communication and aims to develop the basic skills for communication, including language, social skills as well as reciprocal communication • It can be used in a variety of settings • Enables non-verbal children to request/choose • High rate of success in teaching spoken communication
PECS and the Triad • PECS can be used to address the Triad of Impairments… • Social and Emotional Understanding: Teaches that communication needs a person, a topic and another person to ‘hear’ about the topic • Communication & Language: It gives a clear and easy means of communicating with or without language • Flexibility of Thought & Behaviour: By using PECS symbols, situations can be negotiated and information shared
Who should PECS be used with? • The approach was specifically devised to meet the needs of young children with ASD • However, the system has been successful with adolescents and adults who have a wide array of communication, cognitive and physical difficulties. • Now also able to be used with • Difficulty with speech or intelligibility • Poor initiators • To develop sentence structure and length
How to get started • Motivation – it is essential to start with what engages the student • Establish a motivation hierarchy, most preferred to neutral to non preferred items. • Update as preferences change • Determine whether student can understand symbols • Preferably 2 people: • Child aims to communicate with adult 1. • Adult 2 sits behind/beside child to assist.
Phase 1 – THE PHYSICAL EXCHANGE Set-up: Picture of motivator on table in between adult 1 and student. Adult 1 holds the motivator in one hand and has their other hand open • Student reaches/points to motivator • Adult 2 guides student’s hand to pick up picture and place it in open hand of Adult 1 • Adult 1 shows the student the picture and exchanges it for the motivator • Adult 1 may add verbal praise
Phase 2 (1) – DISTANCE & PERSISTENCE Set-up: Adult 1 has motivator in hand and picture is attached with velcro to a communication board/book. • Student practises taking picture off the board/book and giving it to adult 1 • Then, the distance is increased between the adult and student: • Adult 1 moves away so student has to reach to give picture • Adult 1 moves further away so student has to move out of chair to give picture • Adult 1 has their back turned so student has to be persistent to give picture
Phase 2 (2) – DISTANCE & PERSISTENCE • Then, distance is increased between student and picture/book/board • Adult 1 is beside book and student stands to get picture • Adult 1 stands away from picture and student reaches for picture and reaches to give picture • Adult 1 stands away from picture and student stands to get picture and reaches to give picture • Student has to stand to get picture and walk to give picture to adult 1 • Student independently gets book/board form where it is kept and gives picture to adult 1.
Phase 3 - DISCRIMINATION Set-up: 2 pictures on communication book/board (1 x motivator and 1 x irrelevant). Ensure the student can see the motivator • Student selects picture of motivator and adult 1 gives the item and verbal praise • If student gives picture of irrelevant item, adult 1 gives the motivator and points to the correct picture. • When student consistently gives the picture of motivator increase number of pictures to 3,4,5...
Phase 4 – SENTENCE CONSTRUCTION Set-up: Choice of pictures and a sentence strip on board/book. Initially the motivator is in view. • Student places picture on the sentence strip and give the sentence strip to adult 1 (adult 2 may need to prompt this) • Adult 1 reads the strip while pointing and showing student • ‘I want’ picture is put on book/board. Student puts ‘I want’ on sentence strip (adult 2 may need to prompt this) • Motivator moved out of sight, repeat as above.
Phase 5 – WHAT DO YOU WANT? Set-up: Choice of pictures, ‘I want’ and a sentence strip on board/book. Motivator is in sight • Adult 1 asks ‘What do you want?’ and points to the ‘I want’ picture at the same time. • Adult 1 asks ‘What do you want?’ and delays pointing to ‘I want’ picture • Adult 1 asks ‘What do you want?’ Student independently sequences ‘I want’ & picture on sentence strip and gives to Adult 1
Phase 6 (1) - COMMENTING Set-up: Choice of pictures, ‘I want’, ‘I see’ and a sentence strip on board/book. Adult 1 is holding a neutral item • Adult 1 asks ‘What do you see?’ and points to the ‘I see’ picture at the same time • Student places ‘I see’ on sentence strip (adult 2 may need to prompt this) and a picture • If student sequences the correct picture, Adult 1 says ‘Yes you see a…’ and gives a small reward not related to neutral item. • Adult 1 asks ‘What do you see?’ and delays pointing to ‘I see’ picture • Adult 1 asks ‘What do you see?’ and student sequences ‘I see’ & picture on sentence strip and gives to Adult 1 • Adult 1 randomly asks ‘What do you want?’ & ‘What do you see?’ and student responds appropriately to each question.
Phase 6 (2) - COMMENTING Set-up: Choice of pictures, ‘I want’, ‘I see’, ‘I have’ and a sentence strip on board/book. Adult 1 has a neutral item. • Adult 1 gives the student the neutral item and asks at the same time ‘What do you have?’ • Student places ‘I have’ on strip (adult 2 may need to prompt this) and picture of neutral item. • If the student puts correct picture, Adult 1 says ‘Yes you have a…’ and gives a small reward not related to neutral item. • Adult 1 asks ‘What do you have?’ and delays pointing to ‘I have’ picture • Adult 1 asks ‘What do you have?’ Student independently sequences ‘I see’ & picture on sentence strip and gives to Adult 1 • …‘What do you smell?’, ‘What is it?’ & ‘What do you hear?’
Things to Remember • It is important that the child exchanges the picture • Give small quantities of the motivator if it is food/drink • Let the student have the toy/activity only for a short amount of time • Alternate the communication partner/adult 1 so the child is able to communicate with a range of people • Ensure the picture has the written word at bottom • Make sure the picture all the same size • Keep the communication book/board in the same place and where the student can access it
Contact Details Camden Language and Communication Service Monday & Tuesday – 020 7388 6506 Camden ASD Provisions Wednesday & Thursday – 020 7530 4336 Friday – 020 7539 2658 Hannah.Coles@islingtonpct.nhs.uk