The Picture Exchange Communication System: More Than a Menu?

Background:

The acquisition of functional communication skills largely dictates the extent to which individuals with autism participate in daily activities at home and school and develop social relationships.  Further, the attainment of a communication system has been directly linked to the prevention and reduction of problem behaviour.  Numerous studies link the Picture Exchange Communication System (PECS) to enhanced communication and speech development, as well as decreases in inappropriate behaviour.  However, few explore the quality of children’s communication skills following PECS use in detail.  As such, there exists little information about vocabulary diversity (i.e., breadth/type of word use), sophistication of communication (i.e., mean length of utterance, use of attributes/proper syntax) or the range of functions the system serves (i.e., requests, social interactions).   Further, little is known about the environments and activities in which PECS is used.  Most significantly, little is known about specific areas of difficulty (i.e., spontaneity, distance, discrimination).

Objectives:

The purpose of this research is to describe children’s use of PECS in real world settings.  Generalization factors such as the different types of reinforcers requested, vocabulary breadth, the activities and settings within which PECS is used will be described, as well as more quantitative outcomes, such as PECS phase achieved and frequency of requesting.  Finally, the impact of PECS training on overall communicative behavior, in both home and community environments will be described.  

Methods:

Data was collected from 22 children using PECS in a community-based summer program. Pre- and post-camp assessments included measures of children’s requesting behavior and PECS phase.  Two graduate level doctoral students conducted live and video review of children’s pre-post communicative behavior. Interobserver agreement was above 90%.  Parent communication questionnaires were also completed pre- and post-camp to assess general communicative behavior across settings.  Finally, daily data logs recording types of reinforcers requested, frequency of requests and environments in which PECS was used were completed by camp staff. 

Results:

Results indicate that children gained at least one PECS phase during the 7-week summer camp and were reported to use a variety of different pictures (mean =  40, range 15-68) to request reinforcers from several different categories (mean = 4.5 categories, range = 3-5).  PECS use was observed in many different activities and environments (mean= = 8.35 environments, range = 6-13).  Reductions in problem behavior were also observed.  Parent reports indicate overall communicative benefits following PECS training.

Conclusions:

PECS was used by children with autism spectrum disorders and significant cognitive impairments to access numerous different reinforcers across a variety of environments.  Overall improvements in communicative behavior were observed across settings.