picture exchange communication system jenifer majino, m.s. ccc /slp [email protected] cheryl...
TRANSCRIPT
Picture Exchange Communication
System Jenifer Majino, M.S. CCC /SLP
Cheryl Livingston, M.S. CCC/SLPAugmentative Communication Facilitator
Workshop Objectives• Review the history of PECS• Overview of PECS• Why use PECS• Discuss and practice Phases I - III
https://ssdfcs.ssdmo.org/Groups/augmentativecommunication
Wiki
PECS Handouts you can print.
Links to Syncrocloud
What is PECS?Picture Exchange Communication System
Developed by Andrew S. Bondy, Ph.D. & Lori Frost, M.S., CCC/SLP
PECS was developed in 1985 as a unique augmentative/alternative communication intervention package for individuals with autism spectrum disorder and related developmental disabilities. First used at the Delaware Autistic Program, PECS has received worldwide recognition for focusing on the initiation component of communication. PECS does not require complex or expensive materials. It was created with families, educators, and resident care providers in mind, so is readily used in a range of settings.
PECS begins by teaching an individual to give a picture of a desired item to a “communicative partner", who immediately honors the exchange as a request. The system goes on to teach discrimination of pictures and how to put them together in sentences. In the more advanced phases, individuals are taught to answer questions and to comment.
The PECS teaching protocol is based on B.F. Skinner’s book, Verbal Behavior, such that functional verbal operants are systematically taught using prompting and reinforcement strategies that will lead to independent communication. Verbal prompts are not used, thus building immediate initiation and avoiding prompt dependency. Based on broad spectrum application of Applied Behavior Analysis (ABA)
Video
The Six Phases of PECS
PHASE IHow to CommunicateStudents learn to exchange single pictures for items or activities they really want.
PHASE IIDistance and PersistenceStill using single pictures, students learn to generalize this new skill by using it in different places, with different people and across distances. They are also taught to be more persistent communicators.
PHASE IIIPicture DiscriminationStudents learn to select from two or more pictures to ask for their favorite things. These are placed in a communication book—a ring binder with Velcro® strips where pictures are stored and easily removed for communication.
PHASE IVSentence StructureStudents learn to construct simple sentences on a detachable sentence strip using an “I want” picture followed by a picture of the item being requested.
Attributes and Language ExpansionStudents learn to expand their sentences by adding adjectives, verbs and prepositions.
PHASE VAnswering QuestionsStudents learn to use PECS to answer the question, “What do you want?”.
PHASE VICommentingNow students are taught to comment in response to questions such as, “What do you see?”, “What do you hear?” and “What is it?”. They learn to make up sentences starting with “I see”, “I hear”, “I feel”, “It is a”, etc.
Reasons we communicate –
Participation - Engagement - Requesting - Directing / Manipulating others -Commenting - Social exchange - Questioning - Sharing information –
Why PECS?The Picture Exchange Communication System (PECS) teaches communication by breaking it down into steps / phases. The student learns:Phase 1 – How to communicate• You need to do something to communicate. • You need to have a communicative partner• You can ask for something you want• You can trust the communicative partner to give you what you want• You can start / initiate the communication, you don’t need to wait to be
asked “What do you want?”
Phase 2 – Distance and Persistence• You can go to a communicative partner to request something, you need to get their
attention.• You can trust the communicative partner • You need to be aware of who has the stuff• You need to be aware of where your book is located (you need it to communicate).• You can start carrying your book with you to make sure you have it when you need
it. • You can start the communication, you don’t need to wait to be asked
“What do you want?”• You can keep requesting until you get what you want.
Phase 3 A – Simple Discrimination (things you like vs don’t like).• You need to pay attention to make sure you get what you want. You will have two choices.• You can show the communicative partner what makes sense to you (objects, photos or
symbols)• You can practice telling the communicative partner “No, I don’t like that”.• Your communicative partner will practice with you getting the one you want if you are having
difficulty understanding – you will learn how to do it.
Phase 3 B – Conditional Discrimination (two preferred)•You need to pay attention to make sure you get what you want. You need to pick the picture
of the item you want.• You can show the communicative partner that you understand the pictures. When you give
the communicative partner a picture, he/she will tell you to take the item you want. If you gave him/her a different picture than the item you reach for, that tells them that you are having difficulty understanding the pictures.
• Your communicative partner will practice with you getting the one you want if you are having difficulty understanding – you will learn how to do it.
• You will learn to ask for a break when you don’t want to do something.• You will learn to ask for help so you don’t get mad.• You will learn that sometimes you have to wait for something you want. You can trust the
adults to give it to you soon.• You will learn how to find pictures in your book. All of the steps / phases you have learned so
far will continue as you learn more.
Phase 4 - Sentence Structure • You will learn to put pictures together to communicate • You will learn to take your sentence strip to the communicative partner • You will begin practicing pointing to the pictures on the sentence strip• You will begin practicing trying to say the words on the sentence strip• You can practice requesting items you want, when you want them• You will feel more independent because you can find pictures in your book and then put
them away for next time.• You will practice putting the pictures on the sentence strip in the correct order so the communicative partner will understand.• You will learn that sometimes the communicative partners run out of your favorite things.
But that’s OK, you can ask for something else or wait until later. They know you would like to have that item another time. You can trust them.
Phase 4 (continues) – Attributes – Descriptive Vocabulary • You will learn to use new pictures to describe what you want • You will practice using the new pictures to request the color, size, shape, etc. of what you want• You will learn that adding pictures to your strip will give you control to tell the communicative
partner what you want.• You will practice putting the pictures on the sentence strip in the correct order so the communicative partner will understand.• Your communicative partner will practice with you getting the pictures in the correct order if
you are having difficulty understanding – you will learn how to do it.• You will learn more pictures that will help you request actions.• You will practice trying to say the words that go with the pictures. The communicative partner
will be patient and let you have time to practice saying them.
Phase 5 – Answering, “What do you want?”
• You will learn to answer questions like “What do you want?” by making sentences with your pictures. • You can show everyone how independent you are with your system. • You can still ask for things anytime you want.
Phase 6 – Commenting
• You will learn to answer more questions like “What do you hear?, What do you see?” etc.
• You will learn to tell people about things you hear, see, like, feel, etc. • Congratulations! You are doing a great job communicating with lots of
people in lots of places. You know so many pictures and how to use them.
Who is a candidate for PECS?
Question – Does the student use functional communication?
What is functional communication?
Functional communication involves behavior (defined in form by the community) directed to another person who in turn providesrelated direct or social rewards (Bondy & Frost, 2002)
Question – Does the student initiate communication?
Why is initiation important?
Question – Would the student benefit from a structured / visual approach to learn how to communicate?
Why is a structured / visual approach helpful?
When should PECS be used?All day, every day!
During a crisis – quick, flexible, straight forward
To supplement other means of communication -
Reinforcers Major types of Functional Control –
Why we behave the way we do? Why do I need to communicate?
• To gain some type of reinforcer – concrete, activity, social, sensory
•To escape / avoid – demand, activity, setting, pain
Helpful Handy Hints©
Finding ReinforcersBehaviours Observed
Type of self-stimulation
Spinning discsLaser discsSpinning toysSand Egg timers or oil droppersSnow globesTV or videoComputer screensaver programmes
The student gazes at lights or out of the window, fixates at rotating objects, looks at his hands or flaps his fingers in front of his eyes.
Visual
Light toys (such as spinning fan or ball)Flashing toys (such as bouncing ball or stress toy)Spinning topsWind-up toysColoured acetate sheets
Executive toys (such as swinging balls)Sparking toys (such as toy gun or spinning toyKaleidoscopeView MasterCoil toys
Useful websites SEN Switcherhttp://www.northerngrid.org/ngflwebsite/sen/intro.htmPriory Woods Schoolhttp://www.priorywoods.middlesbrough.sch.ukwww. Sensory World.com
Begin with Grandma’s Secret
Principles for Using Powerful Reinforcers
• Use a reinforcer –first strategy “Let’s make a deal!!”
• No reinforcer, no lesson!
• ½ second rule for new skills
• Use differential reinforcement “Better than before? Then give ‘em more!”
PECS is not ….
These are visual supports.
Phase 1
Our Goal: teach initiation- student always “goes” first
Teach how to communicate – we need to teach the “rules” 1. approach communicative partner2. deliver message Need 2 people – Communicative Partner & Physical Prompter
Teach motor response: 3. Pick up4. Reach5. release
All students start here!
Phase ICommunicative Partner____ Non-verbal enticement ____ 1 picture at a time____ Provides open hand AFTER reach____Gives item w/in ½ second____Labels the item____ Fades the open hand
Physical Prompter____ WAITS for the REACH / Initiation ____Phys. Prompts for pick-up-reach- release____ Fades prompts effectively____ Interrupts interfering behavior (playing with the icon)____No verbal prompting____ No R+ to the student
Phase I Mastery Criterion:
Independent Exchange ____With 3 – 5 reinforcers
____With at least 2 Communication Partners ____in 2 different environments
Phase II Distance and Persistence
Our Goal: Persist across obstacles
Continuing to teach “how” to communicate
No Discrimination
Each student must have his own book
Teach student to carry his book
Teach student to request during group activities
Phase IICommunicative Partner____ One Picture at a time____ Non-verbal enticement____ Gradually increases distance from student____ Eliminates “body lang.” Cues, turns away from the student____ R+ within ½ second____ Labels the item
Physical Prompter ____ WAITS for initiation____ Physical assist. to go to the CP if needed____ Physical assist. to go to the book then CP____ Avoids verbal prompting and R+
Phase II
Mastery Criterion =
Before moving to Phase III –____Student should cross room to retrieve picture____Student should cross room to reach
Communication Partner.____Student should have 5 – 10 reinforcers
Phase III A Simple Discrimination
• Long term goal is for student to choose from among all pictures on or in book.
• Motivation to use correct picture is getting desired item and avoiding undesired Item .
• Begin with highly preferred versus non-preferred.
• Silently entice with both items.
• ½ second rule
• Rearrange pictures after correct trial
• Vary the “distracter” pictures
• Alternative Strategies - what if student does not understand the icons?
Symbol Consideration Table for “dog”Object
•duplicate•miniature•remnant
Photograph
…of objects or activity (not person engaged in activity)
Line Drawings
…of objects or activity (not person engaged in activity)
Gesture/Touch Cues ex. pat hand to thigh
Signs
Spoken word
Joey and his dog
“dog”
Sym
bol S
etm
ore
dem
andi
ng
less
de
man
ding
Every Move Counts Clicks and ChatsJane Korsten, MS/SLP Terry Foss, M.Ed.Lisa Berry, MOTR/L (2007)
milk
Hierarchy of Representational Skills
We may need to customize the items to meet the student’s needs.
Phase III A
____ Arranges for preferred and non-pref.
____ Has both items in sight
____ Uses immediate verbal feedback at the point of the choice
____ Uses 4 - step error correction __ Model the correct icon__ Prompts the correct icon__ Change__ Repeat
____ Max. 2 – 3 error correction cycles
Phase III B Discrimination between multiple pictures of preferred items.
Determine whether student’s actions match his request.
Student must demonstrate correspondence between the picture and item.
Called correspondence check
1. Show both items at one time2. Wait for exchange3. Offer items to student4. Allow access to corresponding item or block access to 5. incorrect item.
Phase III B____ Arranges for 2 preferred items____ Uses a plate or tray to hold items____ Does NOT label the icon at the exchange____ Offers the choices on the tray saying “take it” or indicating a choice____ Labels the item if it corresponds to the icon that was exchanged.____ Conducts the 4 – step error correct if the
item he attempted to take did not match____ Teaches to the “reach”
__ Model the icon__ Prompt the correct icon__ Change the focus__ Repeat by offering both items
Multiple Preferred - 3,4, 5 icons preferred (X pattern) on book
student should look inside book – search through organized pages.
Reintroduce distance and persistence .
Phase III Mastery Criteria: ___Student takes corresponding item on
80% of trials, any size array.
___Student looks inside book to find picture.
Introduce ….
How to say “No” (and live to tell about it)
Let’s make a deal
Offer alternativesVisually represent ‘no’
What’s Next ….
• Contact your Aug Comm Facilitator• Visit the Aug Comm Wiki• Check out a PECS Training Manual• Visit Pyramid’s website• Attend a Pyramid Training
• PECS Global Channel – https://www.youtube.com/user/PECSGlobal
• A Clear Picture: The Use and Benefits of PECS – https://www.youtube.com/watch?v=-Bzli1iC_w8
• The Pyramid Approach for Parents and Professionals– https://
www.youtube.com/watch?v=6c8KXeDqB_o&list=UU5OIn7c4hRfVR9E2qBDoNCQ
• Phase I- Phase I PECS (original video of Frost and Bondy)– https://www.youtube.com/watch?v=bm1qdCBj-ho
• Phase II- Phase 2 PECS (original video of Frost and Bondy)– https://www.youtube.com/watch?v=QGYWLuiEn6E
YouTube Videos for future reference!
After 2 mon. of pecs (mabot4kidz) https://www.youtube.com/watch?v=gxNoZORhIHU
Spontaneous PECS Requests (mabot4kidz) https://www.youtube.com/watch?v=dbh_-XD5MuU
• Phase IV- Zain doing PECS (phase 4) part two (ali786haq) – https://www.youtube.com/watch?v=vPRZIg9levk
• Phase V- Phase 5 PECS (over18towatch)– https://www.youtube.com/watch?v=_XvLGZ-bTrk
• Phase VI- Arthur PECS phase 6- (charlottejourdan) in French– https://www.youtube.com/watch?v=WvAJ3XfiWX4
Questions and
Answers