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| The Appropriate Use of PECS? |
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Ann Gresswell |
Published on
1 April 2006
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Vol 20 No 1, April 2006 *
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Communication Matters Journal Vol 20 No 1, April 2006, pp2-3, ISSN 0969-9554
Ann Gresswell & Rachel Moore
The ACE Centre, 92 Windmill Road, Oxford OX3 7DR, UK Email: gresswell@ace-centre.org.uk
Having presented ‘Moving on from PECS’ at the CM2005 Communication Matters National Symposium, we would like to open further debate on the subject of PECS (Picture Exchange Communication System) and the way in which it is often used indiscriminately throughout our special schools.
When preparing our presentation we tried not to be confrontational. However, because of the way in which PECS has been vigorously marketed and taken on board by schools, often without consideration for the differing needs of individual youngsters, we feel that debate within this area is now essential.
When we visit schools, we often see PECS being used inappropriately for youngsters, who either do not need it, or who, if provided with appropriate communication tools, could have moved on to more effective communication. It is clear that the youngsters’ individual needs have not been carefully considered. The situation has not been helped by the publication of articles supporting the use of PECS for all youngsters with communication difficulties (e.g. Stevens, 2006).
Our presentation ‘Moving on from PECS’ was written in response to increasing numbers of referrals of autistic youngsters to the ACE Centre in Oxford. These referrals requested communication technology as well as advice on how to progress the communication of youngsters already using PECS.
We have considered the roots of PECS and what it was originally designed to do. The PECS literature indicates that:
- PECS was developed to support non-speaking students with autism where other communication systems had failed.
- Youngsters learn to give a picture of a desired item to a communication partner in exchange for that item. In this way a youngster learns about one-to-one interaction as a basis for communication. We acknowledge that for some youngsters this step is essential in learning to engage in social interaction.
The PECS literature also provides criteria for giving up PECS as follows:
- Speech vocabulary is as large as PECS vocabulary.
- Initiation with speech is intact.
- Length of spoken utterance is as long as PECS utterance.
- Speech is intelligible to an untrained listener.
This list excludes a significant number of young people for whom we contend this system is no longer appropriate or may never have been appropriate in the first place. There are youngsters, who have not developed functional speech or who continue to need visual support in order to produce speech, with the potential to produce far more creative expressive language than PECS allows. These are young people who need to be able to question, to reason, to evaluate, to describe events, to predict, to plan and to negotiate. For these youngsters, alternative AAC resources are needed.
Alternative AAC resources may include communication books, communication charts and speech output devices. The following points need to be considered:
- The use of a consistent core vocabulary to combine with and modify topic vocabulary can allow a youngster to significantly expand their communication potential.
- The young person will need to understand that these resources are directly accessed by pointing and that a communicative message can be delivered in this way.
- Communication partners need to use the young person’s resources as a two-way system in order to model how it can be used functionally and in context.
There are significant benefits, which result from using a pointing system. For example:
- Speed of communication is likely to be increased.
- The cognitive and physical load involved in building up a sentence on a message strip and handing it to someone is removed.
- Resources accessed by pointing (where no building up of a message on a message-strip or exchange is needed) enables greater creativity of language and a wider range of linguistic concepts.
- Fluency can be significantly increased.
- A growing PECS system adds significant bulk and weight as more vocabulary is added. A low tech pointing system tends to be less bulky.
- Parents and teaching staff report that maintenance of the PECS system can be difficult as symbols can be lost, wrongly re-positioned or destroyed! These maintenance issues are reduced where vocabulary items are not individually attached using Velcro.
Concerns are often expressed when considering moving on from PECS which need to be addressed:
- Typically, concerns are expressed over the loss of a system with which the young person has become familiar. However, the transition between the two systems can be managed in a number of ways. These include:
- Maintaining two resources for a time.
- Maintaining elements of the PECS system within the new resource e.g. a timetable.
- Incorporating the new system within the PECS book initially.
- There may be concern that the youngster is not building up a complete sentence when communicating and that this aspect of language development may be neglected. While developing sentence structure is an important part of language development, the emphasis during face-to-face communication needs to be placed on the meaning of the message being communicated.
- A telegrammatic sentence is acceptable during face-to-face interaction.
- A full grammatical model of the youngster’s message can be supplied at the time by the communication partner.
- Targeted and structured sessions on the computer and elsewhere can be used to further develop language structure.
We wonder whether, in the light of the heavy marketing of PECS in this and other countries, we should be more vigorous in questioning the efficacy of its generalised and inappropriate usage. Surely, we should be promoting a culture where the needs of the young person are paramount, and whatever communication system they use is developed as a result of careful consideration of their individual needs.
For some youngsters PECS can be an essential first step towards social interaction. When this first step has been achieved, other methods should be considered for further developing their communication. For others, PECS is simply not an appropriate communication tool and should never be used. §
Ann Gresswell, Teacher & Physiotherapist
Rachel Moore, Speech & Language Therapist
References
- Frost, L.A. & Bondy, A. (2002) PECS The Picture Exchange Communication System. Training Manual. Pyramid Educational Consultants UK Ltd.
- MacDuff, G.S., Krantz, P.J., & McClannahan, L.E. (1993) Teaching Children with Autism to use Photographic Activity Schedules. Journal of Applied Behaviour Analysis 26, 89-97.
- Krantz, MacDuff and McClannahan (1993) Activity Schedules for Children with Autism’.
- Latham, C. (2005) Developing and using a Communication Book. Communication Matters Vol 20 No 1.
- Mirenda, P. (2001) Autism, Augmentative Communication, and Assistive Technology: What Do We Really Know? Focus on Autism and Other Developmental Disabilities 16(3), 141-151.
- Stevens, N. (2006) Beyond autism: the Picture Exchange Communication System. RCSLT Bulletin Jan 2006 , Issue 645.
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