Content uploaded by Michelle Flippin
Author content
All content in this area was uploaded by Michelle Flippin on Jul 14, 2014
Content may be subject to copyright.
A preview of the PDF is not available
Effectiveness of the Picture Exchange Communication System (PECS) on Communication and Speech for Children With Autism Spectrum Disorders: A Meta-Analysis
Abstract and Figures
The Picture Exchange Communication System (PECS) is a popular communication-training program for young children with autism spectrum disorders (ASD). This meta-analysis reviews the current empirical evidence for PECS in affecting communication and speech outcomes for children with ASD.
A systematic review of the literature on PECS written between 1994 and June 2009 was conducted. Quality of scientific rigor was assessed and used as an inclusion criterion in computation of effect sizes. Effect sizes were aggregated separately for single-subject and group studies for communication and speech outcomes.
Eight single-subject experiments (18 participants) and 3 group studies (95 PECS participants, 65 in other intervention/control) were included. Results indicated that PECS is a promising but not yet established evidence-based intervention for facilitating communication in children with ASD ages 1-11 years. Small to moderate gains in communication were demonstrated following training. Gains in speech were small to negative.
This meta-analysis synthesizes gains in communication and relative lack of gains made in speech across the PECS literature for children with ASD. Concerns about maintenance and generalization are identified. Emerging evidence of potential preintervention child characteristics is discussed. Phase IV was identified as a possibly influential program characteristic for speech outcomes.
Figures - uploaded by Michelle Flippin
Author content
All figure content in this area was uploaded by Michelle Flippin
Content may be subject to copyright.
... Aided AAC systems include low-tech (e.g., paper-based picture exchange) and high-tech (e.g., speech generating device) systems. A substantial body of research has demonstrated the effectiveness of aided AAC interventions in improving communication (Flippin et al., 2010;Kent-Walsh et al., 2015;Therrien et al., 2016), language and literacy skills (Holyfield et al., 2017;Light et al., 2019;Mandak et al., 2018), and reducing problem behaviors (Logan et al., 2017). In addition, AAC interventions also help children with CCN maximize learning opportunities, build relationships, and engage in meaningful activities (Light et al., 2019). ...
... Additionally, families expressed that some service providers ignored family requests for an AAC system. The benefits of AAC interventions are clear and have a strong evidence-base (Flippin et al., 2010;Kent-Walsh et al., 2015;Therrien et al., 2016). Cultural humility requires that service providers, such as SLPs and teachers, engage in ongoing learning of best practice as well as reflection on their own practice and whether they have acknowledged family priorities (Wright, 2019). ...
Introduction:
Culturally and linguistically diverse families who have children with complex communication needs (CCN) often have limited access to augmentative and alternative communication (AAC) devices and interventions due to the lack of services that acknowledge their families' cultural and linguistic needs. Despite the increasing need for culturally responsive services, little is known about Chinese-English speaking families' perspectives and experience related to AAC use and services. The objective of this study was to understand the perspectives and experiences of Chinese-English speaking family members of children who use AAC use.
Methods:
This study employs a qualitative descriptive methodology approach. The researchers conducted individual or group semi-structured interviews with 10 adult family members (mother, father, and grandparent) from four Chinese-English speaking families in the U.S. and Canada who have a child who uses AAC (ages 3-8).
Results:
Chinese-English speaking families have high acceptance and satisfaction with their child's AAC as long as they see the benefits of the AAC system. Mothers and siblings play unique roles in supporting home AAC practice given frequent engagement with and observed influence on the child who uses AAC. Family members indicated goals in building stronger family connections, but noted that the child's speech difficulties interfered with this goal. Chinese-English speaking families felt they can overcome limitations resulting from lower English language proficiency, but still find difficulties in obtaining resources because of the Western expectations of advocacy. Additionally, service providers' lack of responsiveness related to family goals could prevent families in obtaining AAC resources.
Conclusions:
The findings suggest the need for family-centered services with cultural sensitivity and humility for those serving Chinese-English speaking families with children who use AAC. Additionally, involving family members beyond the mother within services may improve both family functioning and child communication.
... Cafiero (2005), citado porMonteiro (2016), mostra aspectos que justificam a importância da CAA para a pessoa com TEA, por exemplo, pessoas com TEA são aprendizes visuais e a CAA utiliza pistas visuais. Além disso, Cafiero também expõe uma série de outras vantagens do uso de CAA, como o uso de ferramentas e equipamentos inanimados, o controle do nível de complexidade para que evolua com a criança, o fato de a CAA ser estática e previsível, por ser mais fácil que a fala, por auxiliar no manejo de comportamentos difíceis e por utilizar o reconhecimento em vez da memória.Algumas revisões mostraram que a utilização do sistema de comunicação por troca de imagens (PECS), melhora as capacidades de comunicação em crianças com TEA(Flippin et al. 2010, Ganz et al, 2012. Este sistema é baseado em uma estrutura de passos que, através de imagens conceituais de ações/emoções e de objetos cotidianos, a pessoa com TEA pode, progressivamente, construir uma via de comunicação.Outro destaque é o programa TEACCH, criado por Eric Schopler em 1966, que possui uma abordagem psicoeducativa. ...
Este estudo visa descrever a importância do uso de meios de Comunicação Aumentativa e Alternativa (CAA) para crianças com Transtorno de Espectro Autista (TEA), através do uso de Tecnologias Assistivas (TA), destacando o papel do terceiro setor para efetivar essa prática. O método utilizado foi a pesquisa básica, qualitativa, exploratória e de campo. O estudo foi feito em uma organização do terceiro setor, onde foi respondido um questionário a respeito das TAs que a instituição utiliza, além de informações como a quantidade de pessoas que são atendidas e quais possuem acesso às TAs. Por meio desta pesquisa, foi constatado que muitas crianças e jovens com TEA poderiam estar fazendo uso das TAs para melhorar habilidades comunicativas, mas por falta de acesso a esse recurso, são privadas da possibilidade de comunicação.
... 44 Using PECS, expressive communication skills are targeted and the children learn to initiate requests and communicate their needs via picture cards. 52 As Bondy and Frost described, "Children using PECS are taught to approach and give a picture of a desired item to a communicative partner in exchange for that item. By doing so, the child initiates a communicative act for a concrete item within a social context". ...
Background:
Autism spectrum disorder is a neurodevelopmental condition which has posed a challenge to carers, pediatricians and dentists through the years. Over the last four decades, the disorder has been better understood and management techniques have evolved. In the field of dentistry, the autistic child presents difficulty in management, even for the simplest dental procedures. A comprehensive understanding of other psychoeducational and behavioral approaches to manage autism is very important. This article aims to introduce various important key techniques such as Applied Behavior Analysis, TEACCH, Sensory Adapted Dental Environment, Picture Exchange Communication System, and Animal Assisted Therapy and analyze their application in dentistry.
Methods:
A search of literature was carried out in Clinicaltrials.gov, Medline and Scopus with the search terms "Applied Behavior Analysis," "TEACCH," "Sensory Adapted Dental Environment," "Picture Exchange Communication System," and "Animal Assisted Therapy" along with "autism OR autistic," "dental OR dentistry OR oral health." After the screening for inclusion and exclusion criteria, 10 eligible articles were included, in English, published within the last 10 years.
Results:
Limited research was available regarding these lesser-known behavioral approaches in dentistry. The few that were available showed encouraging results. The different techniques proved useful in increasing acceptance of dental treatment and reducing behavioral disturbances. The patients experienced reduced dental anxiety, lesser discomfort, improved communication, and knowledge.
Conclusion:
Pediatric and special care dentists are likely to benefit by incorporating the recommended comprehensive behavior management techniques in their practice. There is evidence that these techniques will reduce behavioral disturbances in autistic children thereby making primary dental care possible without the need for sedation or general anesthesia.
... Autism often presents difficulties with social interactions, verbal and non-verbal communication and repetitive behaviours (Autism Speaks, 2013;Happe & Frith, 2020;Hannan et al., 2020). As language and communication are key to establish social interaction in human life, an approach must be taken to help children with Autism be able to communicate verbally or non-verbally (Flippin et al., 2010). ...
The purpose of this study is to design and develop Project Based Learning: Instruments and Rubrics for Autism (PBL-iRA) as a set of tools that can be used in primary schools to enhance the learning experiences of students with Autism Spectrum Disorder (ASD). As there is no guideline in assessing and evaluating students with rning English language, it is a necessity to consider having an outline or module of instruments and rubrics which implement the instructional approach of project based learning. Thus, this study emphasizes three theories that underpinning the development of the instrument and rubric which are the presented the literature on the Design and Development Research (DDR), Nominal Group Technique (NGT) and Fuzzy Delphi Method (FDM) as these approaches were applied and implemented throughout this research as this study is DDR in nature. In line with the purpose of this study in designing and developing instruments and rubrics, analytic rubric is suggested to be proposed in this PBL-iRA.
Approximately 25\% of individuals with autism spectrum disorder (ASD) are unable to use speech as their primary mode of communication and thus require augmentative and alternative communication (AAC) supports such as manual signs, picture communication books, or speech‐generating devices. AAC techniques can be used to support language development in general, as well as to support functional communication for individuals across the range of age and ability. AAC instruction can be provided through structured teaching (e.g., the Picture Communication System, PECS), naturalistic/milieu teaching, and aided language modeling. Potential collateral effects of AAC interventions include enhanced speech production and decreases in problem behavior.
The current study examined vocalizations that occurred during training of the Picture Exchange Communication System for three preschool-aged participants with autism spectrum disorder. In Phase IV, the protocol incorporates a delay to reinforcement in an effort to encourage vocalizations; however, the manual does not suggest additional strategies to try when vocalizations do not occur during the delay to reinforcement. Researchers evaluated a vocal model prompt following the delay to reinforcement and continued to measure vocalizations when the delay to reinforcement alone did not increase vocalizations. Two of the three participants increased independent vocalizations after the addition of the vocal model. Implications for practitioners and future research are discussed.
Purpose:
This article provides a systematic review and analysis of group and single-case studies addressing augmentative and alternative communication (AAC) intervention with school-aged persons having autism spectrum disorder (ASD) and/or intellectual/developmental disabilities resulting in complex communication needs (CCNs). Specifically, we examined participant characteristics in group-design studies reporting AAC intervention outcomes and how these compared to those reported in single-case experimental designs (SCEDs). In addition, we compared the status of intervention features reported in group and SCED studies with respect to instructional strategies utilized.
Participants:
Participants included school-aged individuals with CCNs who also experienced ASD or ASD with an intellectual delay who utilized aided or unaided AAC.
Method:
A systematic review using descriptive statistics and effect sizes was implemented.
Results:
Findings revealed that participant features such as race, ethnicity, and home language continue to be underreported in both SCED and group-design studies. Participants in SCED investigations more frequently used multiple communication modes when compared to participants in group studies. The status of pivotal skills such as imitation was sparsely reported in both types of studies. With respect to instructional features, group-design studies were more apt to utilize clinical rather than educational or home settings when compared with SCED studies. In addition, SCED studies were more apt to utilize instructional methods that closely adhered to instructional features more typically characterized as being associated with behavioral approaches.
Conclusion:
The authors discuss future research needs, practice implications, and a more detailed specification of treatment intensity parameters for future research.
A variety of strategies have been used to help children with autism acquire functional communication skills. The Picture Exchange Communication System (PECS) is a unique communication training program that was developed as a means of circumventing some shortcomings associatd with these strategies. A description of the steps within PECS is provided. Long-term group data have indicated that a large proportion of children started on PECS as preschoolers acquire speech. Individual and group data supporting the use of PECS are provided.
Single-subject research plays an important role in the development of evidence-based practice in special education. The defining features of single-subject research are presented, the contributions of single-subject research for special education are reviewed, and a specific proposal is offered for using single-subject research to document evidence-based practice. This article allows readers to determine if a specific study is a credible example of single-subject research and if a specific practice or procedure has been validated as "evidence-based" via single-subject research.
Originally designed to enable young children with autism lacking functional communication to initiate requests and to describe what they observed, the Picture Exchange Communication System (PECS) has been the subject of an ever-expanding body of research and development. Thirty-four peer-reviewed published reports on PECS are analyzed in this article with documentation of research questions, methodology, and results. Findings suggest that PECS is providing people around the globe who have no or impaired speech with a functional means of communication. Refinements in methodology and additional questions that might be addressed in future research are discussed.
The Picture Exchange Communication System (PECS) is widely used with non-verbal children with autistic disorders as an Augmentative and Alternative Communication (AAC). Most of the participants in prior research on that method, although referred to as non-verbal, had initial vocal repertoires of at least a few words. The purpose of the present study was to examine whether 3 elementary-school-age children with autistic disorders whose vocal repertoires were severely limited, such as only a few phonemes, could acquire elementary communication skills using PECS. The present study incorporated task analysis, in which a sequence of picture-exchanging behaviors was divided into 4 components. The results demonstrated that all 3 children acquired the basic component of PECS within a short period. Data from the task analysis revealed that, with increased use of PECS, their prior mode of communication (grabbing, reaching, or crying) was gradually replaced, thereby indicating the reinforcing value embedded in PECS. In addition, the present data suggest that PECS training produced collateral behavioral changes, such as an emergence of intelligible vocalization, even in students who had previously had severely limited vocal repertoires.
Chapter 18 explores methods of assessing the effect size of outcome research. It provides a sampling of ES indices in three general classes: the difference family (illustrated here by Cohen’s d, Hedges’s g, and the risk difference); the correlation family (including by the point-biserial r, and the phi coefficient); and the ratio family (illustrated by the odds ratio and relative risk).
This research synthesis verifies the effectiveness of the Picture Exchange Communication System (PECS) for improving the functional communication skills of individuals with autism spectrum disorders (ASD). The research synthesis was focused on the degree to which variations in PECS training are associated with variations in functional communication outcomes (Dunst, Trivette & Cutspec, 2002). The communication consequences of PECS were examined in 13 studies, which included 125 participants with ASD who had been identified as having limited or no functional communication skills. Claims that PECS is an effective intervention for improving functional communication skills appeared to be supported by the available research evidence.
This study compares use of the Picture Exchange Communication System (PECS) and a Voice Output Communication Aide (VOCA) with four preschool children who were either non-speaking or limited in their ability to speak and did not use an AAC system to communicate functionally. An alternating treatment single subject design was used to measure participants' preferences for each system and the verbalizations of the participants during system use. Results indicated that participants learned PECS in a relatively short time period, preferences for one mode of communication are not predictable, and the influence of the communication systems on each participant's verbalizations varied.