Research Based Communication

Strategies

Picture Exchange System

A functional Communication System• A way for students without verbal or

limited verbal skills to communicate• Developed to help people with Autism and

other developmental disabilities• Can be used in conjunction with a voice

output system

What is PECS

• PECS was developed by Lori Frost, a certified Speech-Language Pathologist, and Andrew Bondy, PhD., at the Delaware Autistic Program. 

• Using the PECS, the student learns to spontaneously initiate communicative exchanges. People using PECS are taught to approach and give a picture of a desired item to a communicative partner in exchange for that item. Using PECS, students learn to gain the attention of the communication partner in order to make a request.

• Pyramid approach– Start with basic communication and work your way

up! Words first, and then sentences.

• Strongly correlated to Skinner’s behavioral theory (operant conditioning) involving an object and reinforcement

• Population served: PECS can be used with children or adults who are not yet initiating requests, comments, etc.

Benefits

• It’s Visual!!!• Pictures are universally understood • May assist a verbal child in organization of

language• Follows a systematic approach• Progresses through several “phases”• Can be transferred into a variety of settings

Picture Symbols• Three main “types” of pictures are used to

exchange depending on the level the student is at– Actual Pictures (digital camera of specific

items/objects)– TOBI’s (True Object Based Icons)• May be a picture of a sucker, but is cut in

the same shape of the actual object– Boardmaker, or other line drawings– Can be done with objects

Words

• It is beneficial to have words underneath pictures

• Transition to words for students needing assistance with organization or structure (and are “readers”)

Preparing for PECS

• Participants– Student– Communication Partner – Physical Prompter

• Reinforcers– How to determine items of interest– Variability

• Supplies (http://www.pyramidproducts.com/)– Reinforcers– Book with velcro– Pictures with velcro (Boardmaker)

Phases of PECS

• Follows the pyramid format on one stage building upon another.

• Stages 1-6• Each stage has objectives and specific

procedural guidelines

Phase 1 “How” to Communicate

• Terminal Objective: Upon seeing a highly preferred Item, the student will pick up the picture of the item, reach toward the communication partner, and release the picture into the partner’s hand

Phase 1

• No verbal prompting• One picture at a time• Two trainers required to teach initiation• Allow for 30-40 request opportunities per day• Pictures can be any size as long as they match

student motor skills

Phase 1• Procedure:

– Communicative partner sits facing student– Picture is placed between student and trainer– “First one is free!”– Student is enticed by desired item– Student reaches for desired item– Hand-over-hand to assist student in giving the picture to the trainer’s

open hand– Trainer says “I want….”– Trainer gives desired object within ½ second– Trainer puts the picture back in place– If objects is a toy, trainer takes back the object to initiate another cycle

of requesting– Pointing to pictures is discouraged as pointing does not

require interaction with a person.

Phase 1

• Fading– Fade physical assistance– Fade open-hand cue–Move to phase 2 if goal is met

Phase 1: Practical Application

Communicative Partner’s Responsibilities

• Entice the student• Reinforce the student’s

Exchange (with the item)• Time the open hand

appropriately

Physical Prompter’s Responsibilities

• Wait for the student’s initiation• Physically prompt the student

to exchange the picture• Systematically fade prompts

Phase 1 of 6

• Spontaneously Requesting Items or Activities

Phase 2 Distance and Persistence

• Terminal Objective: The student goes to his/her communication board/book, pulls the picture off, go to the communication partner, and release the picture into the partner’s hand.

If object exchange is to be used, collect the items the child will use as the representative sample. The following suggestions may assist in gathering these items:• 1. A plastic cup to request a drink.• 2. A few pieces of the child's favorite snack taped

to a piece of cardboard.• 3. A few pieces of the favorite food inside a clear

cassette case taped shut.• 4. A sample of the favorite item inside a clear

video case box.

Phase 2: Introducing Variables

Listener factors• Distance to communicative

partner• Variety of communicative

partners• Expectant look• Enticement style• Eye contact• Body orientation• Taking picture from room to

room to find communication partner

Environmental Factors• Distance to book• Variety of rooms• Variety of reinforcers• Variety of activities

(lessons)• Sitting vs. standing vs. “on

the move”• Furniture

Phase 2

• This stage may last a long time.• No verbal prompting• Use a variety of communication partners• Get the student to travel.• Allow for spontaneous requesting throughout the

day• Use a communication book to attach the picture to.

Phase 2: Practical ApplicationCommunicative Partner’s

Responsibilities• Plans for student to have a

communication book• Arranges and positions trainers and

environment• Entices appropriately• Gradually increases distance between

student and communication book• Teaches student to cross room to

reach communication book• Reinforces appropriately• Turns away from student without

body cues• Teaches student to travel room to

room• Does not insist on speech

Physical Prompter’s Responsibilities

• Waits for initiation• Prompts removal of picture

from book if necessary• Physically guides student to

trainer if necessary• Physically guides student to

communication book if necessary

• Does not interact socially with the student

• Uses backstepping if necessary

Phase 2 of 6• Child has mastered independently making a

request with one item, now child is required to move a greater distance to get to the first teacher.

• After this is accomplished begin using system in different settings and with different people

• Can use other reinforcing items as well

Phase 3: Picture Discrimination

• Terminal Objective: The student requests desired items by going to a communication book, selecting the appropriate picture from an array, going to a communication partner, and giving the picture.

Phase 3• If trouble discriminating:– Vary sizes of different pictures to contrast each other– Place pictures further apart– Make both pictures larger– Make a blank picture card to compare with one with a

picture– Arrange pictures to correspond with actual objects– Place pictures onto actual items

• By the end of stage 3, student should have a book of items that they can discriminate

Phase 3: Practical ApplicationHigh vs. Distracter discrimination

Communicative Partner’s ResponsibilitiesKim• Arranges effective training environment• Entices with both items• Socially reinforces as soon as student

touches correct picture• Appropriate reinforcement with

requested item• Uses a variety of distracter items anda

variety of target pictures• Conducts error correction• Moves pictures around on book• No insistence on speech

Physical Prompter’s ResponsibilitiesKim• Blocks student from taking items• May assist in some hand-over-hand if

student becomes frustrated

Phase 3 of 6

• Teacher asks child to choose between several items on a board and request item

Phase 3: Practical ApplicationMultiple Preferred discrimination

Communicative Partner’s Responsibilities

• Arranges effective training environment

• Entices with both items• Conducts error correction• Moves pictures around on book

(diagonal, vertical, horizontal)• Teaches 3, 4, 5-way discrimination• Uses a variety of target pictures in

the 2-, 3-, 4-, or 5-way mix• Teaches looking inside book• No insistence on speech

Physical Prompter’s Responsibilities

• Blocks student from taking items• May assist in some hand-over-

hand if student becomes frustrated

Phase 4: Sentence Structure

• Terminal Objective: The student requests present and non-present items using a multi-word phrase by going to the book, picking up a picture/symbol of “I want,” putting it on a sentence strip, picking out the picture of what is wanted, putting it on the sentence strip, removing the strip from the communication board, approaching the communicative partner, and giving the sentence strip to him. By the end of this phase the student typically has twenty or more pictures on the communication board and is communicating with a variety of partners.

Phase 4• The student must be able to request AND

commentThe sequence to teach:

1. Get book2. Remove “I Want” icon from book3. Put “I want” icon on sentence strip4. Remove reinforcer picture from book5. Put reinforcer picture on sentence strip6. Remove sentence strip7. Give sentence strip to communicative partner(Use time-delay strategy while reading sentence strip to

encourage student’s speech. 3-5 seconds)(Student can eventually request multiple items)

Phase 4: Practical ApplicationCommunicative Partner’s Responsibilities

• Waits for initiation• Physically guides student to put picture on strip and

exchange• Fades physical guidance to put picture on strip and

exchange• Verbal praise and turns strip around and reads sentence• Use backward chaining to teach the sentence strip (work

through the seven steps backwards)• Reinforces new behavior within ½ second• Reinforces with tangible item

Phase 4: Practical ApplicationCommunicative Partner’s Responsibilities

• Uses physical assistance to teach student to point while strip is being read

• Uses delay (3-5 seconds) in reading strip• Reinforces if student speaks• Avoids verbal prompting• Conducts error correction for incorrect picture sequence• Organizes communication book appropriately• Does not insist on speech imitation/drill during PECS• Create opportunities throughout the day for spontaneous

requesting• Simplify some aspects of the lesson while teaching new

behaviors, then reincorporate

After Phase 4

• At the same time, add more vocabulary and progress to Phase 5.

• Attributes are excellent to incorporate into a student’s vocabulary. They can be included in the sentence strip.

Phase 4 of 6• After student can quickly and easily

choose between pictures and make spontaneous requests with different people can focus on Sentence Strips.

• Start with “I want”• Attach pictures to sentence strip and

exchange entire strip

Phase 3• By stage 3, student should be socially using pictures to harness the

power of communication• No verbal prompts• Use a variety of trainers• Create opportunities for functional communication throughout the day• Vary positions of 2 pictures on the board/book until discrimination is

mastered– Highly preferred vs. non-preferred– Highly preferred vs. highly preferred

Phase 5 and 6

• Occur simultaneously • Focus on different extensions of

words being added• Add more pictures to book• Use more items, “I see,” “I hear,” “I

feel,” “I smell,” etc.

Phase 5 Responding to, “What do you want?”

• Terminal Objective: The student spontaneously requests a variety of items and answers the question, “What do you want?”

Phase 5

• Continue to verbally and tangibly reinforce each correct response

• Use “delayed prompting” during this phase• Create opportunities to answer “What do you want”

and to spontaneously request• Continue creating multiple communicative

opportunities throughout the day.

Phase 5: Practical Application

Communicative Partner’s Responsibilities

• Uses delayed prompting to teach “What do you want?”

• Uses differential reinforcement if student “beats” the second prompt

• Reinforces new behavior within ½ second• Creates multiple opportunities for

spontaneously requesting AND answering, “What do you want?” within the same lesson.

Phase 6 Commenting

• Terminal Objective: The student answers “What do you want?” “What do you see?” “What do you have?” “What do you hear?” and “What is it?” and spontaneously requests and comments.

Phase 6• Reinforce each communicative act appropriately• Use delayed prompting to train responses to each new

question during this phase• Use discrimination training to teach discrimination

between sentence-starter icons• Create at least 30 opportunities per day for the student

to request or comment during functional activities

Phase 6 Practical Application

Communicative Partner’s Responsibilities

• Facilitate communication• Think of some activities that can involve

special sets of PECS pictures• Make use of PECS as natural as possible