Early phase acquisition of the Picture Exchange Communication System is fairly clear: later phases are unclear given greater variability and fewer data

Backgound: Autism spectrum disorder impacts social-communication. Picture Exchange Communication System is one of the methods to improve communication skills in individuals with autism. In spite of numerous studies on the effectiveness of Picture Exchange Communication System, no studies were conducted to examine the perceptions of practitioners who used the strategy.Method: An online survey was conducted with 120 practitioners (44 teachers and 76 therapists; 80.8% 20–49 years old; 80.8% graduate education) who used the Picture Exchange Communication System with children with autism. Using rating scales, practitioners reported their knowledge of Picture Exchange Communication System and their perceptions about importance, benefits, and barriers of utilizing Picture Exchange Communication System.Results: Practitioners reported they were confident when implementing Picture Exchange Communication System and considered integrating Picture Exchange Communication System at school to be important. Also, the practitioners indicated that Picture Exchange Communication System was easy to use and effective to develop communication skills in children with autism. However, they found that using Picture Exchange Communication System was time consuming.Conclusion: It is important to hear the viewpoints of practitioners concerning the use of Picture Exchange Communication System for individuals with autism spectrum disorder. This study found Picture Exchange Communication System is a useful strategy but has some barriers concerning its use. Future research is needed to confirm the current findings with a larger sample.IMPLICATIONS FOR REHABILITATIONMany students with autism spectrum disorder are non-verbal and may benefit from augmentative and alternative communication methods.Picture Exchange Communication System, one of the augmentative and alternative communication methods, has been widely used by professionals and parents to improve communication skills of children with autism spectrum disorder who are non-verbal or have complex communication needs.Practitioners indicated that Picture Exchange Communication System was easy to use and effective to develop communication skills in children with autism spectrum disorder. However, they found that it is time consuming.Practitioners need ongoing support when implementing the Picture Exchange Communication System.

Although the Picture Exchange Communication System (PECS) has been demonstrated to be an effective intervention to teach people diagnosed with autism spectrum disorder a functional communication system, the research indicates variability in PECS outcomes across people and studies. Therefore, the purpose of the current study was to explore child characteristics and treatment variables that may explain the variation in, and potentially predict, PECS outcomes. A total of 22 children and youth diagnosed with autism or a related developmental disorder, all of whom scored substantially below average on standardized measures of cognitive and adaptive abilities, participated in a PECS intervention. Participants who achieved high phases of PECS (≥PECS phase IIIb) differed significantly from those who mastered lower PECS phases (≤PECS phase IIIa) in terms of overall, verbal, and nonverbal mental age, matching abilities, and adaptive behavior level. Stimulus generalization was also associated with significant variation in PECS outcome. PECS outcomes could be predicted with good accuracy using a combination of these child characteristics and treatment variables. The findings from the current study suggest that children with relatively higher cognitive and adaptive skill levels are more likely to achieve higher phases of PECS; further, approaches to generalization training also play a role. Factors such as autism symptom severity and parental ratings of maladaptive behavior were not associated with significant differences in PECS outcomes. However, more research is needed. Gaining a better understanding of predictors of PECS outcomes is important to inform intervention, provide more accurate outcome expectations for families, and guide PECS teaching procedures. Although participants were more likely to achieve higher phases of PECS if they had a higher mental age, adaptive skill level, and matching skills, the average scores for these measures were well below those expected for same age peers. These results indicate that PECS is appropriate for use with children with clinically significant deficits in cognitive and/or adaptive abilities. Further, results suggest that even children who demonstrate more severe symptoms of autism and exhibit more challenging behavior can achieve higher phases of PECS.

Introduction: Children with non-verbal autism often experience barriers in developing expressive language skills, which impact their ability to communicate and engage in social interactions. The Picture Exchange Communication System (PECS) has been developed as an alternative intervention strategy aimed at enhancing functional communication in individuals with verbal limitations, including children with autism. Objective: Children with non-verbal autism often experience barriers in developing expressive language skills, which impact their ability to communicate and engage in social interactions. The PECS has been developed as an alternative intervention strategy aimed at enhancing functional communication in individuals with verbal limitations, including children with autism. Method: This study is a systematic review that explored seven journal databases, PubMed, ProQuest, JSTOR, Garuda, ScienceDirect, CNKI, and Wiley, from 2010 to 2024, with a population of non-verbal children with autism aged 3–12 years who received PECS intervention. The measured parameters included the number of spoken words, picture exchange ability, and functional communication. Three independent reviewers conducted screening using the PRISMA flowchart, quality assessment with the CASP Checklist, and data extraction based on author, intervention, facilitator, setting, sessions, methods, and research topics. Result: Based on 12 articles involving 158 participants, PECS was found to be effective in enhancing expressive communication in children with non-verbal autism and contributed to improvements in the use of short phrases, comprehension of instructions, as well as the reduction of non-adaptive and aggressive behaviors. PECS therapy with a duration of 30–60 minutes across 129 sessions over 23 weeks proved to be optimal, supported by RCT studies demonstrating its effectiveness in improving individuals’ expressive language abilities. Conclusion: PECS is an effective intervention for improving expressive language skills in children with non-verbal autism. This study emphasizes the importance of assessing a child’s developmental progress prior to implementing PECS, in order to tailor the intervention to individual needs. Furthermore, the active involvement of parents and educators is essential to ensure that PECS is implemented consistently and effectively across various settings.

Purpose We investigated the effects of behavioral skills training package with parents to use picture exchange communication system (PECS) with their children with autism spectrum disorder (ASD) to develop communication skills. Methods Two parents and their children with ASD (one child per family) participated in this study. A multiple baseline design was used during the parents’ training, and a changing criterion design was used during parents’ implementation of PECS with children. Results Results indicated that both parents implemented PECS intervention with their children with high procedural integrity and required minimal feedback through Bug-in-Ear at the end of the intervention. Moreover, both children acquired independent picture exchanges with their parents who implemented PECS training and generalized and maintained the skills. Conclusions The findings suggest that when parents receive appropriate training and feedback, they can train their children to use PECS to independently request desired items or activities. The current study extends existing research on PECS by teaching parents as the primary PECS trainers to implement the strategy with their children. Keywords: Picture Exchange Communication System (PECS); Autism Spectrum Disorders (ASD); Parent training; Communication; Requesting skills; Bug-in-Ear (BIE)

The limited communicative abilities of young children with autism and developmental disabilities may be enhanced by augmentative communication systems such as the Picture Exchange Communication System (PECS). Both children and adults can learn to use PECS, but research is inconsistent in establishing the degree to which PECS training transfers reliably from the training setting to other settings, for example, regular classrooms, and home. Three 5–6 year-old children, diagnosed as autistic and/or developmentally disabled, were given 1:1 PECS training at school, structured to enhance generalisation and transfer. Concurrent observations were made in their regular classroom and at home to probe the extent of generalisation. All three acquired the ability to request a preferred object or activity by exchanging a picture symbol with a communicative partner. In tests of transfer and generalisation, a multiple-baseline across subjects design showed no use of PECS symbols either in the classroom or at home prior to training, with spontaneous initiations of picture exchange (transfer) occurring to a slight to moderate degree in the classroom and to a slight degree at home. Even with PECS training structured to enhance transfer, functionally significant degrees of generalisation of training may be difficult to achieve, and cannot be assumed to occur.

AimsThis study sought to investigate the predictors of spontaneous Picture Exchange Communication System (PECS) use in a naturalistic school setting.MethodThe study recruited 44 students (36 boys and eight girls), aged between 6 to 18 years and their teachers (26 teachers and two teaching assistants). Teaching staff completed measures of student’s communicative ability, autism symptomology and PECS abilities. Teachers also provided information of their PECS training history and PECS teaching experience.FindingsStepwise Multiple Regression Analysis revealed that: (1) teacher’s intentional pre-planning of PECS; (2) context in which PECS is used; (3) PECS phase level; and (4) the number of months of PECS teaching experience teachers had significantly predicted spontaneous PECS use. Child-dependent variables such as the severity of student’s autism symptomology and level of student’s mastery and age did not significantly predict spontaneous PECS use.LimitationsThe limitations of this study are the small sample size, teachers’ self-reported bias, and the lack of exploring other potential factors.ConclusionsThe findings of the study highlight the importance for professionals, such as Educational Psychologists (EPs), to consider implementation factors that will impact the efficacy of intervention. In this study, it was the orchestration of how PECS is taught that had significantly predicted better PECS spontaneous use, rather than within-child factors. This suggests that PECS is suitable for a wide range of ASD learners. Additionally, it provides new insights for EPs to emphasise certain components over others during PECS teachers’ trainings.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, APA, 2000), autism is neurodevelopmental disorder that is characterized by impairments in social and communicative behaviors with great variations in ability, depending on developmental level, intelligence, and chronological age. Thus, autism is spectrum disorder that affects large number of children (1 in every 150) to various degrees (Centers for Disease Control and Prevention, 2007). Autism is further defined as qualitative impairments in social interaction, which include impairments in nonverbal and verbal behaviors ranging from the lack of spoken language with no attempt to use alternate modes to only mild delays in conversation (APA, 2000). Although the degree of communication problems varies, one common thread for all individuals who are diagnosed with autism is that if interventions are not designed to meet the individual's needs in socially significant manner, the individual has poor prognosis (Heward, 2009). Thus, it is important to consider the whole person when designing interventions by taking into account additional disabilities as well as individual strengths. Two of the more common tools for teaching communication skills to individuals with disabilities related to communication are the Picture Exchange Communication System (PECS; Bondy & Frost, 1994), which relies on the exchange of pictures representing desired object, place, or event, and mand training (Rosales & Rehfeldt, 2007; Skinner, 1957). Skinner (1957), behaviorist, coined the term mands, along with other verbal operants (tacts, intraverbals, and echoics), under the umbrella of verbal behavior that is based on the principles of applied behavior analysis. The term mand is defined as a verbal operant for which the form of the response is under the functional control of motivating operations and specific reinforcement (Cooper, Heron, & Heward, 2007, p. 30); that is, people request specific items or things only when they are motivated to do so. This motivation is often derived from state of deprivation. Both methods have endured much success. Sundberg and Partington (1998) provided basic recommendations for mand training: (1) establish that motivating factor or an establishing operation (such as state of deprivation) is in place prior to beginning the session; (2) consider those items that are motivating to the individual; (3) use only items to which the therapist can easily control access; (4) select only those items or activities that the person understands through some means of communication, such as imitation or pulling you; (5) use reinforcers that are easy to deliver; and (6) use reinforcers that can be delivered on multiple occasions (such as sip of juice instead of an entire cup). The study presented here used these recommendations. PURPOSE OF THE STUDY The primary goal of the study was to teach nonverbal man who was blind and was diagnosed with autism to use sign language to mand for two highly desirable items: food and drink. However, because of the severity of the autism and vision loss, the use of mands was selected over PECS, which relies heavily on the ability to see the item that is depicted. To begin the mand training, some preliminary work was required to get the participant to use correct American Sign Language (ASL). The correct use of ASL was required because of the individual's use of idiosyncratic signs that differed from ASL and were all similar to one another in form, which resulted in the caretakers' inability to discern what the individual was requesting. This lack of ability to discern the participant's wants and needs resulted in the desired item not being delivered and the man engaging in self-mutilation or other destructive behaviors until the desired object was provided. METHOD Participant and setting The participant in the study was nonverbal 28-year-old man who was blind because of rare retinal disease he contracted at age 12, and who had profound autism. …

Background: PECS, or Picture Exchange Communication System, addressed in writing. The answers for such schemes to influence word retrieval in autism spectrum disorders in children (ASD). Objective: The objective of the current study finding out the effects of Development of the picture exchange communication system in autistic children's speech and communicative requesting was the main goal of the current study. Materials & Methods: The study design was Qusai experimental. The research was carried out at Riphah International University Lahore campus. Data was collected from Lahore. The study time was six months after the approval of synopsis. Data was collected from the Autistic children and purposive sampling technique was used in this research. The sample size calculated was ten. The picture-exchange technique for communication (PECS) was used for data collection. Data was examined using SPSS software and Endnotes were used for references. Results: Results from the Childhood Autism Rating Scale (CARS) assessment scoring form indicated that there is a significant relationship between the Effects of Communicative PECS speech and request development in autistic children, overall analysis of the pre and post scores of CARS assessment. In which mean of pre score is 36.15 and mean of post score is 29.5. The standard deviation of pre score is 8.47 and the post score standard deviation is 5.39. The mean difference showed the improvement between CARS pre and post assessment. Used was the paired sample t test for finding the mean difference between the pre and post scores. The results indicate that every participant showed improvement in different skills such as verbal and nonverbal communication, visual response. Some participants got higher in verbal communication Practical implication: This will give us a better understanding of how speech develops in children with autism and how children’s vocabulary develops and awareness develops in children. Conclusion: The pre-post assessment of The Childhood Autism Rating scale (CARS) with intervention of PECS concluded that there is significant influence of intervention using a photo exchange communication technology for autistic kids. Keywords: Autism, Chemical Imbalance, PECS, CARS, Autism Rating Scale, Autism spectrum condition

The Picture Exchange Communication System (PECS) is a communication system for children with autism spectrum disorders (ASD). The aim of this study was to assess the effect of a PECS-based tooth-brushing programme on gingival health in children with ASD and assess parents' perception of PECS. This was a prospective interventional study. Using PECS as a pictures/cards series showing a structured tooth-brushing method, 37 children with ASD (31 males, 6 females) (average age 9.49 ± 4.10, 4-16years) and their parents/caregivers were trained on tooth-brushing twice, 2 weeks apart. Data collected after examinations (baseline, 3, 6-months) included gingival and plaque indices (GI, PI) and two questionnaires (baseline, 6-months) for demographic data and parents' perception of PECS including difficulty rating (easy, hard, very hard) and PECS usefulness. Most children with ASD had language abilities (64.9%) and prior PECS use (67.6%). Both GI and PI significantly dropped between baseline and both re-evaluations, (P < 0.001). Age, among studied factors, significantly affected PI only at all stages (P < 0.001). Most parents/caregivers (75.7%) rated PECS as hard, but useful (100%). Age and PECS prior use significantly affected PECS difficulty rating (P = 0.000 and 0.031, respectively), while sex did not (P > 0.05). PECS though rated as hard was useful in improving gingival health in children with ASD.

The purpose of this study is to explore the users’ perceptions of using the Picture Exchange Communication System (PECS). The PECS is written in English and designed for Autism Spectrum Disorder (ASD) children. The research questions of this study are: 1) What are the parents’ positive perceptions of using PECS in English for ASD children? And 2) What are the parents’ negative perceptions of using PECS in English for ASD children? This study is carried out by using a case study approach where the researchers interviewed 5 occupational therapists and 4 parents with ASD children. Data were collected through focus-group interviews and open-ended survey via Google Meet and WhatsApp. The findings for research question 1 are 1) Using PECS in English enhances ASD children’s learning, 2) Using PECS in English improves ASD children’s communication skills, and 3) PECS in English promotes bilingualism for ASD children. The findings for research question 2 are 1) PECS in English is not suitable for children of all ages, and 2) PECS in English is not ideal for collaborative learning for low-function ASD children. This study could help parents with ASD children to utilize PECS in English to teach them new skills appropriately. This electronic document is a “live” template. The various components of your paper [title, text, heads, etc.] are already defined on the style sheet, as illustrated by the portions given in this document.

A pilot study was conducted to evaluate the effects of training teachers of children with autistic spectrum disorders (ASDs) in the use of the Picture Exchange Communication System (PECS). Thirty-four children with ASDs (29 boys and 5 girls) were selected from eight specialist schools. Teaching staff attended a 2 day PECS workshop and received six half-day visits from PECS consultants. Data on the children's use of PECS, spontaneous communication, and adaptive behaviour were collected before the study and at set times following the workshop. Significant, rapid increases were recorded in the level of PECS attained by the children, in their PECS vocabulary, and in their frequency of PECS use over time. Improvements in children's general level of communication were slower to occur. The majority of participants showed improvements in their ability to use PECS. The results are discussed in relation to the methodological and practical difficulties that arose during the project.

This study examined the effects of mother-implemented Picture Exchange Communication System (PECS) training on the independent communication of three young children with autism spectrum disorders. Three mothers were trained to teach their child PECS Phases 1 through 3B, which they did with high integrity. Moreover, all three children successfully acquired independent picture exchanges that were generalized to a different communication partner and maintained for at least 1 month. Vocalizations across participants showed limited or no improvement. These findings systematically extend previous PECS research by training mothers to be the primary implementers of PECS training. In addition, this research provides practitioners with insight into the feasibility and necessity of parent-implemented PECS training.

This study compared the total amount of training time and total number of trial blocks for individuals with severe developmental disabilities to acquire mands under control of unconditioned establishing operations and mands under control of transitive conditioned establishing operations for manual sign and for the Picture Exchange Communication System (PECS). Also examined was the generalization of mands across settings and communicative partners, as well as the emergence of untrained tacts and intraverbals for mands acquired using PECS. Mands for preferred items and for items needed to complete a chained task were acquired more rapidly and in fewer training blocks for PECS than for manual sign. Moreover, mands established using PECS generalized across settings and communicative partners. Finally, untrained tacts and intraverbals using PECS were shown to emerge for some of the participants following PECS training. These results suggest that PECS may be a viable alternative communication system for adults with severe developmental disabilities who have little or no history of systematic instruction and limited imitative repertoires.

The Picture Exchange Communication System (PECS) (Bondy and Frost, Focus on Autistic Behavior 9:1–19, 1994) is a visually-based alternative and augmentative communication system that is considered appropriate for many special populations. However, a variety of challenged populations, such as people with visual impairments, would initially be considered unable to communicate with PECS users. In the present study, a multiple baseline reversal design across children was used to explore the viability of a Braille-modified PECS system for use between a visually impaired therapist and three children with autism. The PECS cards were slightly modified with the addition of Braille labels so that the visually impaired therapist would be able to understand and respond to the requests of the children with autism. Results indicated that the addition of Braille labels allowed children with autism and the visually impaired therapist to communicate with each other using PECS. In addition, children had ancillary decreases in problem behaviors during work sessions with the Braille-modified PECS. This study demonstrated the versatility of PECS and its potential for use with non-sighted populations, increasing opportunities of visually impaired persons in the job market.

The Picture Exchange Communication System (PECS) is a widely used alternative and augmentative communication (AAC) system for children with autism spectrum disorder (ASD) who have limited or no vocal abilities. Vocalizations may emerge with the use of PECS particularly during the training phases. One question that often arises is what effect continued use of PECS has on vocal behavior. The current study evaluated the effects of PECS on vocal responding for participants who had been using PECS for at least 1 year. Four children with ASD participated in this study. Each had functional vocal communication skills but used PECS as their primary mode of communication. One of the participants also used sign language. The effects of PECS on vocal responding were evaluated in two studies using a reversal design. The use of PECS inhibited vocal responding if both modes of communication were on the same schedule of reinforcement. When PECS was placed on extinction (study 1) or removed (study 2), vocal responding increased across subjects. If vocal responding and PECS remain on the same schedule of reinforcement, vocal responses may be suppressed and, consequently, improvements in functional vocal communication may not be seen. Additional studies are needed to replicate the current findings as well as to determine if PECS should be faded if functional vocal communication is established.