1. Picture Exchange Communication System
“What?”, “Why?”, “When?”, “Who?” “Where?” and “How?”
Amanda Craig

2. “What is the Picture Exchange Communication System (PECS)?”
Is used to help individuals who have no, or limited, functional communication skills in a systematic and evidence-based manner.
If taught properly, the use of PECS has been shown to lead to rapidly acquired basic communication skills
Helps with the development of speech
Often precedes a reduction in behavior management issues.

3. Augmentative/Alternative Communication (AAC)
Augmentative Communication
Any device, method or system used to supplement speech
Alternative Communication
Any device, method or system used for communication when speech has not developed or has been lost
PECS can be both!
PECS is an AAC system

4. Low-tech or No-tech
communication aids are defined as those that do not need batteries, electricity or electronics.
No power switch!

5. High-tech
AAC aids permit the storage and retrieval of electronic messages, with most allowing the user to communicate using speech output.
VOCA- Voice output communication aid

6. Digitized- play recorded words or phrases generally more intelligible
Synthesized- uses can be harder to understand but that permits the user to spell words an speak novel messages.

7. Common misconceptions about PECS
If you use pictures, you’re using PECS
If you implement PECS, the learner will never develop speech
If the learner begins speaking, stop using PECS immediately
Sign language is better
Receptive always precedes expressive in language development
There is no research to support PECS
PECS doesn’t work

8. PECS Research Increases in functional communication skills
Increases in spoken utterances, including increases in mean length of utterance (MLU)
Decreases in contextually inappropriate behaviors
Research clearly suggests that PECS is an effective communication tool
When difficulties arise, problems are often due to:
Lack of powerful reinforcers
Trainer error

9. How widespread is PECS?
Over 86 published articles (including )
63 data based or case studies
6 literature reviews
Used in 52 countries worldwide!

10. “Why should we use PECS?”
PECS is an approach that teaches early communication skills using pictures
Teaches functional communication that is immediately useful
Can be used across ages and disabilities
Students are taught to exchange pictures for something they want

11. History of PECS Lori Frost, MS/CCC-SLP Andy Bondy, PhD Began in 1985
Based on principles of Applied Behavior Analysis and on B.F. Skinner’s Verbal Behavior
Protocol was developed as a result of creative problem solving with one learner

12. The Pyramid Approach to Education Developed by Andy Bondy, Ph.D.
A systematic approach to designing effective learning environments
Based on a broad spectrum application of Applied Behavior analysis (ABA)
Blends motivational systems, functional activities, and creative communication training with the science of learning

13. Functional Activities
To teach skills to
Get a job
Live independently
Teach versus “take care of”
“A functional skill… is an action what will be performed by someone else if a person with disabilities does not perform it” Lou Brown, 1984

14. PECS is NOT…. The use of any picture Visual Schedules
First /Then boards
Reinforcement Systems
Choice Boards

15. Following a Visual Schedule
We use them everyday!
Recipes
“To do” lists
Overhead aisle markers in grocery stores
Visual directions for assembling furniture or toys
Menus
Roadside billboards
“Men” or “Women” icons on bathroom doors

16. Other visual schedules

17. Visual Schedule Video!
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4:08
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0:57

18. Make them versus Entice them
Powerful Reinforcers
Powerful motivation that drives learning
Two methods to get students to participate:
Make them versus Entice them
Reinforcers can be social or tangible
Which do you prefer at work?
Are social reinforcers always effective?

19. Reinforcer-First Strategy
No reinforcer, no lesson!
Consider novelty, choice, control
½ second rule for NEW skills
Differential reinforcement
“Better than before? Then give ‘em more!”

20. Let’s Make a Deal Show student potential reinforcers
Ask student to perform short, known task
Immediately give reinforcer
Over subsequent opportunities, slowly “stretch” the deal by asking for more work.

21. Visual Reinforcement Systems

22. Visual Token Economy
2:59

23. PECS is…
The EXCHANGE of a picture to a communicative partner to express a persons wants, needs, and desires.
A functional communication system
An AAC device
A supplement to verbal speech

24. Functional Communication
Skills that are useful now and in the future
Not all behaviors are communicative
Must occur between two people
Communicator directs behavior to communicative partner
Communicative partner mediates access to reinforcer

25. Contextually Inappropriate Behaviors
Focus on functionally equivalent alternative behaviors
“Why we behave the way we do!”
To gain some type of R+
Concrete, activity, social, sensory
To escape/avoid
Demand, activity, setting
Elicited
Loss/delay of reinforcement
Rate of R+ induced
Biomedical factors pain

26. The Pyramid Approach to Education

27. The Top Elements Generalization Effective Lessons
Skills generalized right from the start
Effective Lessons
Sequential, Discrete, Incidental
Specific Teaching Strategies
Goal is to eliminate prompts
Minimizing and Correcting Errors
Opportunities to teach, not just fixing mistakes
Data Collection

28. Advantages of PECS Requires interaction with other people
Individual initiates communication rather than responding to a prompt
Starts with requesting
First PECS lesson= requesting reinforcer
Teach that exchanging a picture is “easier” than current method of getting reinforcers

29. When? Lack of functional communication Lack of spontaneity
Picture is worth 1,000 words!
Lack of functional communication
Lack of spontaneity
Lack of initiation
Lack of intelligible utterances
Lack of gaining attention
Lack of sentence length
Lack of word retrieval

30. Generalize across all environments!
Where?
New story
In the classroom
In therapy
In the sensory/playroom
On the playground
Within the school
At home
Kitchen
Bedroom
Living Room
In the community
Generalize across all environments!

31. How?

32. Preparing to begin PECS
Identify reinforcers
Prepare Data Sheets
Prepare a PECS book
You can purchase planners donated at thrift shops (Salvation Army, Goodwill, etc.)
Make picture icons that represent the students reinforcers
Leave some pictures generic to plan for attributes in the future (Boardmaker, Pics for Pecs, Google images, Digital Pictures)

33. Setting the Stage Identify POWERFUL reinforcers
Items student exerts effort to gain access to
Items students resist having taken away
Item student spends a lot of time with

34. Examples of Powerful Reinforcers
Specific food items (apple, chip, cookie, cracker, banana
Specific drinks (juice m lk)
Toys (ball, car, bubbles, train, playdoush, puzzle, drum)
Physical actions (up, push, tickles, chase, jump)
Individualized reinforcers (hat, book, music, video)

35. Do not pre-empt communication
Do not anticipate and meet needs
Do not ‘speak’ for the student
Do not assume student cannot communicate

36. Phase 1 : Physical Exchange
Goal: Initiate communicative interaction
Teaches how to communicate
The “rules” of communication
Approach communicative partner
Deliver message
Picture discrimination is not a prerequisite
Initiation means student must “go first”
(What does this look like?)
Demonstrate what initiation looks like, they need to reach for item first!!!

37. Phase 1 : Physical Exchange
Upon seeing a “highly preferred” item, the student will pick up a picture of the item, reach toward communicative partner, and release the picture into the communicative partner’s hand.

38. Phase 1 Once student initiates, teach the motor response: Pick up
Reach
Release
Lesson Type: Sequential
Prompt Type: Physical
2-person prompt procedure with backward chaining

39. Phase 1
3:01

40. Phase 1 Must not become a PROMPT! Role of the open/empty hand
Provides information to the student on where to put the picture
Is not shown until student has initiated
Must not become a PROMPT!

41. Communicative Partner
Entices and holds out desired item
Does not put out hand until reaches
Keep hand close to object like a “trap door”
Praise with happy voice
Deliver item within ½ second
State name of item

42. What it should look like!
Communicative partner
Waits for initiation
Present Item
Use happy voice!

43. Phase 1 Video!
1:39

44. Second Person Prompter
Makes sure picture is on the path to the item
Waits for student to initiate
Physically prompts student
Eliminates prompts using backward chaining
Play the role of the “silent partner”
NO SPEAKING!

45. Second Person Prompter Video!
1:40

46. Practice!!!

47. Student doesn’t look at picture?
What if?
Move the picture around!
Student doesn’t look at picture?

48. PECS Phase 2 : Distance and Persistence
Goal: Persist across obstacles
Continuing to teach “how” to communicate
No discrimination
The student goes to his/her communication book pulls the picture off, goes to the trainer, gets the trainer’s attention, and releases the picture into the communicative partner’s hand.
Each student must have book!

49. Phase 2 Traveling Teach students to travel: To communicative partner
With book or to get picture from book
From room to room with book
Lesson Type:
Sequential
Teaching Strategy:
Shaping

50. Phase 2 Persistence Get rid of subtle prompts
Request during group activities
Request items out of sight
Picture- on communication book-moved further from student (still single pictures, no discrimination)
Get Communication partner’s attention when back is turned
Persistence taught
Variety of People, activities, locations, reinforcers involved

51. Phase 2 Video
3:07

52. Naturally come to you first
Say, “I don’t have it!”
No verbal prompts!
“Go to ….”
“Get your book!”
Backward Chaining
Sequence back to where start (before error)
Then to person
With peers

53. Where an apron! No VERBAL Prompts Don’t take book from student
Don’t put it under your desk
Expectations!
Students should take book everywhere!
Generalize across people and environments
Use peers to increase social interactions!
Items should be everywhere for them to ask for! (In sight, but out of reach!)
Have reinforcing items on you at all times!
Where an apron!

54. Practice
Get up and move around!

55. Only one teacher is needed!
Phase 3 Discrimination
Goal: choose from among all pictures on or in book
Only one teacher is needed!
The student requests desired items by going to a communication book, selecting the appropriate picture from an array, going to a communicative partner, and giving the picture

56. Phase 3A Simple Discrimination
Where should you start?
Motivation to use correct picture is getting desired item and avoiding undesired item
Begin with highly preferred vs. non-preferred
Lesson Type:
Discrete
New Skill:
Choose the correct picture

57. Trainer should… Entice with both items
Praise correct item and deliver correct item
Say nothing and give distracter item
Error Correct

58. Discrete Trial Instruction
4 Step Error Correction
Model
Practice
Switch
Repeat
What it should look like!

59. Cycle through 4- step three times
Return to level of mastery
4 step counts as one trial
Keep communication book at level of mastery when not teaching Phase 3A
What it should look like!

60. What it should look like!
“Switch” ideas
Give the student a single task to complete (e.g. clap your hands, touch your nose, stand up, turn around)
Gesture for the student to pick something up form the floor
Turn PECS book over
Model a motor action for the student to imitate “Do this”
What it should look like!

61. Phase 3A
3:04

62. “Ooh” at the moment of choice and give reinforcer after the exchange (1/2 second)
“Ooh the new”
If give distracter picture, say nothing, and Give the non- preferred item
If student plays with distracter find a new one!
Picture being taught varies by what is currently reinforcing
Vary the “distracter “ picture
Switch you switches!
Move pictures around on book
Pair preferred item with picture ON BOOK!
No Verbal Prompts!

63. Practice “Ooh the new” 4-step Model Practice Switch Repeat
Pair item to picture on book “NOT IN SPACE”
Say nothing when distracter is given
Move the pictures on the book
No verbal prompts!

64. Alternative Strategies
Big Pictures far apart
High Preferred vs. Blank
Big vs. Small
High Preferred vs. Aversive
Try different symbol sets Boardmaker vs. digital photo or Google images

65. Phase 3B Preferred vs. Preferred
Student exchanges picture
Student must demonstrate correspondence between picture and chosen item
State “Take it,” “Get it,” “I want that”
Determine whether student’s actions match his request
This is the “correspondence check”

66. What if student takes the other item?
Block it! Don’t let them take it!
Muffin Tin
Teach to the Reach
Use 4-Step Error Correction Procedure following mistakes
What it should look like!

67. Increase amount of preferred items on book
Move pictures inside book, student has to look inside book
Student will turn pages to find picture
Begin organizing pictures
Reintroduce Phase 2

68. Practice Entice with both items “Take it” “I want that”
Give item if corresponds!
Block item if does not correspond
Teach to the reach
4-Step
Drop Back to level of mastery after 3 errors

69. Phase 4 Sentence Structure
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 form the communication book, approaching the communicative partner, and giving them the strip.

70. Get book
Remove “I want” icon from book
Put “I want” icon on sentence strip
Remove reinforcer picture from book
Put reinforcer picture on sentence strip
Remove sentence strip
Give sentence strip to communicative partner

71. Phase 4 Sentence Structure
Lesson
Sequential
Prompt
Physical
Teaching Strategy
Backward Chaining
One Teacher!

72. Phase 4 Sentence Structure
“I want”+ reinforcer picture put on sentence strip
Exchange entire strip given to adult
Building toward spontaneous commenting
Sentence Starters provide information to listener on function of communication
Teach student to construct and exchange a sentence strip while maintaining a requesting function
20 or more pictures!
Variety of Communicative partners!

73. Phase 4 Step 1 Add Reinforcer Picture to Sentence Strip
“I want” sentence starter already on strip
Wait for initiation
Physically prompt to add R+ picture and exchange strip
Eliminate prompts over trials
Quickly read strip to student and give R+
Reinforce target behavior within ½ second
“Ooh the new”

74. What should it look like?

75. Step 1 Video Physical Prompt
0:21
Naturally give you picture, “new skill” put picture on strip!

76. Phase 4 Step 1 Fading Prompts
0:22

77. Step 2 Add both pictures to Sentence strip
Wait for initiation
Prompt adding “I want” to Sentence strip- eliminate prompts over time
Student will independently add R+ picture and exchange strip
Quickly read strip to student and give +
Reinforce target behavior within ½ seconds
“Ooh the new”

78. What should it look like?

79. Read Back Strip!
0:36

80. Step 3 Read the Sentence Strip
Teach student to point to pictures as you read strip
Use backward chaining to eliminate the prompt
Differentially reinforce when independent

81. Step 3 Pointing to icons Video
1:25
What did she do?

82. What should it look like?

83. Phase 4 Sentence Structure
Continue to perform correspondence checks!
Add more pictures to front of book
Move pictures inside book!

84. Step 4 Encourage Speech
Add constant time delay (3 seconds) to encourage speech
Differently reinforce talking (have a party!)
Do not insist on speech!
Do not withhold reinforcer if student does not speak!
Honor the exchange!
No Verbal Prompts!

85. Phase 4 Begins with “I want” already on sentence strip
Waits for initiation
Physically guides student to put R+ picture on strip and exchange strip
Verbal praise, read strip
Teaches the assembly of entire strip-backward chaining
Reinforces new behavior within ½ second
Uses physical prompt to teach student to point while “reading” strip
Use 3 second delay
Differentially reinforce when student speaks

86. Practice
No Verbal Prompts

87. What if?
Student adds the 2nd picture to the strip first but puts it in the correct order?
This is okay!
The sentence strip is handed to you with the pictures in the wrong order?
Back Step Error Correction
“I don’t understand”
The student taps out the strip but doesn’t exchange it?

88. Responsive Requesting
After Phase 4
Attributes
Responsive Requesting
Commenting

89. Attributes Use attributes to clarify requests for specific reinforcers
Must demonstrate a preference for a particular attribute
Does not have to know the attribute receptively as a prerequisite

90. Attributes Step 1: Three-picture sentence construction
NO attribute discrimination required
Step 2: Discrimination between high and non-preferred attribute icons
4-Step Error correction
Step 3: Discrimination between 2+ preferred attribute icons
Correspondence Checks

91. Examples of attributes
Big/Little
Colors
Colored containers with items in
Crayons
Flavors
Numbers
Why to keep some icons generic?
Have a way to increase sentence length, plan for this at the beginning
Actual DVD’s
Artists
Type of Chip
Exact books

92. Phase 5: Responsive Requesting
This is begins to…
Teach a building block towards commenting
Teach responding to a question while maintaining requesting function
Introduce new prompting strategy
Progressive time delay

93. Finally! We begin to use “I want”
Phase V
Step 1
Simultaneously ask question (natural cue) and point to Sentence Starter
Progressive time delay
Step 2 Gradually lengthen interval between natural cue and prompt until student “beats the prompt”
Step 3 Alternate between opportunities for spontaneous requesting and answering, “What do you want?”
Create lessons
Maintain Spontaneous requesting

94. Our lessons must have these elements!
Why do we comment?
Surprises
Changes in expectations
Novelty
Unusual events
Our lessons must have these elements!

95. Phase 6: Commenting
Many of our students do not respond to social reinforcement so spontaneous commenting may be difficult
Our first commenting lesson involves answering a question
Start with questions that are likely reinforcing from the student’s perspective

96. Examples What do you smell? Student really likes smells
What do you hear?
Student likes particular artists
What do you see?
Student likes to look in mirror
People
Objects
What is it?

97. Step 1 Answer the Comment Question
No sentence starter discrimination
Ask, “What do you see/hear/smell/have?”
Eliminate prompts using a progressive time delay
Differentially Reinforce

98. http://www.youtube.com/watch?feature=player_detailpag e&v=WvAJ3XfiWX4

99. Step 2 Sentence Starter Discrimination
Alternate asking, “What do you want?” and “What do you see/smell/hear/have?”
“Ooh the new” at moment of correct choice
Differentially reinforce

100. Decrease Question Prompt
Decreasing the question to elicit spontaneously commenting
Shorten utterance
Fade volume
Time Delay

101. Generalization Books! The Hungry Caterpillar
Brown Bear “What do you see?”

102. Thank You!