Some children communicate by saying words, however many children cannot communicate by saying words and need an alternative method of communicating.
Some of these alternative methods include American Sign Language and Picture Exchange Communication System (PECS; Bondy & Frost, 1994).
In order to select a method of communication, we first assess the child’s repertoire and their level of functioning. If a child does not have any spoken language, at BCOTB we typically begin by using sign language paired with vocalizations as a first alternative method of communication and assess the progress regularly.
We closely monitor their progress over several months of quality teaching to determine whether a change should be made in the form of communication being used. We consult with the parents throughout the entire progress on the type of communication method we are using.
The literature suggests an alternative, primary method of speaking that is based on the physical skills of the learner, size of the audience, ease of implementation, and potential for advanced language should be used (McGreevy, Fry, & Cornwall, 2012). An alternative non-vocal communication method may lead to more vocal communication (Carbone, Lewis, et al., 2006). At BCOTB, we will use a form of communication that will be most effective for your child with the end goal being the development of spoken language.
The primary goal of teaching verbal behavior through any communication system is to give children an effective tool to make requests to get their wants and needs met. PECS is one approach that teaches early communication skills using pictures, and children are taught to select a picture card to exchange for something they want (Bondy, 2012). A practitioner may choose PECS as a communication method if the learner has limited fine and gross motor imitation skills, has not mastered more than a few signs, and is scrolling through his or her signs. One of the most important goals of PECS is that the child learns to initiate communication independently. Some advantages of PECS include the social interaction with others, encouraging the individual to initiate communication, it is portable and fairly inexpensive, it provides a means for teaching requests for items/actions, and it promotes eye contact.
Teaching requests through PECS is most effective when the learner is highly motivated for the item or action being taught. When given different edibles and toys to choose from, your child will indicate the ones he or she is most interested in by selecting or moving towards those items. We then use the most highly preferred items and activities to teaching communication. There are 6 phases that we used when implementing PECS that may be modified based on the learner.
6 Phases (Bondy, 2012)
- Physical exchange and initiating communication (one picture)
- Expanding spontaneity and range (increasing distance between therapist and board)
- Simple picture discrimination (an array of 1 preferred item with non-preferred items)
- Conditional discrimination (an array of preferred items)
- Building Sentences (I want + item/action)
- Answering, “What do you want?”
- Answering “comment” questions such as “what do you have/hear/see?”
Other important teaching strategies for PECS include using error correction and correspondence checks.
- Error Correction: If the child selects an incorrect card, block the incorrect selection and prompt the correct selection, followed by a transfer trail where the learner independently selects the card.
- Correspondence Check: Show both items at one time and wait for student to reach for an item if it is unclear what the child wants.
PECS and sign are both effective ways to teach communication. Your clinical team will discuss the best possible outcomes for your child with you in efforts to ensure they perform at their fullest potential.
Bondy, A. S. (2012). A clear picture: The use and benefits of PECS: The picture exchange communication system. Pyramid Educational Consultants.
Bondy, A. S., & Frost, L. A. (1994). The picture exchange communication system. Focus on Autism and Other Developmental Disabilities, 9, 1-19.
Carbone, V. J., Lewis, L., Sweeney-Kerwin, E. J., Dixon, J., Louden, R., & Quinn, S. (2006). A comparison of two approaches for teaching VB functions: Total communication vs. vocal-alone. The Journal of Speech and Language Pathology–Applied Behavior Analysis, 1, 181.
McGreevy, P., Fry, T., & Cornwall, C. (2012). Essential for living: A communication, behavior and functional skills assessment, curriculum and teaching manual.