Visuals, symbols and PECS Emily Roberts 1st October 2015

What is the difference between Visuals symbols and PECS? Visuals or symbols are a visual way to provide or explain information. • Timetables/schedules • Cue cards • Social Stories™ PECS is a communication system. It is taught using a specific structure.

Visuals and symbols – Time tables Time tables or schedules provide a visual prompt of what is expected.

They show what task/activity is about to be completed and provide visual support when an activity is finished.

Children can refer to them throughout the day which can reduce anxiety about what is coming next.

Visuals and symbols – Time tables

Visuals and symbols – Belt clips Belt clips or cue cards are portable symbols to support children when you are out and about.

They provide a visual to support the request you are making.

They can be photographs, symbols or traffic light discs.

Visuals and symbols – Social Stories™ Developed by Carol Grey.

They are a positive way of explaining different social situations to children with autism.

They can explain what is happening, offer support for how children are feeling and explain how they are expected to behave in the specific situation.

PECS This training is meant as a brief introduction and NOT meant to take the place of formal training in PECS.

Picture Exchange Communication System or PECS Developed in 1985 and since then has been been widely research in 16 countries. Developed as a unique augmentative/ alternative training package that teaches children with autism to initiate communication with other people.

Some common misconceptions • If you are using pictures, it means you are using PECS (PCS vs. PECS) • PECS inhibits speech development • PECS can only be used for requesting • PECS can only be used with younger learners

PECS does not require complex or expensive materials. It was created with families, educators and resident care providers and families in mind, and so it is readily used in a variety of settings.

Before starting to use PECS with a child a Reinforcer Assessment is needed. This ensures that the most motivating items are used to teach a child how to use PECS. Reinforcer Assessment Procedure • Gather items that are likely to be motivating for the child (observe the child and what they like to play with, ask those that know the child well) • Offer pairs of choices • Document which items the child chooses most often, most quickly, uses for the longest and what they seemto enjoy the most.

Phase 1: The Physical Exchange Outcome: Upon seeing a reinforcing item, the child will look at the picture, pick it up and hand it to the communication partner

• No verbal prompts • Initially two adults are needed (one as the communicative partner one to prompt Physical exchange

Phase 1: The Physical Exchange The communication partner non-verbally entices the child with the item WAIT for the learner to initiate/reach for the object Physical prompter physically guides the learner to pick up the picture, reach for the communication partner and release the symbol

Phase 1: The Physical Exchange The communication partner waits with open hand cue and immediately delivers the item to the learner while labeling it. Retrieve the object after 20-30 seconds and repeat.

Phase 1. The Physical Exchange Present numerous opportunities throughout the day! Fade physical assistance Introduce a variety of pictures (representing motivating items) one at a time.

Video clip then practice!

Phase 2: Expanding Spontaneity Objective: The child will go to their communication board, pull the picture off, travel to their communication partner, and give them the picture. Increase distance between child and communicative partner Increase distance between child and communication book

Phase 2: Expanding Spontaneity Shhhh! Still no verbal prompts Use a variety of communicative partners Be mindful of and eliminate any subtle prompts

Continue to present numerous opportunities throughout the day! Continue to introduce a variety of pictures (representing motivating items) one at a time. Mastered when student can cross the room to get a picture and cross the room to the communication partner. Need to also have 5-10 items they request on a regular basis.

Phase 3: Discrimination Now PECS is divided into two phases Phase 3A: Simple Discrimination Phase 3B: Discrimination between multiple reinforcers

Phase 3A: Simple Discrimination Only one adult is needed now Ideally 40 opportunities per day Start with ONLY 2 symbols. One highly preferred

One non-preferred

Have both items available and entice with the child with both Wait for learner to select one of the pictures If motivating item is selected, social praise and delivery of reinforce within ½ second If non-preferred is chosen, neutral respond and deliver item

Rearrange picture location after correct trial

Phase 3B: Picture Discrimination Outcome: Child takes the item that corresponds with the picture on 80% of trials from any size array. Child can look inside the book to find pictures. Discrimination between preferred items Child demonstrates correspondence by choosing the correct item after the picture exchange has occurred

Progress gradually

Begin to categorize the symbols or pictures within the book

Phase 4: Sentence Structure Outcome: The learner will use the sentence strip to construct sentences and exchanges the strip in 80% of opportunities. Step 1: Start with “I want” picture already on the left hand side of the strip Wait for the learner to initiate a request Physically prompt the learner to add the picture to the sentence strip instead of moving right to the exchange

Phase 4: Sentence Structure Step 2: Start with empty strip and wait for initiation Prompt the child to add the “I want” picture then the child independently adds reinforce and exchanges the strip Communication partner reads the strip and delivers reinforce quickly

Phase 4: Sentence Structure Step 3: Teach the learner to point to the pictures as communication partner reads the strip Also targeted in this phase: Asking for things not in sight Remember no verbal prompts!

Child is ready to move onto Phase 5 when: •They are using sentence strip independently •They are asking for things both in sight and out of sight •They are communicating with a variety of partners and in a variety of environments •They are discriminating between 20-50 pictures

Phase 5: Responsive Requesting Outcome: The learner will spontaneously request a variety of items and can answer the question “What do you want?” This is the FIRST time in the protocol where we ask, “What do you want?”

Phase 5: Responsive Requesting Step 1: Ask, “What do you want?” while pointing to the sentence strip. Step 2: Increase the time between the question and the point. Step 3: Alternate opportunities for responsive requesting and spontaneous requesting

Child is ready to move onto Phase 6 when: They are answering “what do you want?” by forming the “I want ----” sentence with minimal delay.

Phase 6: Commenting Outcome: The child will appropriately answer “What do you want?”, “What do you have?”, and “What do you see?” and similar questions Long term Outcome: Spontaneous commenting! Start with “I see/hear/smell” with pictures, books and films

References and further reading. Grey, C (2001). My Social Stories Book. London: Jessica Kingsley Publishers ltd Bondy, A and Frost, L (2011). A Pictures Worth: PECS ad other visual communication strategies in autism. Second Edition. Bethesda: Woodbine House Frost, L. A., & Bondy, A. S. (1994). The Picture Exchange Communication System Training Manual. Cherry Hill, NJ: Pyramid Educational Consultants.