PECS Training – Impact on Speech

PECS Training May Increase the Production of Spoken Words in Children with Autism
Deborah Carr and Janet Felce, two researchers in Wales, United Kingdom, recently published an article in the Journal of Autism and Developmental Disorders describing an experiment they conducted. The experiment investigated the results of the Picture Exchange Communication System (PECS) training on speech production in children diagnosed with Autism (Carr & Felce, 2007). 
The PECS (Bondy & Frost, 1994) is an augmentative communication system designed to increase meaningful communication in children.  Bondy and Frost (1994, p. 3) define the fundamental goal of PECS: “Children are taught to approach and give a picture of a desired item to a communicative partner in exchange for that item.  By doing so, the child initiates a communicative act for a concrete item within a social context.”  PECS is taught in six phases.  Phase I focuses on the initial exchange of the picture to the adult. Phase II teaches the child to travel to a communicative partner to initiate a request, and Phase III focuses on discriminating between pictures.  Phase IV teaches children to use a sentence strip to communicate. Phase V teaches the child to respond to the question, “What do you want?”, and Phase VI teaches the child to use pictures to comment both spontaneously and responsively (Carr & Felce, 2007).
In Carr and Felce’s study, children between the ages of 3 and 7 who were diagnosed with Autism were divided into two groups. One group, the experimental group, received 15 hours of PECS training through Phase III in their school environment.  The control group did not receive any PECS training or any treatments beyond the interventions they were already receiving in school.  All of the children were assessed for use of language at three points throughout the study: five weeks prior to treatment, one week prior to treatment and one week after the completion of treatment.  Treatment lasted approximately 4 to 5 weeks. 

Results indicated that, overall, the children who received the PECS training learned more spoken words during the treatment phase than those who didn’t receive the training.  Specifically, three children who already used some spoken words during the first two observations showed significant increases their total spoken words at the final observation.  Two children in the PECS group, who did not speak words at the first two observations, used spoken words at the last observations.  In the control (non PECS) group, one child demonstrated a small increase (two words) in total words.  The four other children in the control group demonstrated decreases in total words spoken at the final observation.  The results support the current view that teaching the PECS could promote speech in some children. 
It is worth noting that the PECS program does not include the purposeful teaching of speech.  Yet, despite the fact that there was no deliberate attempt to teach spoken language, the children who received PECS training demonstrated increases in spoken words.  The authors think that the reason this increase in spoken language is observed is because, in PECS training, the person who is receiving the picture from the child repeats the item clearly to the child during the exchange.  Therefore, the combination of the spoken word, physical item, and picture of the item all at once may clarify the meaning of the word for the child. This might lead to the eventual use of the spoken word without the picture.

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