PECS Methodology in High Tech AAC

CSUN AAC-1014 Picture Exchange Communication System Methodology In High Tech AAC Devices

1

Picture Exchange Communication System

Methodology In High Tech AAC Devices


2

The following information was presented at the 25th annual CSUN Technology & Persons with Disabilities Conference in Los Angeles in March, 2009.

It does not provide training in Picture Exchange Communication System (PECS) methodology, but instead is a case study.

For PECS information and training, please contact Pyramid Educational Consultants, Inc. at pecs.com or 1-888-732-7462.


3

Because Slideshare processing makes this presentation non-ADA compliant please note the following:

All of the videos are at:http://www.youtube.com/josephkoconnor

They are not captioned. Sorry.

If you want a copy of the PowerPoint file, please email us or DM at:http://twitter.com/blacktelephone

Or use contact form at:http://www.blacktelephone.com/contact/


4

Session ID: AAC-1014

Title: Picture Exchange Communication System Methodology in AAC Devices

Speakers: Donna Banzhof, Joseph Karr O'Connor

Date: Thursday, March 19, 2009Start Time: 10:40 AMEnd Time: 11:40 AMLocation: Renaissance - International A


5

Donna Banzhof, M.Ed.Pyramid ConsultantSenior PECS Supervisor & Trainer1-888-732-7462 (toll free)[email protected]://www.pecs.com

Joseph Karr O'Connor (Siobhan's Dad)Manager, University Web CommunicationsCalifornia State University, [email protected]://www.youtube.com/josephkoconnor


6

We will discuss…

• Review of today’s purpose

• Brief history of Siobhan

• Brief history of PECS

• Objective 1: Why start with PECS before transitioning?

• Objective 2: Demonstrate how to apply PECS methodology to high tech AAC.

• Objective 3: Supporting Siobhan as she grows and learns.


7

Purpose of Presentation

When a recommended AAC device arrives, where do you begin?

How do you introduce the client to a new way of communicating when there is no foundation on which to build?

Why is Siobhan laughing so hard?

Video: “Since You Were A Fish” http://tinyurl.com/dmro8k


8

Brief history of Siobhan

• Age: 16 years old

• Diagnosis: Cri du Chat Syndrome (or 5P-) www.fivepminus.org

• Non-verbal, poor balance (ataxic), loose and floppy (hypotonic), with developmental delays in all areas.


9


• Started PECS when 4 years old.

– Video http://tinyurl.com/b9sp27

• Communication consisted primarily of all-purpose sounds and/or taking an adult’s hand to desired object/activity.

• Spontaneous communication extremely limited, occurring exclusively with familiar adults.


10


Why transition to High Tech AAC (HTAAC)?


11


• Siobhan resists all direct efforts to make her communicate, but responds well to Picture Exchange Communication System (PECS) reinforcer-based routines.

• Putting Siobhan's interests first results in communication, using PECS methodology ensures her success.


12

Pyramid Educational Consultants

• Founded in 1992 by Lori Frost and Andy Bondy

– To provide training to professionals and families of individuals with disabilities

– To ensure high-fidelity implementation of PECS

• Exclusive home of PECS (Picture Exchange Communication System) and the Pyramid Approach to Education


13

What is PECS?

• Development began in 1985

• Training protocol based on B.F. Skinner’s Verbal Behavior (1957)

• Taught within a broad-spectrum applied behavior analysis protocol

• Originally developed for children on the Autism Spectrum, but now used across ages and diagnostic categories


14

PECS is Evidence Based Practice

• Over 40 published articles

• 31 data-based or case studies

• 12 articles - descriptive

• Articles generated in USA, UK, Wales, New Zealand, Greece, Japan, Australia, France, Peru


15

How widespread is PECS?

"The most widely used intervention was "The most widely used intervention was PECS, with almost all of the participants PECS, with almost all of the participants mentioning it, even those who did not use mentioning it, even those who did not use any other intervention in their program."any other intervention in their program."

Stahmer, A., Collings, N. & Palinkas, L. (2005). Early Intervention Practices for Children With Autism: Descriptions From Community Providers. Focus on Autism and Other Developmental Studies, 20, 66-79.


16

What is 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!


17

The “why” of behaviorThe science of learning

The Pyramid Approach to Education

The “how” of teaching

Teaching

Strategies

Erro

r Corre

ction

Gen

eral

izat

ion

Eff

ect

ive L

ess

ons

Data

Pow

erfu

l Rei

nfor

cers

Functional ActivitiesCont

extu

ally

Inap

prop

riate

Beha

vior

s

Functional Communication

© Pyramid Educational


18

The Pyramid and PECS

Functional Activities Students engaged in functional activities have something to communicate!

Reinforcement The first lesson in PECS is requesting a reinforcer, so we must identify a powerful reinforcer before beginning


PECS begins by teaching requesting- the communication skill associated with access to a powerful reinforcer

Contextually Inappropriate Behaviors

Communication skills could be potential Functionally Equivalent Alternative Behaviors (FEABs)



19


“Functional communication is behavior (defined in form by the community) directed to another person who in turn provides related direct or social rewards” (Bondy & Frost, 2001).



20


• Two broad functions of communication

– Requests - direct reinforcement

– Comments - social reinforcement

• Two ways to begin teaching communication

– Spontaneous vs.

– Responsive


21

Decisions PECS

Modality Pictures

Communicative function to teach first Requesting

Approach to spontaneity From beginning

Pyramid Principles for Teaching Functional

Communication


22

Objective 1

Why it is so much easier to start clients off with a paper based PECS system and then transition them to high tech AAC devices?

– PECS, a low tech AAC, relatively low training and device costs

– High tech AAC relatively high training and device costs


23

PECS: low tech AAC

• Paperbased system

• Student learns how to communicate first

• PECS requires use in social context, must exchange a symbol with someone

• No device distractions or buttons to push

High tech AAC

• Requires power

• Student must learn how to navigate device first

• Device can be used without interacting with someone

• Excessive button push can lead to miscommunication


Objective 1


24

Objective 1


• PECS:

• Only need “powerful R+” to start

• Teaches HOW to communicate

• First skill = spontaneous requesting


25

Objective 1Why it is so much easier to start clients off with a

paper based PECS system and then transition them to high tech AAC devices?

• PECS:

• Systematically teaches:

– Discrimination training,

– Sentence structure,

– Expanding sentences by using attributes,

– Question answering,

– Commenting

• Incorporates systematic error correction procedures


26

Objective 2

We will demonstrate that Picture Exchange Communication System methodology, when properly applied to high tech AAC devices, and following the principles of evidence-based practice (EBP), is the perfect basis from which to proceed.

• Problem: evidence showed error with “I like” vs “I want.”

– Error correction video: http://tinyurl.com/brp6kp


27

Objective 2

We will demonstrate that Picture Exchange Communication System methodology, when properly applied to high tech AAC devices, and following the principles of evidence-based practice (EBP), is the perfect basis from which to proceed.

• Problem: Siobhan making placement errors returning icons to communication book.

• Solution: Simplify mainpage (works for the Web too!)


28

Objective 2• FAIL! Communication book with complicated mainpage


29

Objective 2• WIN! Communication book with simple mainpage


30

Objective 2• Dynavox MT4 with simple mainpage


31

Objective 2• Dynavox DynaMyte with simple mainpage


32

Objective 2

Elements to consider

• Maintain skills

– Spontaneity

– Persistence and travel

– Sentence structure

• Continue to expand vocabulary and communication skills


33

Why use both?

Pros of PECS

• Easier for Siobhan to carry

• Good in noisy environments

http://tinyurl.com/ao7llv

• Does not need repair http://tinyurl.com/c5lhpq

• Can be used at the pool http://tinyurl.com/cpnh3q

Pros of HTAAC

• Voice is appealing to people unfamiliar with AAC

• Incorporate “stories” about her weekend or dayhttp://tinyurl.com/d66v2g

• Can be responded to when someone is driving http://tinyurl.com/cpwunx


34

Objective 3

What it takes to support Siobhan as she continues to grow and learn and what it took to get her and keep her communicating.

• Dedicated effort by Siobhan, parents, friends, teachers, aides, SLPs, consultants, and others… regardless of media (PECS, HTAAC).


35

Objective 3

What it takes to support Siobhan as she continues to grow and learn and what it took to get her and keep her communicating.

Communication planning across the day

– Assessing Siobhan’s routines

– Sabotaging known routines

– Teaching new skills and related items needed in the routines


36

Communication Across the Day

Activity Expressive Communication

Receptive Communication

Feeding Gaynor “I want help” Follow schedule

Meal time Request desired food item

Request help

WAIT

Retrieve requested item

After school Request activity

Request snack

Respond to “what did you do today”

Follow schedule

WAIT

Understanding “no”

Follow directions


37

Siobhan with PECS

• PECS strategies increased frequency and quality of spontaneous communication.

– “Living Room Derby” video: recorded over continuous 31 minute period on September 10th, 2008 ending at 8:32 p.m.

– Siobhan initiated 35 communicative exchanges, all for the pleasure of interaction. Siobhan is doing this for fun! (She’s also doing this because Dad was sitting down:-)

– 4 minute edited piece contains 22 interactions.

– http://tinyurl.com/bsjsn5


38

Siobhan with PECS

• Communicates in various settings and with various communicative partners

– “Orders Taco” video http://tinyurl.com/ao7llv

• Communicates in the classroom

– “Siobhan PECS 2004” video http://tinyurl.com/cjtwb3


39

Siobhan with MT4 or Dynamite

• Able to invent clever substitutes

– “Today” video http://tinyurl.com/dfjw7c

• She makes jokes

– “Hamburger” http://tinyurl.com/bthjou

• She has conversations

– “I Like Circus” http://tinyurl.com/bhnvfy


40

Siobhan Using Picture Schedule

• Schedule shows what she’s doing in

order – no surprises means peaceful

transitions

– “Morning Schedule” http://tinyurl.com/bwky8q


41

Conclusion

• Having a functional communication system allows someone to express herself

• Communication training should be begin requesting items that are interesting to that person

• Using a low tech AAC system, such as PECS, to begin provides a foundation to teaching a person “HOW” to communicate

• When transitioning from a low tech to a high tech system make sure the system is taught, previous skills are maintained and communication continues to be expanded

PECS Methodology in High Tech AAC

Education

Transcript of PECS Methodology in High Tech AAC