Picture Exchange Communication (PECS)

I had the opportunity to speak with another wonderful mom recently from Sidney about her 7 year old son Matt. Matt’s primary communication system is PECS, or picture exchange communication. Receptively Matt was able to hear and understand single concept sentences, like bed time or jump on the trampoline. Sentences that centered on his needs or wants. His speech was restricted to single functional words like car or mom and so forth and his articulation was reasonably understandable. He is attending a special day class for children with autism in a mainstream school. At school his primary communication system is PECS or picture exchange where pictures are used to communicate both expressively and receptively. Matt likes watching YouTube videos on his IPAD. He uses icons and some texting to access the internet. Mickey Mouse Clubhouse is a real favorite of his. Given Matt’s ongoing use of PECS, his mom recently added an app to his IPAD called ProLoQuo2go. This app is a computer based PECS system and is an advancement over the bulky hand held PECS books. In addition the program allows Matt to type with text to voice functionality. What this means is the app electronically reads what Matt types.

Matt additionally has significant sensory integration needs which his mom felt were being addressed particularly at school. She described Matt as an “energizer bunny” who rarely sat down and ran on his tippy toes.

The issues with Picture Exchange communication (PECS)

The issue that Matt’s mom Vicky was raising is one we hear all over the world. Picture exchange communication (PECS) is a great method to get a nonverbal child going with communication. But the problem is that a visually bright child can quickly outgrow the system. Even on an IPAD, PECS can become cumbersome. It is frequently very limited when compared to what a child is trying to express. Without being able to effectively communicate a child can become frustrated right through to melt downs. Given this frustration, a child can easily abandon PECS altogether. Further, there are very limited options available to effectively learn the spelling from PECS. So taking advantage of IPAD apps with text to speech features is very difficult indeed.

From a sensory perspective, I felt that Matt’s needs were being raised by his mom but were not being addressed in any meaningful way. Professionals being able to comment SI based on reading a text is a long way from effective practice. If a child’s sensory integration or sensory processing deficits are not being accommodated, then you are on a highway to nowhere. It’s a real game breaker.

A conversation with Vicky, Matt’s mom in Sydney

Hi Vicky, it was nice speaking with you about Matt today. These are some ideas from our conversation which I hope will be helpful to you.

I thought about our conversation and it’s clear you have worked very hard on Matt’s language. He has made great progress with picture exchange communication (PECS) to meet his basic needs. However, Matt is out growing the system and you are stuck much as we were with our boys. Like Matt, Conor had been using PECS and Proloquo2go. He had demonstrated some use of text like Matt, but it was limited and it wasn’t growing. He also loved Disney videos (YouTube hadn’t started yet) and listening to Disney music on his IPOD. But overall, we had gone as far as we could with picture exchange.

Given these limitations, Conor’s behaviors were really becoming difficult. He was either melting down or receding into the fog we spoke of. The school district was primarily focusing on behavior, whereas to us the problem was clearly a lack of language. Compounding this he was moved to a very restricted school placement. When teachers looked at Conor they assumed he wasn’t intelligent enough for complex language. We felt the issue was one of teaching method and unaddressed sensory needs.

So, we put everything we knew together. We came up with a visual, to text, to oral language learning program using Disney movies. It’s gone through a lot of changes over the years and we work with families the world over. This is a video from one of our schools: Starting speech language learning. If you feel this approach would be helpful to you, have a look at Animated Language Learning to take this further. I’m a bit biased about this approach because my autistic sons are leading the development of this program. Their work is based on their personal success with ALL. And we are just so proud of them as you can see from this video of Conor!

On the sensory integration side, here are a number of posts which I have written on the subject. This is a good introduction:
Learning readiness and sensory integration. This is another post which will be helpful to you: Driving expectations and strengths despite language disorders .

Summary

I think what we all want as parents is to have a language system that allows us to communicate fully with our children. One that allows us to engage our children in productive learning activities that will help them reach their potential. PECS is a good starter communication method to get basic reciprocal communication going with your autistic child. But once your child gets a taste for language, his communication expectations and needs generally grow quickly. This is what happened with Conor and Eoin and we felt it vital that we met this need. This was the driver behind our Disney based language development programs. And they have been enormously successful.

Having said that, this is not an easy road. The Animated Language Learning (ALL) approach requires daily use as does managing sensory integration. Its a major commitment for parents both at home and in school. But for us, these became fun activities which just needed lots of structure and planning. And once we got this up and running the melt downs stopped and the boys got busy learning. Parenting went from being a nightmare to a joy. And we got our lives and children back.

Let me know if I can help you further,

Kind regards, Enda.