PECS: Potential Benefits and Risks

The Picture Exchange Communication System (PECS) is an augmentative /alternative communication strategy for those who display little or no speech. The rationale for PECS and its training sequence is described. Each phase of training is associated with specific behavior analytic teaching strategies. Skinner's analysis of Verbal Behavior forms the basis for teaching particular skills at specific points in the training sequence and also provide guidelines for how best to design the teaching strategies. Common problems and potential solutions are offered for various levels of training. The relationship between PECS and the co-development of speech, as well as its impact upon other behaviors (e.g., behavior management concerns, social orientation, etc.) is briefly reviewed. ********** The Picture Exchange Communication System (PECS: Bondy & Frost, 1994; Frost & Bondy, 1994) has become a popular communication strategy for children with autism and other communication disorders (see Siegal, 2000; Yarnall, 2000). As with any system that rapidly expands in use, there are pitfalls associated with its application (and misapplication). I will briefly describe PECS and its potential benefits as well as review several important concerns associated with its use. What is functional communication? To best understand the sequence of training steps in PECS, it is helpful to review the key aspects of functional communication as well as common difficulties sometimes encountered with other modalities of communication. The cornerstone to an analysis of communication from a behavioral perspective rests with Skinner's Verbal Behavior (1957). (This brief review does not permit detailed definitions of the key verbal operants, i.e., mands, tacts, intraverbals, echoics, autoclitics, etc. but the reader is advised to read the original source as well as recent comments and suggestions within the journal The Analysis of Verbal Behavior.) Skinner's primary points about this topic include that the verbal behavior of the 'speaker' (quotation mark used to avoid overemphasis of the vocal modality) was under the stimulus control of the 'listener. ' Furthermore, the role of the listener is to mediate reinforcement of the speaker- either in terms of consequences specified by the speaker (as in the mand function) or social reinforcement (including 'educational' reinforcers--see page 84). A succinct paraphrase defining functional communication is suggested: Functional communication involves behavior (defined in form by the community) directed to another person who in turn provides related direct or social rewards. Just as the consequences of verbal behavior help to define the function so, too, do the antecedent conditions. "Pure" tacts are under the stimulus control of some aspect of the environment, rather than the verbal behavior of someone else. That is, by asking, "What do you see? " while holding a pen up to a child, we enhance the probability of the child saying "pen" but we have introduced additional stimulus control issues. Thus, responding to questions is not the same verbal operant as spontaneously manding or tacting. This observation is important given the common practice in many communication-training programs of beginning with imitation and/or responding to questions to begin training. The potential problem with such strategies is that if the questions are not rapidly and carefully removed, some children are reported to be 'prompt dependent. ' This observation is not a recent one. In fact, early descriptions of vocal imitation-based training often contained remarks in the discussion sections such as, "While Billy acquired 50 words via imitation, he failed to generalize to spontaneous communication. " That is, without stimuli such as, "Say. " or "What Is . " or "What do you . " many children remained essentially silent. Various strategies, including incidental teaching were developed precisely to overcome these types of limitations of communication acquisition. …