Practitioner Knowledge and Implementation of the Picture Exchange Communication System (PECS) in UK Schools
Creators: name: May, Richard
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Applied Behavior Analysis
subject: Clinical Psychology
subject: Social and Behavioral Sciences
subject: Psychology
subject: FOS: Psychology

description: It is estimated that up to 25% of children with an autism spectrum conditions (ASC) never acquire speech, and therefore rely on augmentative and alternative communication (AAC) systems as their primary mode of communication (Lord et al., 2004). The Picture Exchange Communication System (PECS™) is one such AAC system. Individuals learning to use PECS are initially taught to communicate simple requests for items and activities through the exchange of pictures and icons. Once the initial phases are mastered, the picture system is later expanded to enable the learner to use more elaborate language (e.g., making comments, responding to questions). There is some evidence in support of the use of PECS for learners with minimal verbal repertoires (e.g., Brignell et al., 2018; Lamb et al., 2018; Preston &amp; Carter, 2009). The intervention is also widely used; in an international survey of over 500 parents of children with ASD, Green et al. (2006) reported that PECS was being used by 28% of respondents, with a further 31% reporting having used it in the past. Finally, in a survey of 160 parents of children with ASD focusing exclusively on the United Kingdom, Denne et al. (2017) reported that PECS was currently used by 19% of respondents, with 23% having used it previously. While the available evidence suggests that PECS is widely employed in special education settings in the UK, the level of training of those tasked with implementation is often very limited (Howlin, Gordon, Pasco, Wade, &amp; Charman, 2007). Consequently, the intervention is at risk of not being implemented as intended (Bondy, 2012). May et al. (under review), evaluated how well PECS is understood and implemented in special education schools in the UK. The study revealed a high degree of variability in teachers’ knowledge and implementation of PECS. Notably, we identified gaps in knowledge and implementation in particular aspects which could serve to weaken its effectiveness. Importantly, the paper found that staff who have received PECS-specific training were more accurate in their understanding and consistent in their implementation than those who had not received such support. These are important findings; the consequences of compromised treatment integrity can range from reductions in the effectiveness of an intervention (Arkoosh et al., 2007) through to the outright rejection of evidence-based treatment programs (Moncher &amp; Prinz, 1991). The present research aims to refine, replicate, and extend existing research (May et al.,) in two ways. First, the study will serve as a preregistered replication of the original study by May et al., (under review) in order to test the robustness of those findings. Second, we will explore the impact of controlling for additional factors than those in the initial modelling. Specifically, we will look to estimate the impact of type of PECS training (the estimand of interest) on knowledge and implementation survey scores (outcomes), adjusting for job role and supportive environment (covariates) in the model.