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Abstract | Summary | Original Article
The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: a pragmatic group randomised controlled trial.
Howlin P, Gordon RK, Pasco G, Wade A, and Charman T.
Journal of Child Psychology and Psychiatry. 2007; 48(5): 473-481.
Bottom Line
In this study PECS was shown to be useful in the classroom while being taught by trained teachers. The effect did not last once the teaching was finished. Students’ exposure to the PECS teaching should be maintained for a period longer than the two school terms of this study. |
Question: Did expert training and access to consultants for teachers increase the use of the Picture Exchange Communication System (PECS) and improve the communication skills of their students with ASD?
Background: Many children with ASD are unable to use speech to make their wants and needs known or to initiate communication with other people. It is difficult to teach them these skills because most of these children seem not to have any motivation to interact with others. PECS might give children a means of communicating that does not rely on their ability to engage in joint attention, another skill that is difficult to teach. Parents and teachers have been encouraged to use PECS with nonverbal children, but it is not known if teacher/parent training in PECS would enhance its use by their students with ASD. For this study, the training consisted of a 2-day workshop and 6 half-day, in-school sessions delivered over a 5-month period.
Design: Group randomized trial. There were 3 groups: treatment with PECS immediately after teacher training (ITG); delayed treatment started within 3 terms of teacher training (DTG), and the no treatment group. (NTG).
Setting: 18 classes in 15 schools in London and South East England.
Participants: The child participants were 84 elementary school-aged children with ASD. The adult participants were their teachers.
Intervention: For this study, teachers received training in the use of PECS, which consisted of a 2-day workshop and 6 half-day, in-school sessions delivered over a 5-month period.
Main Outcome Measures: At the start of the study, the ADOS-G was used to measure symptom severity and use of expressive language. The Mullen Scales of Early Learning were used to determine the nonverbal developmental score for each child participant. To determine the degree of improvement in social communication , the children were videotaped during their daily snack time. They were watched to see the frequency of their comunication initiations, the frequency of their use of PECS symbols, and the number of times they used speech or vocalized.
Main Results: There was a significant increase in the use of PECS, both in the number of times the children initiated interactions and in their use of the symbols. The PECS teacher training produced modest effects on the children’s behavior. However, there was no improvement in ADOS ratings, language test scores, or the use of language. Once the treatment ceased, its effects were not maintained.
Conclusion: Training teachers in the use of PECS seemed to increase their students’ use of the symbols and the number of times they initiated interactions with other people. The effect was only modest and stopped once the treatment was over. The children did not increase their use of language and the severity of their autistic symptoms did not decrease
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