In recent years the number of devices and apps designed for communication has rapidly increased and can be purchased for as little as a couple of pounds. This has led to many people asking us why a learner should use the Picture Exchange Communication System® (PECS), instead of one of these Speech Generating Devices (SGD).
When teaching any skill, it is rare that we would start with the end goal, no one has a motorbike as their first bike or learns to first write with a fountain pen. Simpler apparatus are used first to teach the basic skills, which are then generalised to the more advanced machine or implement. Using an augmentative or alternative form of communication is the same. When a learner uses an SGD there are a variety of skills that they need to have at their disposal. Firstly, basic device manipulation skills, such as turning on and navigating to the appropriate app, swiping between pages, and accurately tapping a specific button on the screen. Secondly an SGD user must have the skills to independently and accurately identify the symbols that reflect their communication message, while assembling them in the correct order. Most importantly the SGD user needs to have the skills to communicate effectively, finding a communication partner and gaining their attention before delivering their message. I’m sure you’ll agree, this is a huge number of skills to teach simultaneously!
Current research suggests that low-tech approaches are critical to teach effective, functional, and robust communication (Gilroy, McCleery & Leader, 2017), therefore it would be recommended to teach these skills on a modality such as PECS before planning a transition to an SGD. Using PECS through to at least Phase IV of the protocol will help to establish spontaneous, functional picture-based communication skills. A learner at Phase IV of PECS will have acquired an independent social approach, picture discrimination, communicative persistence, and the building of multi-picture sentences. This is a firm foundation in communication from which to develop greater sentence length, an increased range of pictures and a diversity of communicative function. All these skills could continue to be taught using PECS, however this could also be a good time to consider a transition to an SGD.
Ethically the team has a responsibility to plan a transition that maintains the skills of the learner, therefore before the transition data needs to be collected about the learner’s real-world communication skills. Primarily, this data will provide the rationale that the learner has an existing PECS skill set which is robust enough to transition from. Four key areas that would be appraised are as follows:
- Persistence in approaching a range of Communication Partners across environments. This also includes the learner having appropriate initiation skills in gaining the attention of the Communication Partner before delivering the message.
- Discrimination between at least 20 symbols on each of at least three pages within the PECS book. Research has found that insufficient picture discrimination skills can lead to abandonment and/or misuse of the SGD by the learner (Calculator & Johnson, 2008).
- Mastery of the multi-step process of navigation between pages while building a Sentence Strip™ will be a key component of effective SGD use.
- Pointing with a single finger to individual pictures during a Sentence Strip™ exchange will be a core skill for effective SGD use to create an accurate communication message.
This data can be additionally used for two other purposes, firstly to identify a best-fit SGD and secondly as a comparison post-transition to document the maintenance of communication skills. For more information about this pre-transition assessment you can download our PECS to SGD guidelines and recommendations.
After collection and analysis of this data a decision can be made as to the learners’ suitability for a transition from PECS to an SGD. In some cases, the data may highlight gaps in a learner’s repertoire which can be filled with effective communication lessons using the PECS teaching protocol. Alternatively, the data may demonstrate a learner who has a robust communication system which would benefit from transition to an SGD. At this point the next exciting step would be to identify the app or device that would best fit the learner’s current skill set and provide a platform for those skills to continue to develop over time. One such app that could be considered is the PECS IV+ app which looks just like a PECS book and is available in a range of languages.
If you want to know more about how to successfully transition your learner from PECS to an SGD you can join us at our one day workshop coming up in December.
by Louise Maggs, clinical director of Pyramid UK
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