Saturday, 10 February 2018

Autism & PECS

We love acronyms.

Whether they evolved due to laziness (the effort of using entire sentences is just ......) or expediency (it's much easier to say you're quickly going to the ATM,  than to the Automated Teller Machine to be publicly humiliated by your financial  starvation... I'm pretty certain the noise I hear gurgling up through it's innards is mocking laughter), is anybody's guess, but  BTW they've been making us LMAO for years now.
My son, interestingly enough, has decided to forgo the  acronym path as 'what the fuck?' is his new favourite phrase.  It's a question humans have been asking themselves for thousands of years, and there is still no clear consensus on what the fuck actually is.  Evolution is slow.  But I'd actually be quite happy for him to ask "Mammy Jean, just WTF is it all about?" so that I wouldn't have to explain to his teacher that we don't swear at our son like salty sea dogs, but reserve choice language for, well, everyone else.  So, fuck knows where he picked it up.  Must've been on YouTube.
So acronyms are handy fellas sometimes, but swearing and Autism is where they shine.

And now for the acronym bit.
PECS (or Picture Exchange Communication System) arose out of the behaviourist movement and teaches the child to use pictures to request what they want.  It's ingeniously simple in that the child learns that they are rewarded with their desired object in exchange for a picture of it (imitating the two-way flow of conversation).  They will ultimately learn to spontaneously request items and hopefully progress on to asking questions and passing comments (speech therapy code for 'having the craic').
As long as the desired object is Nutella and not a troop of dancing badgers, it's all good.

no dancing badgers were harmed in the making of this blogpost

When I did an image search for PECS  I was assaulted by images of bare-chested men who would benefit from wearing good, supportive bras... I had a bit of explaining to do when my husband walked in on me.  But now that he's reassured that I'm not trolling Tinder for gym bunnies, here's an example of what PECS (and not pecs) look like.

Here's how it works;
Phase 1; The child exchanges a picture for an item they want more than life itself  (avoid pictures of badgers at this stage).
Phase 2; The child learns to generalise exchanging  a single picture in different environments, with different people and at different times  (consistency is important.  Mammy can't say "No dear, you can't play with guns" if Daddy says "Yes, son, have a fully loaded semi-automatic.  Go shoot badgers").
Phase 3; The child learns to discriminate from two or more pictures to request their favourite thing.  The pictures are stored in a binder using velcro for access when required ( the badgers are off having PTSD therapy at this stage).
Phase 4; The child learns to form simple sentences, usually using an 'I want' picture followed by a picture of the desired item  (now he wants Nutella. The badgers feel rejected).
Phase 5; The child learns to answer simple questions  ( the badgers, in an exciting plot twist, resolve their abandonment issues and use their new-found dancing skills to court fame in the next production of Riverdance).

PECS was developed in the 1980s when Lori Frost and Andy Bondy wanted to upgrade autistic kids from using a  teacher/carer led communication style to a child-led approach.  They capitalised on the strong visual learning styles typical of autism, and advocated the use of reinforcers to cement the behaviour.
These reinforcers are gradually pared back, and at a later point the child is introduced to the difficult concepts of "no" and "not yet".
PECS is revolutionary in that it aims to teach the autistic child to initiate communication.  This is a game changer because it shifts the focus from 'training' our kids to meet social demands and become compliant and 'well-behaved'.  It helps to change the view of our kids as feral creatures that need to be tamed, and nudges society to realise that they are individuals in their own right, with their own needs and opinions; PECS, for the first time, gives many of our kids a voice to express this.

My son had no speech until the age of 4, and until then we were using PECS to help him tell us what he needed.  Some people worry that using pictures will somehow make our kids lazy about using speech, but in our experience the opposite is true.  It opened our boy's eyes to the advantages of using words, and we were able to stop using PECS about a year after this. Research shows mixed results when analysing the effectiveness of PECS; some papers show modest effectiveness that is not maintained after the intervention is stopped, while others show that kids tend to use more spoken words after treatment.  My experience is that it's positive, it works and it empowers your child (hopefully with the added bonus of reducing melt-downs and dangerous behaviours as they are less frustrated).

PECS is great in that it's  cheap (there's loads of free resources online), easy to use and adaptable;  new pictures can be added constantly, and written words can be used for the readers.  It's also not exclusive to autistic kids and is effectively used for people with a broad variety of problems, such as deafness, physical impairments and other cognitive disabilities.
However, it's  cumbersome (as the child needs to carry an ever-expanding ring binder with him/her)  and lacks a cool factor that older kids might seek.
PECS has probably been largely eclipsed by apps on smart phones, but it's still valuable for younger kids, and worth it's weight in gold for teaching the to-and-fro of conversation.

It'd be worth looking around for training days to learn how to do it properly (lots of schools run these locally) but I think I've found the perfect request strip for those days when I'm just too tired to speak.

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