Reported advantages of PECS are few prerequisite skills (e.g., eye contact, oral motor skills) are required, it is inexpensive and the pictures are easy to create, and strategies to teach generalization of behaviors are programmed into the intervention ( Bondy & Frost 1998 Ganz et al., 2008 Garfinkle & Schwartz, 2002). Phase VI: Responsive and Spontaneous Comments is focused on vocabulary expansion and responding to adult questions (e.g., “What do you see?” and “What do you have?”). In Phase V: Responding to “What Do You Want?” the child responds to an adult's question by selecting the appropriate symbol. In Phase IV: Sentence Building, the child selects present and nonpresent items by selecting multiple symbols together on a sentence strip (e.g., “I want + object”). In Phase III: Picture Discrimination, the child selects preferred and nonpreferred items from an array of symbols. In Phase II: Expanding Spontaneity, the variety of communication partners and the distance the child must travel to request a preferred item increase (i.e., programmed generalization). In Phase I: The Physical Exchange, the child exchanges a picture to request a desired item, and physical prompts are used to guide an exchange with an adult. The PECS training protocol consists of six phases. It is a low-tech system consisting of pictures that are exchanged with a communication partner. PECS was originally developed for nonverbal children with ASD to teach spontaneous, functional communication via symbols or pictures ( Bondy & Frost, 1994). PECS is considered a promising communication intervention for children with ASD based on recent evaluations of studies conducted by the National Autism Center (2015).PECS Instruction for Children With Autism Recent reviews have documented the effectiveness of one type of AAC system, the Picture Exchange Communication System (PECS Bondy & Frost, 1994), for individuals with autism spectrum disorders (ASD) ( Flippin et al., 2010), with the most positive outcomes evident for preschool age children ( Ganz, Davis, Lund, Goodwyn, & Simpson, 2012). Over the past few decades, investigations of augmentative and alternative communication (AAC) interventions for young children with complex communication needs have revealed positive gains in requesting behaviors, vocalizations, vocabulary, and, for some, spoken communication ( Bock, Stoner, Beck, Hanley, & Prochnow, 2005 Flippin, Reszka, & Watson, 2010 Ganz, Simpson, & Corbin-Newsome, 2008).
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