Visual systems (PECS, visual timetables, etc.) are widely used, and are very helpful for autistic visual thinkers both to understand what’s going on and to express themselves.
Picture Exchange Communication System (PECS) was developed by Dr Andrew Bondy, a psychologist, and Lori Frost, a speech and language therapist in the Delaware Autistic Program, to help individuals with autism and other developmental disabilities acquire communicative skills. This system is based on principles of intentional communication and visual aids in development of communication. Though these principles had been worked out long before PECS was introduced, PECS presents them as an augmentative/ alternative training package, to be used with children and adults with autism and other communication disorders in a systematic and prescribed way. The fundamental principle of the system is to teach children communication (not just language) from the very beginning. The main techniques used are identification of reinforcers to motivate a child’s communication (usually food, drinks or favourite activities), prompting, shaping and fading. Advantages of PECS and its differences from other pictorial systems of communication are:
- from the very beginning the interaction is intentional. (Children are taught to express their needs to adults who then meet those needs;
- it is the child who initiates the interaction;
- communication is functional and meaningful.
As the main goal of this approach is to teach spontaneous communication, direct verbal prompts such as ‘What do you want?’, ‘Show me what you want’ and ‘What is it?’ are avoided. From the very beginning children are taught such social and communicative skills as to approach and interact with another person spontaneously.
Many traditional approaches start with teaching the child to label objects. The child responds only to prompts (either physical or verbal); for example, the child is asked whether he wants something or is offered to sign or point to a picture. In this case the child is taught first picture discrimination, matching pictures, vocal imitations and mastering a pointing response while communication skills training has to wait. All these preparatory exercises take a lot of time and often are meaningless to the child. The child can learn to point to something he wants even if no one else is present to respond to his communicative attempt. Or the child can learn to answer questions such as ‘What is this?’ or respond to ‘Point to…’ ‘Show me…’ without any understanding of what it is all about.
There are several stages of introducing the PECS method, each stage building on the previous one. PECS has been proved successful for those who either do not use (and/or understand) speech or are echolalic. However, like with any other approach in autism, PECS doesn’t work for every child.
PECS works with those whose visual perception is reliable. Individuals with visual processing problems may merely see the cards as something to flap, chew or flick. Some can memorise pictures and words but may find it difficult to relate the 2D image to objects because they remember things using other senses (movement, smell, sound or taste). Some with severe visual perceptual fragmentation may not see whole objects. So the development of the ability to think in pictures (as opposed to fragments) is like colour to the blind (Williams Undated).
Visual communication systems can take various forms – objects, photographs, pictures, drawings. These visuals make it easier for autistic children not only to orient in the world around them but also to comprehend such concepts as time, sequence of events and abstract notions. For instance, a visual timetable is a way to show a sequence of activities in the classroom. It helps the child to see the predictability of forthcoming events and/or changes, and consequently helps the child cope with changes, reduce stress and increase independence.
Visual systems make the process of understanding and expression easier and, what is more important, help children communicate with intention (in contrast to just parroting words and phrases they can say which have no connection to what they want to say).
The decision of which visual system to use (objects, photos, pictures, written words or a combination of these) depends on the child’s inner language (https://integratedtreatmentservices.co.uk/blog/autism-speak-language/ ) and his level of understanding of a symbolic/verbal language.
Different types of pictures may be more or less meaningful for a child. One must experiment to see what works best. For example, some children find photographs easy to understand, others find them too literal, representing only the object that is on the photo and no other object, then pictures or drawings should be tried. However, line-drawings may be confusing to some children, for instance:
“At around the age of nine, I began to recognize pictures far more, although not line drawings because that’s all they looked like – lines. I didn’t interpret them and when I finally did it usually wasn’t what they were trying to represent. The PECS symbol for play that involves two figures with hands throwing a ball between them was, to me, a spider… The picture for dinner looks like a face with a black eye” (Williams 2003).
One must remember, however, that existing visual systems are limited and cannot allow the child to make complex sentences and express complex ideas. Another limitation of visual systems is that the child must always carry them with him, and if access to them is difficult it may result in frustration.
Whatever visual system is used, it is important to combine it with a written word, to develop the child’s understanding of written language.
This is the explanation of the power of written language by Naoki Higashida (he was 13 years old at the time):
“As I write, I’m recalling what I’ve seen – not as scenes, but as letters, signs and symbols. Letters, symbols and signs are my closest allies because they never change. They just stay as they are, fixed in my memory… Letters and symbols are much easier for us to grasp than spoken words, and we can be with them whenever we want.”
Sometimes teaching autistic individuals to read and write can bring a real breakthrough in communicating with them. Many autistic individuals find their voices in their writings.
Higashida, N. (2013) The Reason I Jump. Sceptre.
Williams, D. (Undated) Not Thinking in Pictures: www.donnawilliams.net/new2/page5.html .
Williams, D. (2003) Exposure Anxiety. Jessica Kingsley Publishers.
Written by Olga Bogdashina on behalf of Integrated Treatment Services