Picture Exchange Communication System (PECS) or Sign Language: An Evidence-Based Decision-Making Example

I chose this article because it uses a 7-step decision-making process with three hypothetical students in order to determine whether each student should use PECS or Sign Language as a communication intervention. The decision-making process outlined for the three hypothetical students with ASD is evidence-based. 

Here are the 7-steps in the decision-making process: 

1.) Develop the Parameters to Guide the Search for Evidence: 
- This step is used to answer a specific question or solve a problem. A child's characteristics, intervention or practice and the outcome you want through intervention to occur should all be listed under this step. 

2.) Search for Evidence: 
- This step is used to search for evidenced-based research that covers the intervention you are thinking of using. Ultimately, you want to find research studies that involve students that are similar to the one that you are determining the intervention for and covers the desired outcome that you are wanting. 

3.) Evaluate Each Study for Quality and Summarize Findings: 
- Teachers must determine whether the research studies they find are "high-quality" based on similar standards that we are currently using for our own research studies. However, this process needs to be short and simple for teachers as they do not have extensive time for this step. Spencer, Peterson, and Gillam (2008) give three questions for teachers to follow in order to determine if the research study is "high-quality". 
     1.) How strong is the relationship between the intervention or practice and the outcome? 
     2.) Is the effect replicated across multiple individuals? 
     3.) Can alternative explanations for the outcome be ruled out? 

4.) Consider Student and Family Factors: 

- Teachers need to consider several factors with the child in order to help guide them to which intervention would be more effective. Some factors include, the child's fine motor abilities, independent vocalizations, and matching and discriminating between graphics, symbols, and pictures. Teachers also need to consider a few family factors such as willingness to utilize the chosen intervention as well as how involved they are in the decision making process for their child's education and interventions. 

5.) Consider Teacher and School Factors: 

- Teachers need to determine how likely they are to utilize the chosen intervention, school policy with communication interventions, and can all members of the child's team support and utilize the communication intervention. 

6.) Integrate the Evidence: 

- Based on the research evidence and the child's ability levels, teachers can then determine which communication intervention is the best "fit" for the child. 

7.) Monitor the Outcomes: 

- Teachers need to maintain an accurate data log of the child's progress throughout the intervention cycle in order to determine if the chosen intervention is working for the child. 

I found this article to be extremely helpful for my own decision-making process with students that I work with. Although I will be using a randomized selection process for my research participants, I will utilize these methods for students that I work with in the future. 

References:

Spencer, T. D., Peterson, D. B., & Gillam, S. L. (2008). Picture exchange communication 
        system (PECS) or sign language: an evidence-based decision-making example. 
       Teaching Exceptional Children, 41(2), 40-47. Retrieved from 
        http://search.proquest.com/docview/201172195?accountid=166077

Link Link to the Article: 

           Unfortunately I cannot provide a link to this particular article as I got it from the BACB database through my supervisors login and it does not allow me to Permalink the article. If anyone is interested in reading this article let me know and I can send you the PDF format. 

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Language Outcomes in Toddlers with ASD

I chose to read this research article because I was curious about language deficits in one and two year old children with autism. Researchers took 37 children with autism, ages 15-25 months, and followed them for a two-year period. They focused on three main language area deficits, which are: expressive language, joint attention, and responsiveness to speech. It is no surprise that the researchers found that there was a higher rate of vocabulary growth in the children that had more verbal imitation skills, joint attention, and words at baseline. They also found that the best predictors of verbal acquisition at 3 years of age happens at 18-24 months, which were requesting, receptive language, and number of consonants the child can sound out. After the 2-year follow-up visit, the researchers found that 54% of the participants were considered to have "good" language.

After reading this article, I learned that I may see more language acquisition growth in some of the participants that may have more of the verbal language communication skills described in this study (e.g. joint attention, requesting, etc.).

Here's the link to the article:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946084/

Reference: 

Paul, R., Chawarska, K., Cicchetti, D., & Volkmar, F. (2008). Language outcomes of toddlers 
       with autism spectrum disorder: a two-year follow up. National Institute of Health 
       Manuscript, 1(2), 97-107. doi:10.1002/aur.12.

Comparing PECS vs Signs

I chose to read this particular article because it reflects the research study that I will be doing in the Spring. The study focused on comparing sign language and the Picture Exchange Communication System (PECS) effectiveness of children with autism acquiring verbal manding, or requesting, behavior. Researchers took two school-aged children with autism (one boy and one girl) and used an alternating treatment design with two phases (baseline and "best-treatment").

The procedure involved assessing the two participants for preferred items, imitation skills, and baseline in verbal language ability. Next, each participant was trained in Sign Language and PECS alternating for 15 sessions then switched to the other treatment for the next 10 sessions and finally used the "best treatment" design for 5 sessions.

The results of the study were very interesting and differed for both participants. Participant A (Carl) responded better to Sign Language, increasing verbal mands by 38%. Participant B (Jennifer) responded better to PECS, increasing verbal mands by 95%. The parents were interviewed at the conclusion of the study and stated that they thought their children's communication skills improved, however they did not like the alternate treatment design of the intervention.

I gained a few ideas by reading this study. First off, my initial idea of not implementing an alternative treatment design was a good choice as this study stated, it would have been more effective to only teach one method. Secondly, I learned that I need to do an interest inventory of the 5 words that I will teach my participants in order to ensure they are motivated (e.g. for "ball" find out if there is a particular ball that each participant enjoys. Overall, I really enjoyed reading this study and found it very helpful for my personal research purposes.

Permalink:

https://ezproxy.western.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14239117&site=eds-live

References: 

Tincani, M. (2004). Comparing the picture exchange communication system and sign 
       language training for children with autism. Focus on Autism and Other Developmental 
       Disabilities, 19(3), 152-163.