The relevance of family engagement in the implementation of the Picture Exchange Communication System (PECS) in children with Autism Spectrum Disorder

Abstract

Purpose: to analyze the relevance of family engagement in the implementation of the Picture Exchange Communication System (PECS) in children presented with Autism Spectrum Disorder (ASD). Methods: a longitudinal study with a sample of 22 mother- child dyads with ASD; 17 boys and 5 girls, with a mean age of 7 years and 2 months. The Executor Skills Protocol was used. The PECS implementation program consisted of 24 therapy sessions with the active presence of mothers. The family's support was measured by the frequency of the sessions. Spearman's correlation test and a significance level of 0.05% were used. Results: mothers performed most tasks correctly in the first three phases. There was a tendency to correlation between the executor´s skills and the number of sessions in all phases of the program, and in the four initial phases, the indexes showed a statistical significance. Family compliance was 96%. Conclusion: family engagement was relevant for the appropriation of children to the PECS during the time of exposure, reaching phases of discrimination and construction of sentences with cards.

Picture Exchange Communication System (PECS) Implementation Program for children with autism spectrum disorder

“…In our study, maternal education may have positively influenced the implementation and management of the alternative and augmentative communication system (4,5,7,8,(16)(17)(18)(19)(20)(21) .…”

“…Participants age ranged from six to 12 years, and mean age was 7 years and 2 months (SD=2.1). Although most studies with PECS were conducted with participants aged between five and seven years, some comprised children aged above or below, proving that learning is unrelated to children' age and all can benefit from this alternative or augmentative communication system (4)(5)(6)(7)(8)(9)(10)(16)(17)(18)(19)(20) . In this study, we selected children older than six years who had previously received speech therapy for at least six months, so that the sample communication profile was characterized as nonverbal or minimally-verbal, making it more homogeneous.…”

“…Several studies highlight the three initial phases as primordial for a successful implementation of the system, as they boost the ability to discriminate pictures, providing independency and autonomy for children to make their own choices and adhere to the system (3,(5)(6)(7)(8)(9)(10) .…”

“…Clinical practice has shown that PECS plays a role in improving verbal comprehension by adding visual and contextual cues to verbal information and, in some cases, it even increases verbal production. However, PECS implementation must be individually evaluated, ensuring all interlocutors engagement (3)(4)(5)(6)(7)(8)(9)(10) .…”

“…Based in our experience from weekly sessions in a school clinic from the Brazilian Unified Health System (SUS), the routine use of cards can only be guaranteed by parents' engagement in this process, and family empowerment over PECS operation mechanisms is fundamental (5,7,8) .…”