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A Review of the Efficacy of the Picture



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J Autism Dev Disord DOI 10 1007 s10803 009 0763 y ORIGINAL PAPER A Review of the Efficacy of the Picture Exchange Communication System Intervention Deborah Preston Mark Carter Springer Science Business Media LLC 2009 Abstract The Picture Exchange Communication System PECS is a communication program that has become widely used especially with children with autism This paper reports the results of a review of the empirical literature on PECS A descriptive review is provided of the 27 studies identified which included randomized controlled trials RCTs other group designs and single subject studies For 10 appropriate single subject designs the percentage of nonoverlapping data PND and percentage exceeding median PEM metrics were examined While there are few RCTs on balance available research provides preliminary evidence that PECS is readily learned by most participants and provides a means of communication for individuals with little or no functional speech Very limited data suggest some positive effect on both socialcommunicative and challenging behaviors while effects on speech development remain unclear Directions for future research are discussed including the priority need for further well conducted RCTs Keywords Picture exchange communication system Augmentative and alternative communication Autism Introduction Serious deficits in communication form part of the primary diagnostic criteria for autism American Psychiatric Association 2000 It has been estimated that around D Preston M Carter Macquarie University Special Education Centre Macquarie University Sydney NSW 2109 Australia e mail mark carter mq edu au one third to one half of children and adults with autism do not have functional speech Mirenda 2003 Such individuals may show only pre intentional communication such as reaching for a desired item or communication may demonstrate intent through behaviors such as alternating eye gaze and conventional gestures such as pointing Yoder et al 2001 Communication may



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