Tuesday, July 24, 2012

Goin' Old School

You know how technology just keeps moving forward and all these electronic devices just keep getting better and better?

Well, things are just a little bit different at the Rush house these days.

 For the past year or so, Lily's behavioral therapists have been attempting to use an iTouch and the Proloquo2Go app as Lily's main means of assistive communication.  And while there have been vast improvements in her ability to "talk" with the device, the missing ingredient still seems to be plain and simple functional communication.

As in, grabbing the device spontaneously (with no directive from an adult) and using it to say something like, "Drink" or "Cookie" or "Potty".

She is a whiz at scrolling through and finding all kinds of stuff on the iTouch but hasn't seemed to yet grasp that when she needs or wants something, she should get the device and use it to tell us exactly what that is.

Or at least, she's not doing this at home.  

So we're going back to what we know works.  Or worked at one time, maybe I should say.

Before the iPad, Lily was using something called PECS, or a picture exchange communication system. 

In a nutshell, PECS is an alternative form of communication that uses pictures rather than words to help individuals "talk".  For example, when given a stack of pictures of food items, the person can flip through them, make a selection, and then be given the actual object in exchange.

We're using the door of our coat closet as "PECS Central".


Setting up PECS requires just a few supplies:

lots of sticky backed velcro,


a small laminator,


and all the pictures you can think of.


I haven't put labels at the top of the columns yet but I usually try to organize my cards into categories such as food, routines, and play.  The top half of the door displays all the cards:


The bottom half of the door has strips ready for arranging the cards for specific purposes, such as:


long strips to indicate steps in a routine,


a First Then card that allows Lily to see that when she first does a less desirable activity, then she gets to do a more preferred activity,


and a Choice Board containing a few Mom-approved activities that Lily can choose from.


We did a PECS system with Lily back when she was two and it actually worked well.  She caught right on to the idea that giving me a picture card meant that she would get the real object in exchange.

While this system has its drawbacks, I'm hoping that it enables us to get back to basics with Lily and reaffirm for her that pictures can help her get what she needs and wants.  Once I feel like she's really got a good handle on the meaning behind the pictures and is using them functionally and comfortably, we'll try transferring the concept digitally with apps such as First Then, My Choice Board, and other PECS-type assistive programs.

Simple and straight-forward.  That's the goal.

Anyone got other ideas for me?  Please share!



26 comments:

  1. We found the IPAD to be too much for our daughter. She never grasped the concept. We had trouble with PECS too. It was much easier for her to go to the cabinet, sign more, and point (scream) for the cookie!

    We are retrying the PECS system now. I think we (the parents) were not using them properly. They are going to try it in her school program and then tranisition it home.

    Good luck! I love the idea of the closet door for choices, rather than the book. Boo used to just flip thru the pages. Thanks for the ideas.

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    1. Since I've heard from several of you interested in doing PECS, I think I'm going to do Friday's post on it as well. I'll go into a little more detail of how we did it the first time around because we really experienced a good deal of success with it. We only moved on because we thought the technology would be better and Lily was so captivated with the iPad - but I think it's kind of backfired on us. I'm expecting the PECS to work well again - we'll see!

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  2. Wow! You have got a SETUP! I really hope that the back-to-basics approach works for you.

    We tried some PECS, but Little Miss tends to hoard the cards and not use them for the intended purpose. The only way we could use the cards was if I controlled them -- and that kind of defeats the purpose, doesn't it?

    Again -- good luck -- and keep us posted!

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    1. Thankfully, Lily's not a "hoarder" and "bag-filler" like LM is so she doesn't feel the need to collect all the cards. I have to tell you, it feels counter-intuitive to "go backwards" to all these PECS cards floating around the house but I just think Lily hasn't connected with the iPad as a means of communication. She's certainly connected to it in other ways - fun, a reward for ABA tasks, etc... and that makes it even harder to get her to focus on using it as a tool rather than a toy. Plus, Proloquo2Go is just too much - nonverbal adults can use it which means I spend the bulk of my time deleting all the stuff she doesn't need on there to make navigation easier. Which means I just need to start with something easier when we go back to using the iPad for talking.

      UGH! Do you think things will ever just get EASIER???

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  3. Have you thought of a simple commication board like the GoTalk or the EasyTalk? I am a middle school special ed teacher. We have a simalar PECS setup on the back of the door leading outside. One of my students uses the elaborate PECS on the door and another uses a GoTalk. Two others use picture schedules and squence strips.

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    1. I have some single GoTalks and a 4 choice GoTalk. That's what we'll move to next. And with Lily starting school (kindergarten) in the fall for the first time ever, I'm hoping that their resources will offer some choices we haven't discovered yet and we'll hit on something that works. Functional communication is going to be a major part of her IEP.

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  4. Thank you for posting this today! I am in the process of making a felt communication board for my non-verbal two year old at our Speech Therapist's suggestion. He likes the iPad games, but we haven't found a way to aid his communication to his development level. I love your setup and will be showing it to our ST at our next session. Keep up the good work!

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    1. Are you on Pinterest? There are TONS of ideas for PECS on there. All kinds of ways to set it up, store the cards, make it look cute and functional, incorporating the cards into visual schedules, etc.... You name it, you can find it there. Let me know if you're not on Pinterest and I can send you a link to how it works and help you get started. :)

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    2. Hi ! My son uses Pecs and a visual schedule at school... but I'm wanting to make him one at hime.. with daily / weekly schedules from getting ready in the morning to after school routines and bed... but i have no clue how to get the Pecs pictures. Help!

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  5. Just out of curiousity... because the PECS are on the back of the door how do you use them while out of the house? I am thinking of doing a similar setup for one of my clients(I am a speech therapist)

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    1. And therein lies one of the things that makes PECS not ideal - travel. There are notebooks you can purchase for carrying the cards in but they're bulky and inconvenient.

      What I'm going to do - put the cards on key rings. One key ring for food, one key ring for out of the home activities, etc.... That way, if we're out and it's getting close to lunch time (for example), I can hand Lily the ring of food cards and let her choose what she'd like to eat. If we're running errands, I can show her the ring of cards that shows where we're going. If we're going out to do something fun, I can give her the ring of outside the home activities and let her choose the bouncy house place or the playground.

      I'll hang the rings on my purse strap so they're accessible in the car as well as in stores, etc... I'll also travel with the minimum cards possible - just ones I think we'll really need. It limits her choices but most of the time, when we're out, our choices are limited anyway.

      Make sense?

      Obviously, this is one of the drawbacks to PECS as opposed to an iTouch or iPad. It's much easier to have one device and just pull up what you need rather than have all these cards floating around. But Lily just hasn't made the connection yet that she can use the iPad to make requests like she can with the picture cards. To her, the iPad signals play or free-time or the reward for doing ABA tasks. And she can do very therapist or parent directed communication with it as well, just not spontaneous communication on her own. YET! We'll get there....

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  6. A good app to ease into the iPad with that is PECS like is My First ACC. It costs $24.99

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    1. I've seen that app but haven't really looked into it yet. We own Proloquo2Go which everyone seems to think is the cadillac of assistive communication apps and I agree but it's got SO MUCH STUFF that it's almost overwhelming to navigate through. I've gone through and deleted so much stuff in an effort to simplify it - which means I need something simpler to start with, to my way of thinking!

      I'll definitely check out My First ACC - thanks for the info!

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  7. Thanks Lana! It does make sense

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  8. I just got an email from www.especial needs.com. They're having a closeout sale on various items. I noticed they have some notebooks, etc., designed for the PECS system. I didn't know if anyone would benefit from this as a portable system may be handy for those times when your away from home. There may be a cheaper method, but, the price is a sale price. Hope this can help someone. :)

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  9. Of course, I just noticed your post about them being bulky...sorry! I've used key rings with cards too when we've had foster children with communication difficulties. Next time I'll read all the posts before commenting!!

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    1. Don't feel one bit bad about letting us know about the sale on the binders! I have 2 of them myself! Even though they may not be my favorite thing, someone else may love them! And it's always good to know when useful things are on sale! So thanks for the comment - and thanks for sharing! :)

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  10. We are having some communication issues right now when it comes to making choices. I'm thinking of pulling PECS back out. If I did it on the door like you are doing, I think it would be much easier than digging around in the binder we were using.

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  11. Hi! I just found this post through Pinterest. Since your daughter is used to using this board and PECS, have you thought about putting the Easy Talk (or IPod touch or whatever you have) on the closet door along with the rest of the PECS symbols. Maybe have it replace two or three of the PECS since she's used to grabbing "drink" for example, she can grab the iPod which would have the drink symbol on it. Then after a few days change it to a different symbol on the iPod. Get her used to grabbing the iPod just as she would grad the paper symbol. Then maybe she could move on to useing mor espontaneously. Just a thought.

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  12. I'm with John and Allie, we HATED the binder. What worked for us was similar to the closet door, but instead of all in one place we have mini "PECS central"s all over. The bathroom has has all our bathing, toothbrushing, etc. routines, the kitchen has foods, the basement door has play stuff, you get the idea. It helped when my son started climbing the dishwasher to get to the cups when he wanted a drink. I could grab him in one arm and the picture in the other and reward him right away. If he needs something at dinner, he doesn't have to leave the room to ask. It just works better for us. (We use thin cutting boards hung on 3M coat hooks so we don't have to mark up our walls in every room.)

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  13. Hi. I just came across this post through Pinterest. I am an elementary school student support services teacher. Have you heard of MyVoice? It is by far the most superior product I have seen. http://www.ctvnews.ca/new-app-helps-those-who-can-t-speak-to-be-heard-1.628048
    Definitely worth a look.

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  14. Do you happen to have any websites that offer free PECS pics? I have been looking for a couple days as this is something that I would like to use with my 6 year old Autistic son, but haven't had much luck. Just wondering if you knew of any sites. Thanks! : )

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  15. I have been looking for pictures that are real and not just the stick drawings like most PECS systems. Where did you find these?

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    1. I just take pictures of REAL items and slap them onto a template, print, laminate, cut, and velcro them myself. It is totally worth the effort. This way I get exactly what I want every time, without countless hours of searchingredients online

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  16. hi they look nice,,.can u plz share d pictures on email???

    ReplyDelete

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