Parent Support University: Week 13

June 24, 2020

AnswersNow Chief Science Officer, Adam Dreyfus, speaks about Picture Exchange Communication Systems as a part of the Parent Support University series.

Transcript:

Speaker 1 (00:02):

Hello AnswersNow, friends and family. I am Adam Dreyfus, chief science officer, and co founder of AnswersNow. And your host on these weekly parents support universities. What we are doing here during the pandemic is we're trying to demystify all of those terms and clinical terms that you hear as you sit in IEP meetings, as you get assessments cause the whole goal of AnswersNow is to reduce the barrier of entry to all of this information to parents and caregivers. It's just ridiculous here in 2020 that parents and caregivers are so stressed out, so overwhelmed and really so isolated when it comes to caring for their child who is diagnosed or adults who's diagnosed with autism if you just kind of get online and the type of way they would have you think that we don't know what we're doing and there's not a whole lot of stuff and everything's new and we're not sure what causes it.

Speaker 1 (00:55):

And that's true. We don't know what causes autism, but we absolutely do know how to educate individuals diagnosed with autism. We've got 30 years, 40 years or so of really great research, hundreds and hundreds of interventions. And so about 10 years ago, eight years ago, a couple of universities sorta hit pause on all the noise and it's like, well, listen, what, what did we just know? What did we just know that we can tell people works? Right? There's always going to be new stuff. There's a lot of new research coming in, but we can just say here, this is a box of stuff that just works today. We know it works. This is how it works. And so they identified about 25 evidence based practices. And that's just a fancy way of saying this works. So here at AnswersNow I am walking through all of those evidence based practices on a week by week basis.

Speaker 1 (01:44):

And just unpacking a little bit explaining what they mean. I'm giving you some tips on how they might work. And we're on our 16th one today. It's hard to believe that it's been 16 weeks. We'd like to give credit where credit is due. All of this stuff was put together by the National Professional Development Center. And what they did is they built these afirm modules. And you can find them here at this website, afirm.fpg.unc.edu. And each module takes, I don't know, an hour and a half, two hours to complete their free. You can do them on your own time. They probably want to, if you have no experience with them be talking to somebody who has a little bit more experienced, cause they're still pretty technical, but they're, they're about as good as it gets.

Speaker 1 (02:32):

It's like a little how to help somebody with autism university. And so they're thus parents support university. You can find out more about us at getanswersnow.com. We are also a downloadable app. You can go into your Apple store or your Google play store and type in AnswersNow my little whiteboards. So we, you can find out more about us at getanswersnow.com or go into your Google play store and just type in AnswersNow don't put in a space, it confuses the system for some reason. So we've gone over all kinds of evidence based practices so far and today's is going to mirror in a lot of ways. One that we've done visual schedules. I know that the PECS folks will get upset at me for saying that PECS is not a visual schedule PECS.

Speaker 1 (03:29):

When I keep mentioning this PECS picture exchange communication system, I dunno, I peek out from behind. They're like, I do know what's written on that. I wrote it. I know what it says. I just want to make sure you can see it. That's that's, that's the goal here. So picture exchange communication system, this was developed by Laurie Frost and Andy Bondy. And if you are interested, they are prolific presenters. So you should go to PECSusa.com. If you want to find out more information about them, they've got tons and tons and tons of free information on pecs as well as their schedule. It's a wonderful thing. I've seen, I've been to probably half a dozen of them. And it's always great to see parents there cause it's hugely useful.

Speaker 1 (04:17):

Cause the parents main concern, especially if communication is really impacted by their children and I don't know what they want. Right. They're sitting on the floor, the crying they're screaming. Do they want a cookie? Do they want a notepad? Do they want me to play with them? I have no idea. And so there's a lot of misconceptions about PECS. I'm going to talk about that a little bit. People think that it's just a picture system and if you hear dr. Bondi present he is really, really clear. It is a communication system. It's not just pictures where the kid gets to pick the Skittles. There's six phases to PECS. That's why it's a highly recommended that if you decide to implement pecs or frankly, if somebody is implementing pecs with your child, like they say, Oh, Hey I think the, your child can use some pecs and they explain it to you and they tell you what you're gonna, they're gonna do.

Speaker 1 (05:12):

You should ask, do you have training in this? Cause most people just do phase one of PECS phase one, a PECS is I got a picture of something. And then I exchange it for the thing that I want. And usually you start out with food or some really highly preferred item. So like their Teddy bear, you have their Teddy bear on a table, they reach for it. You hand them the card that has a picture of a Teddy bear on it. They're supposed to hand it to you, then you give them the Teddy bear. It takes a little while for kids to learn this, but not all that long. Like, all right, I just have to, there's a little interruption and me getting exactly what I want, which is a lot of what ABA does is we interrupt their normal routines and try to build language and social skills in there.

Speaker 1 (05:51):

And that's really what it is. So what they're taught to do is, Hey, if I want my bear a muffin, eggs some time with mom, whatever I hand over the picture and I get it. And that's just, that's pretty, that's kind of the prerequisite skill for the rest of it, but a lot of folks just stop on that. They're like, Oh, this is great. Look he'll know. I know what he wants. Sort of in phase one, phase two is generalizing and that's mostly, you're just kind of wandering around the world. So you know, if they're asking for a glass of water, you want to do that near a sink. If they're requesting some kind of food item, it's probably best to do that in a kitchen. Cause that's where most of the food is. If they're requesting to splash in the bath, you want to be standing next to the bath, if you can.

Speaker 1 (06:32):

Cause context is huge, right? We spend a lot of time and you probably see it a lot. When the folks come into your house to work with your kids is they're sitting at a table doing a lot of flashcards and that's really efficient. You can get through a lot of information that way, but generally lacks context, right? Like yeah, here's a picture of a horse and you're sitting at a table in a room picture of a horse at a farm would be would make a lot more sense because you can't really underestimate the power of context to QS into the, the meaning of language and why we're using certain words in certain situations. And then phase three and yeah, you see me glancing down to my right. I'm looking at my cheat notes. I've, I've taken a bunch of times, but I don't remember all the names all in order is a discrimination.

Speaker 1 (07:21):

So you go from one card to several cards. So you know, you see these in kind of notebooks, sometimes that the kids carry that have lots of PECS cards in them. You want them to be able to discriminate, to select, you know, a banana card as opposed to a PlayStation card if they want a banana. So that's a simple discrimination. You we call it kind of adding the field size field is like how many things they have in front of them from one to two to three, to some of these notebooks have hundreds of things and the kids discriminations are incredible. Then you start working on sentence structure, usually with I want something. So we call that a main, a request of some kind. So you're trying to expand their language out a little bit and build out sentences.

Speaker 1 (08:10):

So instead of just one word Pec responses, you're getting multiple word Pec responses phase five is you see if they can kind of answer questions. And again, you're just expanding functional language out. And then phase six is commenting, right? You're a, you're having them comment on things. So they're not necessarily responding. They're not just answering the question. They're trying to sort of use language to make comments about the world super important point here. The point of PECS is to result in verbal like vocal talking communication, most kids, well, most probably not the best word. Quite a few kids that are nonverbal end up talking under. If they run, if they happen to be fortunate enough to get a, a really good ABA therapist or really good speech therapist, or even really good occupational physical therapists that understand the power of context and how to promote language using motivation.

Speaker 1 (09:14):

And so one of the theories behind why kids don't speak is they don't see the function of language. They don't make that connection like babies and toddlers. Do they make that connection? Oh, I make a sound. Something happens, right? Mom shows up, I make this sound, mom shows up with a bottle. I make this sound mom shows up with my pinky. And so you are super motivated to learn as much language as possible because it gets your needs met and it gets your needs met in ever increasing levels of specificity. So for example, I pull up to a Starbucks and they say, what can I get for you, sir? And I say coffee, and I pull around and they gave me a coffee, but what I wanted was a double frothy latte with vanilla and nonfat milk, but I don't, I didn't have those words.

Speaker 1 (10:04):

The only word I had was coffee. So I get my coffee and I'm like, that's, that's not what I wanted. And so the, what languages was, what increasing your language from one word to 10 words to 20 words is lets you refine exactly what it is that you want you to get exactly what you want. You go into a restaurant and you say food and they bring you a plate of mashed potatoes. You don't like mashed potatoes. You say, hell no, I like, I like the steak, medium rare with the Bearnaise sauce. I don't want the asparagus cause I don't like asparagus very much can I get broccoli with that. Oh, perfect. And for dessert. So you see what I'm talking about, expanding language is always a, the key. So packs, even though it is picture exchange, communication is done within the context of, we want to get this kid talking, why most people talk, right?

Speaker 1 (10:52):

You want to give somebody the tool that most people have access to with the least amount of training. This is why sometimes people are resistant to teach, sign language, cause they're like not many people teach no sign language. So if you walk up to someone and you know, you're doing sign language and they don't know it, it's not functional communication. It's not serving a function for you. I disagree wholeheartedly. If a sign language is what they are running with, then you run with a sign language. I wouldn't do, what's called the multimodal approach. If I could help it where you're teaching, like sign language and pecs and vocal stuff all at the same time. It's better to pick one and focus on it for a little while. I'm not crazy opposed to the multimodal approach.

Speaker 1 (11:40):

It's just a, I think it, if someone's having trouble with something and you're trying to get them to do it like, Hey, I'm trying to teach my daughter how to ride a bike and she's struggling with that. I don't necessarily think it's a great idea to say, let's try it to do a unicycle and a bike and a Pogo stick and see which one works. And which one works better. So six phases, very important pecs, hugely, hugely useful. Don't give up on it if you're having trouble with it. If you do have somebody working with you that is using the picture exchange communication system, ask them how much training they've got. It is a fairly complex server instructional delivery. There are six phases. There's very structured ways to go about doing each phase.

Speaker 1 (12:30):

There's a lot of training that goes into, when do I go from phase one to phase two, phase two to phase three and so forth. How do you troubleshoot if you're having problems? So Def and I also want to mention, like I showed up, showed this and this Tobi, what does that mean? That's kind of another kind of pecs. It it's usually it's like a, what it looks like Tobi is they try to make it look exactly like the thing. So a PECS card is literally a card with a picture on it. But a Tobi is like, looks like a banana. It's like a banana cut out, basically. It's like a PECS card cut out, but you might hear that sometimes people be like, Oh, did you try Tobi, Tobi what's Tobi.

Speaker 1 (13:19):

And so it's it's another form of visual a card. So definitely credit where credit is due Lori frosted, an antibody invented pecs. You definitely want to go to PECSusa.com to check it out. Cause I got free downloads, free resources, especially right now they've got stuff around the pandemic around washing hands around wearing a mask. Cause a lot of these kids are like, what is going on? And one of the absolute strengths of most kids on the spectrum and adults is they have very strong visual skills. That's why they tend to be really good at matching and a lot of visual discrimination. And so pecs picture exchange communication system is right up their alley. I want to remind you, I'm Adam Dreyfus. I'm the chief science officer of AnswersNow. What is AnswersNow ? AnswersNow is a mobile app you download on your phone and it connects you directly to a clinician.

Speaker 1 (14:12):

So you get to sign up and you basically, it's just a subscription to your own clinician. We're going to be taking insurance soon. So definitely check us out at, getanswersnow.com. I got my cards here getanswers now.com. And you can download us off of the App store for free. We've got all kinds of blogs stuff. We've got communities. We've got a lot of ways that you can interact with us. The main way though, being is that you can video chat, talk to your own board certified behavior analyst. You can either do that as a one off, like just sign up and say, Hey you know, I want a 20 minute conversation cause I have some questions about a specific thing. Or our kind of our main offering is an extended month by month subscription.

Speaker 1 (14:56):

Kind of like you know all the doc in a boxes where you can call your doctor whenever same thing you can connect to your BCBA. Even if you got ABA stuff. A lot of our folks have ABA services, but the parents kind of want their own, you know, seven day a week access to somebody. So thank you very much for listening. I hope you and your family are doing well in these very loopy times. I'm Adam Dreyfus check us out at getanswersnow.com and have a great day.


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