Communication Challenges in Young Children with Autism Spectrum Disorder

Introduction

Young children with Autism Spectrum Disorder alongside other bipolar disabilities present with the challenge of poor communication besides poor interpersonal skills. This has been a great challenge to them as they suffer numerous adverse academic and behavioural outcomes. Children are born with the ability to learn language mostly the one used around them. This has been noted to take substantial time. However, due to varied health conditions this has not been the case as various children present with speech and communication disorders, which can be crucial to consider when seeking education dissertation help. Some children experience temporary delay in speech and language development. The distinct communication disorders are inclusive of speech disorders and language disorders.

Williams et al have defined speech as the production of specific sounds while they have defined speech disorders as the conditions that affect the ability of an individual to produce sounds that produce words (2010). The types of speech disorders include stuttering that entails the interruptions to the flow of speech. These include repetitions, blocks, and prolongations n the pronunciation of words. Another type of speech disorder has been termed as the Apraxia which defines the condition of brain damage thus impairing the motor skills of an individual thus affecting the ability to form sounds correctly (Damico et al., 2010). Dysarthria is another speech disorder due to muscle weakness in the organs and parts involved in sound formation due to brain damage. Speech disorders can be intervened for through speech therapy as well as physical exercise (Damico et al., 2010).

PECS

PECS promotes the education of students with ASD. Through the exchange of tactile object alongside objects like photographs, pictures of objects, amongst others, the children are able to earn how to communicate their desires and needs (Flippin et al., 2010). A child has been noted to learn to request for what they need or an activity that relates to a picture or a symbol that they have been exposed to. Also, the children are able discriminate between distinct request in the setting. The Picture Exchange Communication System provides children with an alternative way of communication in cases where they are yet to develop speech due to a speech disorder. It enables effective communication of a child with other entities. Besides, it is helpful for non-verbal children with limited or unclear speech (Flippin et al., 2010). Also, PECS is essential for children without functional communication system in school environment. The intervention has been fruitful with people of all ages as it has shown a varied line of communicative, cognitive and physical difficulties (Jurgens et al., 2019). Learners who have used PECS in the past have been able to effectively develop speech. In special education needs and disabilities, it includes those children who are autistic thus has a problem with communication (Flippin et al., 2010). These kinds of students have the same rights to enjoy the same education rights as those without SEND.

Learners with speech disorders face various challenges as a result of such a disability. Various interventions have seen considered to assist them. One of these is PECS. The picture examination system has been defined as a modification of applied behaviour analysis program that is designed for early nonverbal symbolic communication raining for young learners (Boesch et al., 2013). Having been used for many years, PECS was first developed at the Delaware

Children with speech disorders are unable to pronounce most words thus making it understand to understand their speech. Speech and learning disorders significantly affect the earning of the affected children. They have difficulty in not only understanding but also processing verbal information as articulated by instructors. This equally impacts the children’s ability to complete assignments as expected of them by the instructors. Such students are categorized as learners with special education needs. The Special Education Needs and Disabilities (SEND), refers to define the learning disabilities and difficulties that make learning hard for disabled children relative to other children of the same age. However, through support form instructors, the children can overcome the challenges. The children need additional assistance to learn. SEND in children can be contributed to by medical conditions or various disabilities while in other cases; it can result without diagnosis of an underlying medical condition. Students who have SEND can be noted if they have significantly greater difficult in learning than the majority of the other children alongside other young leaners of the same age group. Also, the learners can be identified if they present with a disability that hinders their usage of facilities offered for others of the same age in mainstream education centres. A disability in such children refers to a state where they have a physical or mental impairment that substantially and adversely affects their ability to undergo the daily activities. SEND difficulties can be categorized into various distinct groups. These are inclusive of cognition and learning disorders whereby a child finds it challenging to go through activities such as reading and spellings. Another condition can be difficulties in communication and interaction where a leaner cannot effectively talk to others or understanding what others are saying. Besides, SEND problems can involve physical and sensory problems that involve hearing and vision loss. Lastly, SEND entails social, emotional and mental health disorders where a child may display behaviours that demonstrate low self-esteem or anxiety. They may also display distressing behaviours. These children need various interventions that entail special education provision techniques. This basically refers to a form of education that is dissimilar to a kind if education offered to a group of learners of the same age. This is so since these students either present with Moderate learning difficulty, severe learning difficulty, profound and multiple learning difficulty or Specific learning difficulty. One of the interventions that has been considered is the PECS. This essay thus aims to explore and discuss the application of PECS for children suffering from SEND. PECS Training

While conducting the PECS training, the stakeholders are significant in identifying the new vocabularies besides assisting in the construction of various picture display symbols and nonverbal individuals with the changes to learn the new vocabulary (Burns et al., 2012).

PECS’s training is unlimited to factors such as age. However, it can be limited by other small sets of criteria. It can thus be provided to the old as well as the young. One requirement for the PECS training candidature is being an intentional communicator (Burns et al., 2012). Thus, the adult or the child being trained should be aware of the need to communicate the message to an individual. Also, the candidate needs to possess sort of personal preferences.

PECS Training Format

Phase I: how to communicate

While programming for PECS, three individuals are commenced with in the training situation. These individuals would be composed of the candidate transmitting the message, the recipient of the message and the facilitative adult that helps the candidate to make the desired response. Phase of the training session begins with enticement where the child is presented with a substance, followed by assistance by the facilitator to pick a picture for the desired item and being physically helped to give the picture to the recipient physically close to the candidate (Burns et al., 2012).

Phase II: distance and persistence

The second phase of PECS’s training involves a continuation of the exchange initiated in the first phase with trials to increase the independence of the candidate. In this phase, the student gets to learn how to remove the picture from a display board for the exchange. The student engages in more physical movement relative to the first phase. This is geared towards accomplishing the exchange (Burns et al., 2012).

Phase III: Picture discrimination and correspondence checks

The student learns to select the target picture from a collection of many pictures that are different in various aspects. In cases that the response is incorrect, error correction strategies are deployed.

Phase IV: sentence structure

Involves the student combining the object picture with the carrier phrase denoted as ‘I want’ on a sentence strip that offers the strip to the communication partner.

Phase V: answering questions

In this particular phase of PECS training, the student gets to know how to respond to question such as ‘what do you want?’ via the exchange of the strip (Michalik & Solak, 2017).

Phase VI: commenting

Being the last phase of the training, the student learns to respond to the question stated on the previous phase by clearly being able to articulate what they want (Burns et al., 2012). The phase is essential to introducing the communicator to commenting behaviour since the previous phases of the training had focused on requesting behaviour.

Implementation of PECS

While implementing the technique to SEND students, the trainer needs to use colourful graphic images, pictures that can be cut out from newspapers or magazines, actual photos, or drawing which must be accurate and simple to understand. Just as the PECS training, using PECS for SEND students is conducted in various phases (Chua & Poon, 2018). In the first phase, the trainer identifies what motivates the child the most. After that, he or she creates a picture or finds a picture of that particular object or activity in a graphical illustration or either, an actual picture of the same. S/he then introduces the picture to the child and works alongside the child to establish that using the picture can be a way of communication between the two (Chua & Poon, 2018). Also, the child realises that he or she gets what they desire by handing the card to the trainer. In the second phase, the distance between the trainer and the student is increased to allow the child learn that they need to move towards the trainer to hand in the card. Through thus, the child’s skills of seeking and obtaining attention are enhanced. In the third phase, the trainer presents multiple pictures to the student to help him or her learn how to differentiate when needing something (Chua & Poon, 2018). Through patience and perseverance, the learner and the trainer will be able to get through the phase and attain the specific goal of the particular phase. In the fourth phase of implementing PECS to SEND students, the learner is trained on structuring sentences through the use of strips. The strips are basically a combination of pictures and spoken words below, e.g., the words ‘I want’ are used alongside a picture of a banana so the child learns to request for a banana. In the subsequent phase five, the trainer is presented with the duty of assisting the child not only to formulate but also to commence the usage of questions through the picture cards and sentence strips. In phase six of the usage of PECS in this particular setting, the child is trained to respond to questions asked by the instructor such as, ‘what do you want?’ As the child gets through with this particular phase, he/she learns to construct more complex sentences that improve their communication skills besides enhancing their speech capabilities (Chua & Poon, 2018). Using PECS for this group of students leads to the child’s individual communications skills.

Rationale for the Topic

The topic was chosen based on the rationale that speech disorder is a growing concern that needs apt address for effective management. The prevalence of SEND conditions across the globe have been reported to have seen a dramatic upsurge over the past few years. Besides, the consequences of the condition have been termed as being detrimental. The chosen intervention, SEND, has been applied in various cases and it has proven successful. However, studies for this particular setting are limited. Consequently, we saw it fruitful to explore the effectiveness of using PECS in assisting students with speech disorders. Typically, the paper aimed to prepare an audit tool for the improvement of communication capabilities of a group of learners with speech disorders in mainstream SEND setting.

Literature Review

Various authors have worked on the usage of PECS in enhancing communication skills of leaners with speech disorders. According to Ariwijava, (2020) the use of PECS for pre-school children with Autism Spectrum Disorder has proven fruitful. The author adds that various researchers have anticipated the ability of PECS to improve the interpersonal relations of students besides reducing their frustrations and tantrums (Ariwijava, 2020). PECS equally regulates the social behaviours of the students. According to Bitterman et al (2008), most ASD patients present with speech disorders that significantly impact on their learning abilities and communication capabilities. The author adds that most of the children have recently enrolled for special education systems in their pre-school years. The learners are obliged to free appropriate public education (FAPE) that effectively assists them (Bitterman et al., 2008).

PECS is a communication system useful with non-verbal individuals of all ages. Such non-verbal cues make use of pictures and other symbols to represent their needs and wants in making choices among various objects (Ivy et al., 2020). PECS in special education students involve the use of picture schedules to familiarize the students with routines besides improving their abilities of predicting events. Visual displays that have been noted to be used in PECS also serve the purpose of preventing students from being upset in the event when schedules are changed (Ivy et al., 2020). Also, other researchers have defined PECS as a picture representation of activities or other choices that gives the non-verbal special needs students to speak out their desires alongside their needs (Rush et al., 2020). Through the choice of picture cards located in front of them, the students are able to express themselves. Prompting of students with food rewards is conducted by trained PECS’s professionals when the students offer the cards to them.

PECS has been initially applied to students with ASD interpersonal behaviour. It can be applied in giving students choices about their desires (Sulzer et al., 2009). Besides, it has been used in the promotion of positive behaviour among special education students of the junior ages (Versyck et al., 2019). It promotes effective communicative relations among adults and their special need children or students (Raja et al., 2017). Also, it allows for communication between professionals to communicate with non-speakers besides enabling non-verbal students to express themselves in more reasonable ways. Typically, PECS applies the 1 to 3 square computer-printed and laminated pictorial icons. When applied, a small set of these icons are applied to applied investigation to decrease irritabilities and distinct behavioural eruptions (Bondy & Frost, 2011). Through PECS, research has reported an increased in eye contact besides an upsurge in the frequency of communication like-responses alongside verbal responses. PECS strictly uses picture in representation with zero wards on the used cards (Boesch et al., 2013). Through this, it is able to enhance and encourage social, language as well as communication skills. It improves he communicative competence of children with ASD amongst other special needs by educating on functional communication focusing on spontaneity (Gyasi et al., 2020). The technique has not only been implemented in homes and school but also in the community. It does not call for the possession of complex and costly equipment as it only uses picture symbols as the modality.

In Autistic Program, it was noted to indirectly encourage speech and fruitfully, there is evidence of children who developed speech after being enrolled in the program (Ferreira et al., 2017). While conducting the PECS training, it is usually conducted in the course of typical activities that occur within the natural setting, that is, either at home or within the schools (Ferreira et al., 2017). Besides, the communication training takes place in a wide positive behavioural support context known as the pyramid approach. Various training techniques are deployed in the application of PECS in communication training. These have been noted to include chaining, prompting or cuing, modelling, and environmental engineering. To implement the program as designed, professional training is a necessity (Ferreira et al., 2017). This is usually provided in span of approximately two days coordinator primarily by a speech pathologist. However, other entities can attend the training too as their roles are equally significant. The entities can be inclusive of parents to the learners, classroom instructors as well as classroom assistants.

Methodology

The audit tool aims to improve the communication capabilities of SEND students in mainstream settings. The group identified PECS as the most effective intervention for helping the situation. PECS has already been defined in details in the literature section (Cagliani et al., 2017). Qualitative method of data collection and analysis was used for this study. The methodology that was used for this survey included a questionnaire that was used to gather information on the use of PECS for enhancing communication for learners with speech disorders. The questionnaires were designed separately for parents of children with speech disorders and for the teachers of the children with speech disorders. The responses form the teachers and the parents were analysed using thematic data analysis where themes were identified, discussed and conclusions made. The questionnaires used are in the appendix section.

Results and Discussion

Results Analysis

Tabular representation of Results

Learners Response to PECS

In many children with ASD and in mainstream SEND settings, it was noted that PECS has successfully been used to enhance the communication skills of students. The program has enabled children meet several of their needs through the improvement of their communication skills. The candidates whom have responded positively to the intervention in the past include children whom do not speak, unintelligible children and minimal effective communicators whose current communication systems are ineffective. The system has improved the communicative competence and the reduced behavioural interruptions evidenced prior to the training. PECS has resulted in varying levels of improvement in pre-school students with ASD ability to effectively ad independently communicate with their instructors as well as their peers. Some learners have been noted to respond via slow but steady improvements in their independent responses. Besides, at the end of the implementation of the intervention, most of the leaners have been noted to be able to choose preferred without notable facial prompting. Most of the learners respond favourably to the intervention. In other instances, leaners have been noted to show clear improvements in vocabulary in cases where the completed all the six phases of the PECS implementation. Their social behaviours have been noted to improve besides a notable marked reduction in the disruptive behaviours. Most of the leaners are able to play bids with their peers besides showing improvements in the communication competencies. They have had elimination of their emotional outbursts besides enjoying their card exchanges in particular. Findings present studies have indicated effectiveness of PECS to various student populations. PECS have been successful in preventing behaviours such as emotional outbursts in learners, thus, terming it appealing to practitioners.

Indicators of Difficulties in Learning PECS

The responses from the instructors indicated that some learners experienced difficulties while using PECS. This was indicated via various factors. First, the learners are not motivated to request items. Besides, they are noted to be resistant to hand-over-hand guidance form the instructor. Also, they often tend to get frustrated whenever they fail to put their messages across. They have difficulty in sustaining attention to a particular task. They also cannot match physical objects to a picture of the item. These factors are considered as the basic indicators to learning the picture exchange communication system.

Problems Due to Such Difficulties with PECS

Due to the inability to learn the PECS, various problems have been noted to rise. One, receptive understanding has been observed to arise as a problem. Also, such learners have problems with expressive communication as they cannot effectively use language through speech amongst other forms of communication to talk out their needs, thoughts or ideas. They have difficulties in the articulation since there speech is unclear alongside unclear sounds of spoken language. Also, the leaners cannot imitate whatever the leaner says, and they have low working memory as they cannot retain and manipulate information that is associated with language temporarily. They lack fine motor skills such as finger and hand skills which are significantly involved in the PECS learning. They present with difficulties in planning and sequencing a multi-step activity to get a well-defined result. Also, the students lack social skills as they cannot engage in interactions with others.

Conclusion

Speech disorder is a great barrier to the learning of a child. The condition has been noted to be contributed to by various and distinct factors that can be social or medical. Occasionally, children tend to have delayed communication development and this is similarly a result of various factors that have been discussed in the paper. This essay aimed to answer the question on how PECS can be used in enhancing the development of communication skills in leaners with SEND. The paper first introduced the topic before clearly explain the rationale behind the choice of the topic. In the introduction, the paper introduced SEND as a condition besides exploring speech and language disorders, the causes and the distinct parts. The paper then explored a brief review of literature before the methodology where PECS has been discussed in details. The PECS training process has been discussed highlighting all the important phases, the challenges and the ways of addressing the challenges. Also the factors that contribute to difficulties in using PECS has been discussed and the various ways of managing them. Also, the paper has discussed the recommendations that are essential to improving the learning of PECS. Undoubtedly, this audit tool is of utmost significance to the efforts that are geared towards improving the communication development for learners with speech and language disorders.

Recommendations

What can be done to improve learning PECS

To ensure effective leaning of PECS, motivation can be a good intervention to discover factors that are extremely interesting and motivating to the learner to make them request for the items. Also, aversion can be of help as this would make discriminate items that the child does not like easily as some will not be obviously appealing to them (Jusoh Abd, 2017). Trainers can also decide on lowering sensitivity to touch thus lowering the child’s resistance to being touched by observing an occupational therapist to touch on the sensory processing issues. Photos can be used instead of drawings so the picture used for requesting is easier for the learner to notice. Lastly, real objects can be used in the miniature form of the items that the leaners want to request to ease the recognition of the candidate (Kapp, 2017).

Activities to improve the PECS

Various recommendations can help improve the PECS system. First, a desired item or an object can be put high so that the child would need to make a request to get the item. This is known as the out of reach technique (Jusoh Abd, 2017). Also, sabotage can be applied where the learner ensures to only complete a part of an action for the leaner to request a completion of the same. Short episodes are essential where by the child is only allowed to engage shortly in an act and would thus need to request for a continuation of the activity (Kapp, 2017). The trainer can also start to play with an object such as a toy and wait for the child to ask for the toy to have a turn with it. During times like snack time, the child can be encouraged to choose what they would like to have or the utensil they would love to eat from (Jusoh Abd, 2017). In school, while reading books. Trainer can take in turns to comment about pictures and lastly, the trainer can also place a variety of items in a bag and take in turns to select and pick an item and say what they have using the picture sentence strip. These amongst other measures can assist in improving the Picture Exchange Communication System.

Continue your exploration of Commercial Awareness Report with our related content.

References

Ariwijaya, T. (2020). PECS vs. iPad Intervention for Students with Autism Spectrum Disorders: A Literature Review. IJDS: INDONESIAN JOURNAL OF DISABILITY STUDIES, 7(2), 207-218.

Bitterman, A., Daley, T. C., Misra, S., Carlson, E., & Markowitz, J. (2008). A national sample of preschoolers with autism spectrum disorders: Special education services and parent satisfaction. Journal of autism and developmental disorders, 38(8), 1509-1517.

Boesch, M. C., Wendt, O., Subramanian, A., & Hsu, N. (2013). Comparative efficacy of the Picture Exchange Communication System (PECS) versus a speech-generating device: Effects on requesting skills. Research in Autism Spectrum Disorders, 7(3), 480-493.

Bondy, A., & Frost, L. (2011). A picture's worth: PECS and other visual communication strategies in autism. Woodbine House.

Burns, M. I., Baylor, C. R., Morris, M. A., McNalley, T. E., & Yorkston, K. M. (2012). Training healthcare providers in patient–provider communication: What speech-language pathology and medical education can learn from one another. Aphasiology, 26(5), 673-688.

Cagliani, R. R., Ayres, K. M., Whiteside, E., & Ringdahl, J. E. (2017). Picture exchange communication system and delay to reinforcement. Journal of Developmental and Physical Disabilities, 29(6), 925-939.

Chua, B. Y., & Poon, K. K. (2018). Studying the implementation of PECS in a naturalistic special education school setting. Educational and Child Psychology.

Da Fonte, M. A., & Barton-Arwood, S. M. (2017). Collaboration of general and special education teachers: Perspectives and strategies. Intervention in School and Clinic, 53(2), 99-106.

Damico, J. S., Müller, N., & Ball, M. J. (Eds.). (2010). The handbook of language and speech disorders (pp. 317-336). West Sussex: Wiley-Blackwell.

Ferreira, C., Bevilacqua, M., Ishihara, M., Fiori, A., Armonia, A., Perissinoto, J., & Tamanaha, A. C. (2017, March). Selection of words for implementation of the Picture Exchange Communication System-PECS in non-verbal autistic children. In CoDAS (Vol. 29, No. 1, pp. e20150285-e20150285).

Flippin, M., Reszka, S., & Watson, L. R. (2010). Effectiveness of the Picture Exchange Communication System (PECS) on communication and speech for children with autism spectrum disorders: A meta-analysis. American journal of speech-language pathology.

Gyasi, M. N. K., Okrah, A. K., & Anku, J. S. A. (2020). Teachers' Knowledge of Special Educational Needs and Disability Students and Their Classroom Management Approaches. World Journal of Education, 10(4), 160-172.

Hailpern, J., Karahalios, K., DeThorne, L., & Halle, J. (2010, October). Vocsyl: Visualizing syllable production for children with ASD and speech delays. In Proceedings of the 12th international ACM SIGACCESS conference on Computers and accessibility (pp. 297-298).

Hu, X., & Lee, G. (2019). Effects of PECS on the emergence of vocal mands and the reduction of aggressive behavior across settings for a child with autism. Behavioral Disorders, 44(4), 215-226.

Hughes-Lika, J., & Chiesa, M. (2020). The picture exchange communication system and adults lacking functional communication: A research review. European Journal of Behavior Analysis, 1-19.

Ivy, S., Robbins, A., & Kerr, M. G. (2020). Adapted Picture Exchange Communication System using tangible symbols for young learners with significant multiple disabilities. Augmentative and Alternative Communication, 36(3), 166-178.

Jusoh, W., & Abd Majid, R. (2017). Using Picture Exchange Communication System To Improve Speech Utterance Among Children With Autism. Journal of ICSAR, 1(1), 46-49.

Kapp, K. L. (2017). Teaching a Picture Exchange Communication System to Young Adults with Moderate to Severe Disabilities Using the PECS Phase III Application.

Kurniawan, I. (2018). The improvement of autism spectrum disorders on children communication ability with PECS method Multimedia Augmented Reality-Based. In Journal of Physics: Conference Series (Vol. 947, No. 1, p. 012009). IOP Publishing.

Kyselova, A., & Chernishova, E. (2020). EFFECTIVENESS OF USING PECS AMONG CHILDREN DIAGNOSED WITH ASD WHO HAVE PROBLEMS WITH COMMUNICATION. Збірник наукових праць ΛΌГOΣ, 43-48.

Lerna, A., Esposito, D., Conson, M., Russo, L., & Massagli, A. (2012). Social–communicative effects of the Picture Exchange Communication System (PECS) in autism spectrum disorders. International journal of language & communication disorders, 47(5), 609-617.

Lyakso, E., Frolova, O., & Grigorev, A. (2017, September). Perception and acoustic features of speech of children with autism spectrum disorders. In International Conference on Speech and Computer (pp. 602-612). Springer, Cham.

McCoy, A., & McNaughton, D. (2019). Training education professionals to use the Picture Exchange Communication System: a review of the literature. Behavior analysis in practice, 12(3), 667-676.

Michalik, M., & Solak, A. (2017). The pace of speech in autistic spectrum disorder (ASD),„. Acta Neuropsychologica, 15(4), 433-441.

Raja, P., Saringat, M. Z., Mustapha, A., & Zainal, A. (2017, August). Prospect: A picture exchange communication system (PECS)-based instant messaging application for autism spectrum condition. In IOP Conference Series: Materials Science and Engineering (Vol. 226, No. 1, p. 012088). IOP Publishing.

Rush, K. S., Mortenson, B. P., & Birch, S. E. (2020). The Inadvertent Effects of PECS on Vocal Responding of Children with Autism Spectrum Disorder. Advances in Neurodevelopmental Disorders, 4(3), 308-318.

Sulzer-Azaroff, B., Hoffman, A. O., Horton, C. B., Bondy, A., & Frost, L. (2009). The Picture Exchange Communication System (PECS) What Do the Data Say?. Focus on autism and other developmental disabilities, 24(2), 89-103.

Versyck, B., van Geffen, G. J., & Chin, K. J. (2019). Analgesic efficacy of the Pecs II block: a systematic review and meta‐analysis. Anaesthesia, 74(5), 663-673.

Williams, A. L., McLeod, S., & McCauley, R. J. (2010). Interventions for Speech Sound Disorders in Children. Brookes Publishing Company. PO Box 10624, Baltimore, MD 21285. Williams, A. L., McLeod, S., & McCauley, R. J. (2010). Interventions for Speech Sound Disorders in Children. Brookes Publishing Company. PO Box 10624, Baltimore, MD 21285.

Appendix 1: Questionnaire for Parents

1. How have you ever heard of PECS? If yes, where from?

…………………………………………………………….

2. Has PECS being applied for your child?

…………………………………………………………….

3. How is your child responding to the intervention?

…………………………………………………………….

4. Have you noticed improvements since the commencing of the program?

…………………………………………………………….

5. Would you recommend the use of PECS for other children?

…………………………………………………………….

6. Did your child have difficulties in using PECS?

…………………………………………………………….

7. What indicated these difficulties?

…………………………………………………………….

8. Which problems rose from these difficulties?

…………………………………………………………….

Appendix 2: Questionnaire for the Teachers

1. How have you ever heard of PECS? If yes, where from?

…………………………………………………………….

2. Has PECS being applied for your student?

…………………………………………………………….

3. How is your student responding to the intervention?

…………………………………………………………….

4. Have you noticed improvements since the commencing of the program?

…………………………………………………………….

5. Would you recommend the use of PECS for other learners and teachers?

…………………………………………………………….

6. Did some leaners have difficulties in using PECS?

…………………………………………………………….

7. What indicated these difficulties?

……………………………………………………………

8, Which problems rose from these difficulties?

…………………………………………………………….