Transitioning from PECS to a full communication system

We are frequently asked “How do I transition a student / a client / my child from Picture Exchange Communication System (PECS), to some sort of speech output device?” People give a variety of reasons for wanting to move on from PECS. Sometimes it’s a desire for voice output. Other times it’s the difficulty of organizing, maintaining and carrying around an increasingly large PECS book. But most of the time we hear “he’s stuck at requesting”, “she is only asking for things”, “we can’t have a conversation beyond ‘I want’ or ‘I see’”, “I want to know what he’s thinking”, “how can she tell me if something’s wrong?”

Introducing Core Words

If we look at all the reasons we communicate, we see that requesting is a very small part of what we do to connect with other people. There are many other reasons we communicate:

  • To refuse something or to protest
  • To give our opinion
  • To express our feelings
  • To ask questions
  • To tell stories
  • To talk about future or past events
  • To plan and negotiate
  • To explain
  • To be polite
  • To express affection, tease, flirt

We need to add different kinds of words to enable full communication. We can’t rely on just “I want” and “I see”. We have two questions to answer - which words to introduce, and how to introduce them?

We usually start with adding core words to a language learner’s communication system. Core words are those words that are most frequently used in everyday conversation - verbs like stop, go, come, get; adjectives like more, good, little; pronouns like I, you, it, that; prepositions like up, on, there. With words like these, there’s so much more we can say. Learn more about core words.   

Transitioning from PECS "I want apple" to a full communication system "Can we make applesauce?"

Switching, Fast or Slow?

So now we know which words to include - how do we introduce them into a communication system? There are two directions we can go. We can switch right away to a new communication system with a robust language system and voice output. Or we can gradually transition to a new system by adding core words to the PECS system and the environment, while making a plan to eventually switch to a more robust communication system. 

The choice between these two alternatives will depend on how well the child and the child’s team (school staff, therapists, parents) tolerate change. In making this choice there are two issues that are often forgotten. First, the people most resistant to change are often the child’s team rather than the child. And second, while it may be tempting to take the gradual route to a robust voice output system, remember that this may result in more changes in the end than going directly to the robust system.

Adding core words to a PECS system

If you choose the gradual route to core words, here are a few ways you can add core words to the existing PECS system:

  • Add a core word display to the front or back of the PECS book.
  • Add core word displays to the environment - there are many ways to do this, from a few selected core words in specific places (“open”, “go” on the door; “eat”, “like”, “more” at the snack table), to letter-sized laminated core word displays worn by classroom staff, to a large wall display of core words.
  • Dust off some of your old static display devices. A TechTalk, TechSpeak, CheapTalk, or GoTalk can be a great way to introduce voice output and core words at the same time, and can be shared between students or used by staff to model as needed.
  • Create what Megan Brazas calls a Core Vocabulary Exchange System. This allows the user to create sentences using core words as well as the nouns and “I want” / “I see” sentence starters included in PECS. Find out more about CVES reading this presentation and listening to this podcast

Don’t forget to model!

No matter how you add core words into the mix, remember that core words, while powerful, are difficult to represent in a picture. What would a picture of “do” or “it” look like? This means that in order for the child to learn the meaning of these new words, adults will need to model the words in 1-2 word sentences during daily activities and conversations. At this stage, when the child is just transitioning from PECS, you’ll want to model telegraphic sentences like “get it”, “put here”, “go in”, “you eat”. 

It’s important to model just above the child’s current level - you’re showing the child the next step they will take when they're ready. And remember, you should model without requiring the child to imitate what you’re doing! You’re just showing the child the possibilities, not correcting him or teaching him using drills. See the presentation Core Words: Focus on Model(l)ing to learn more about modeling with core words.

Transitioning to a full communication system

Don’t stay too long with a hybrid PECS / core word system - you’ll be missing the depth and richness of a full vocabulary of all word kinds, as well as voice output which can be helpful in understanding language and even providing a consistent model for speech. There are a number of AAC solutions that can help you take the next step in language and communication teaching. In any system, here’s what you should look for:

  • Lots and lots of words - thousands, in fact.
  • Words from all grammatical classes - nouns, verbs, pronouns, adjectives, articles, question words….
  • A way to access verb conjugations (past, present, future, -ing…), plural and possessive forms for nouns, and comparative (-er), superlative (-est), and adverb (-ly) forms of adjectives.

Customizing your new system  

The AAC system you are transitioning to may have different vocabulary levels to choose from. If you’re transitioning to Proloquo2Go, we recommend using Crescendo, the built-in vocabulary that comes with Proloquo2Go, and selecting the Intermediate Core vocabulary level. While it may be tempting to select the Basic Communication vocabulary level, because of its similarity to PECS, that’s exactly the reason NOT to use Basic Communication! You need to be taking the student to the next step on their communication journey, not repeating the same step they’ve already mastered.

You’ll also want to set up the new system to have as many buttons per page as possible. Choose the smallest button size that the child can physically tap. This will give them access to as much language as possible without having to navigate away from the home page. If the home page seems too busy at first, it’s easy in most systems to hide or mask some of the words temporarily, and reveal them gradually as the child progresses. This way, the buttons that have already been learned stay in the same location as new words are revealed. For more information on how this can be done in Proloquo2Go Crescendo, watch Getting started with Proloquo2Go 4 and Introduction to Crescendo Vocabulary.  

Using the PECS book and the new system in parallel

You may want to have the PECS book around during the transition to the more complex system. If the learner has been successful in getting their needs met using the PECS book, it is likely to cause distress if the PECS book disappears. How long both systems will need to be available will of course vary from person to person. 

If the learner uses the PECS book to communicate, you can model on the new system how they would find the same item there. But remember you’re modeling on the new system just to show them it’s possible to find the word on that system, not to require them to re-communicate what they've already told you quite clearly with the PECS book! You can also take the opportunity to use the new system to say something about what the learner requested with the PECS book - describe it, make a comment about it, use a verb that is not in the PECS book but that is appropriate to item that was requested. This will show the learner that there are possibilities available with the new system that they can explore.

Congratulations, it’s a full communication system!

However you manage the transition from PECS to a full communication system, you can be sure that you’re allowing someone to communicate more fully - and they’ll thank you for it. They may also protest, refuse, flirt, tell you a story or a joke, or ask you questions - because you’ve given them the means to communicate more fully!

Have you done the transition from PECS to a full communication system? Share your experience below.

Recommended links for additional information:

~ Jennifer Marden, MA CCC-SLP
 
Jennifer is VP of Clinical Development at AssistiveWare. She became a Speech-Language Pathologist in 1999, after 14 years as a software engineer at Hewlett-Packard. Jennifer specializes in AAC for children and adults with a wide variety of communication disorders, and has provided AAC services in school, hospital, clinic, home, and adult day program settings.

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