If you don’t know what the Picture Exchange Communication System® is then start with my post about phase one. For those that do in this post I am going to look at stage 4 – Sentence Structure.
Phase 4 of the Picture Exchange Communication System is Sentence Structure. The objective is to move from the child from handing over one picture to using the sentence strip and creating multi word phrases.
Implementing PECS Phase 4
With my eldest I waited a long time to move onto phase 4, in my mind it seemed like such a big step. I wish I had done it sooner with him as he nailed it in one session with a PECS consultant.
I am now working on phase 4 with my youngest and it’s a little more complicated. The reason it’s harder with him is he is verbal (echolalia) but delayed and less patient after he has made a clear request verbally with one word. I am using PECS with him to try and extend his sentences and encourage direct communication. Whist he can use the sentence strip really well in a structured activity such as commenting on a book he needs lots of prompting to use the sentence strip when he is making independent requests.
One of the key things we teach when using PECS is to differentiate between requesting something and commenting on it. To do this we will use sentence starters.
As the child has already learnt to make requests in the earlier phases in Phase 4 we will just use the ‘I Want’ sentence starter. Once using the sentence strip has been mastered we can go onto use other sentence starters in later phases.
So when my son comes to me requesting some ice cream I need to prompt him to do the following:
- Go to his communication book
- Put the ‘I want’ picture onto the sentence strip
- Add the ‘ice cream’ picture to the sentence strip
- Remove the sentence strip and hand it to me
- Then point at the pictures and verbalise the sentence (if able to)
There are several steps to this so it can be very easy to get distracted and not complete the exchange. It is much easier to have two of you when you first implement the sentence strip, one to be the communication partner and the other acting as a silent prompter. As your child gets used to using the sentence strip you would phase out the prompting.
Using the communication book
I would really recommend having a PECS communication book once you get to phase 4. Not only to store the picture cards but because you need the sentence strip. It is easier to keep the most requested items on the front of the book or to use the front when encouraging communication for example at snack time.
It is also important for the sentence starters to be in one place, initially I had the ‘I want’ symbol on the front of the book on the top left. Once the child is more confident and you have filled your book with lots of symbols, it may be easier to keep them on the first page inside the cover again on the top left.
Remember to use your child’s preferred items when encouraging communication, they are not going to be motivated to use the sentence strip if they are not motivated to communicate in the first place.
You may be interested in using my TV Choice board.
As your child increases their independent requests and your book is filled with more symbols you will find yourself having to say no more often. It is important not to remove symbols and say no because this is a vital skill your child needs to learn to accept. You may want to try using the Universal No Page.
Snack time is always a good time to increase PECS use and once your child has mastered requesting one item with the sentence strip you can encourage requests of multiple items.
If you haven’t been on the PECS training I really recommend it, PECS is a structured approach and the training is essential to fully grasp what you need to do. You may also be interested in the PECS Parent Pack.
Do you use the Picture Exchange Communication System? How have you got on with the sentence strip?