PECS Phase 1: The Physical Exchange

Prior to beginning PECS training it is necessary to determine what items will be so motivating to the child that she would initiate communication with an adult to request them. A reinforcer assessment is done by presenting the individual with numerous selections of foods, toys, or objects and documenting those that are most consistently selected and those that are not. After identifying a number of reinforcing materials, Phase 1 training can begin.

Components of Phase 1

The training environment

The child and two trainers are seated at a table. One of the trainers serves as a prompter who sits behind the child (or next to, if the individual is large) and is available to provide physical assistance to the child. The other trainer is the communicative partner, who sits in front of the child. One of the highly preferred items that has been identified through the reinforcer assessment is available, but out of reach of the child. The picture or symbol of that item is on the table between the child and the item. Fully assisted exchange

The communicative partner does not give verbal prompts such as “What do you want?” or “Give me the picture.” As the child reaches for the preferred item, the prompter physically assists her in reaching, picking up the picture, reaching to the communicative partner, and putting the picture in their hand. The communicative partner has an open hand and grasps the picture, then responds as though the child had spoken a request by saying, “You want the ______,” and giving the child the requested item.

If the child does not reach for the item, the teacher presents the reinforcing items again to be sure that it is still a highly desired item. In addition, the communicative partner may use attentional cues such as showing the object or playing with the object in front of the child. Neither the prompter nor the communicative partner says anything until the picture is in the communicative partner’s hand.

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Fade physical assistance

Initially, total physical assistance is used to help the child learn a successful exchange. A method known as “backward chaining” is used to help the child initiate and complete an exchange with fewer prompts. As the child touches the hand of the communicative partner with the picture, the partner waits to verbally respond until the child releases the picture into his hand. As the child becomes more consistent with releasing the picture independently, prompts are faded in the reach stage, and in the pick-up picture stage. The prompter may find it helpful to fade physical assistance by using tapping or pointing to the picture on the table as a prompt. The communicative partner continues to show an open hand whenever the child reaches for the picture. Many opportunities for practice should include a variety of reinforcing items.

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Fading the “open hand” cue

After the child has had many opportunities to practice picking up the picture and handing it to the communicative partner’s open hand, the partner will start to fade the open hand cue by waiting increasingly longer to show an open hand. The goal is to wait until the child picks up the picture, reaches toward the communicative partner and releases the picture into the partner’s hand independently.

The outcome of Phase 1 is to initiate communication. By the end of Phase 1, the child will look at, reach, pick up, and release the picture into the communicative partner’s hand. In other words, the process of initiating a communication exchange has begun.

Key Points

• Outcome of Phase 1 is approaching people to initiate communication; 2 individuals are needed; one as a communicative partner and one as a prompter
• Do not use verbal prompts (Do not say “What do you want?”)
• Initially use fully assisted physical exchange for pick up, reach, release
• Fade physical assistance
• Reinforce each successful exchange
• Fade “open hand” cue
• Use highly desirable items; the child should immediately get what he asked for when the picture exchange occurs
• Provide many opportunities for practice and keep it fun

Helpful Tips

• The communicative partner and prompter should change places after a few trials so that the child learns that communication occurs with a variety of people
• When an child releases the picture into the communicative partner’s hand, the partner may choose to use the words that the child would say if verbal, “I want the _______” rather than “You want the ____.” This is especially helpful with children who repeat phrases exactly as they hear them.
• After the child has become successful in the exchange, every few turns say “Take it” after the child has given the partner the picture, rather than always handing him the item. Document reinforcing items and activities regularly. Consider using a list such as the one included. (see attachments)