Howlin, P., Gordon, R.K., Pasco, G., Wade, A. & Charman, T. (2007). The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: a pragmatic, group randomised controlled trial.

Journal of Child Psychology and Psychiatry, 48, 473‐481.
Abstract: Objective: To assess the effectiveness of expert training and consultancy for teachers of children with autism spectrum disorder in the use of the Picture Exchange Communication System (PECS). Method: Design: Group randomised, controlled trial (3 groups: immediate treatment, delayed treatment, no treatment). Participants: 84 elementary school children, mean age 6.8 years. Treatment: A 2‐day PECS workshop for teachers plus 6 half‐day, school‐based training sessions with expert consultants over 5 months. Outcome measures: Rates of: communicative initiations, use of PECS, and speech in the classroom; Autism Diagnostic Observation Schedule‐Generic (ADOS‐G) domain scores for Communication and Reciprocal Social Interaction; scores on formal language tests. Results: Controlling for baseline age, developmental quotient (DQ) and language; rates of initiations and PECS usage increased significantly immediately post‐treatment (Odds Ratio (OR) of being in a higher ordinal rate category 2.72, 95% confidence interval 1.22–6.09, p < .05 and OR 3.90 (95%CI 1.75–8.68), p < .001, respectively). There were no increases in frequency of speech, or improvements in ADOSG ratings or language test scores. Conclusions: The results indicate modest effectiveness of PECS teacher training/consultancy. Rates of pupils’ initiations and use of symbols in the classroom increased, although there was no evidence of improvement in other areas of communication.

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