Enhancing communication for children with autism in Kenya. insights on the picture exchange communication system

Abstract

Picture Exchange Communication System (PECS), has been used successfully as an intervention strategy for children with Autism Spectrum Disorders (ASD) and other developmental disorders, without a functional means of communication. PECS uses photos to convey needs, wants and express their feelings, which enables the non- verbal student to initiate communication, request for a desired item, and also to have spontaneous speech by exchanging a photo for a real item. Although it was founded more than three decades ago, there has been no tangible evidence of its use in Kenya, yet the numbers of non-verbal children with autism who need to be able to express themselves is increasing. In this study, we apply Behaviorist theory by B.F. Skinner, which relies on direct reinforcement, holding that; behavior can be changed by repetition of drills and rewards, hence the reason for having ten trials in each of the three sessions in twenty four days, adding to a total of 720 trials thus the theory guided in the data collection, choice of tools and how they were administered. The study explored the ability of the student to initiate communication, request for a desired item and spontaneously speak using PECS with a view to improving communication, using experimental single subject changing criterion design. The experiment involved two non-verbal boys, 6-8 years old with autism spectrum disorders. The focus was on the first three phases of PECS, which are: The physical exchange, Expanding Spontaneity (distance and persistence) and picture discrimination, in which research has indicated evidence of change. Each of the study subject, student one and student two, was under one teacher (communication partner) and one parent (physical prompter) for training of PECS. Recording was done by communication partner for either student. The researcher (independent observer) also recorded for each student. The teachers and parents were trained before baseline, on their roles in the experiment. The data was analyzed using Standard Mean Difference (SMD), Percentage of Non-Overlapping Data (PND) and Inter-Observer Agreement (IOA). The findings indicated that initiating communication improved from a range of 10%-30% in the baseline to a range of 47.5%-100% in the treatment phases. The Inter Observer Agreement (IOA) gave a result of 9.5% for student 1 and 4.8% for student 2. The Standard Mean Difference (SMD) for student 1 was 1.04% and 1.67% for student 2 while the Percentage of Non-overlapping Data (PND) both student 1 and student 2 had 100%, an indication of high level effectiveness. The ability to request for a desired item also improved greatly for both student 1 and 2, with a baseline range of 0-10% to treatment phases’ range of 45-100%. The IOA gave a result of 14.3% for student 1 and 4.8% for student 2. The SMD for student 1 was 70.85% and 2.09% for student 2, while the PND was 100% for both student 1 and 2. In the spontaneous speech using picture cards, the baseline was at 0% while the treatment ranged from 0-100% for both students. IOA was 71.4% for student 1 and 52.4% for student 2. The SMD for student 1 was 58.11% and 46.05% for student 2. Meanwhile, the PND was 75% for both student 1 and 2. The impact of this training was high in the first two depended variables, initiating communication and requesting for a desired item, while the spontaneity proved difficult during baseline and the treatment phases. However, there was a clear indication that PECS could indeed help the students express their needs and wants to teachers, parents and significant others by use of Pictures, given more time, repetition of drills and rewards, and therefore enable the pictures to truly speak for the student.