Effects of iconicity on requesting with the Picture Exchange Communication System in children with autism spectrum disorder

doi:10.1016/j.rasd.2007.09.004

Research in Autism Spectrum Disorders

Volume 2, Issue 3, July–September 2008, Pages 430-446

https://doi.org/10.1016/j.rasd.2007.09.004 Get rights and content

Abstract

Research on graphic symbol learning suggests that symbols with a greater visual resemblance to their referents (greater iconicity) are more easily learned. The iconicity hypothesis has not yet been explored within the intervention protocol of the Picture Exchange Communication System (PECS). Within the PECS protocol, participants do not point to a symbol but exchange the symbol for an object. The purpose of this study was to examine whether children learn to request more readily with PECS when the symbols involved are highly iconic versus symbols that are low in iconicity. An adapted alternating treatments design combined with a multiple baseline design across subjects was used to evaluate the effectiveness and efficiency of symbol learning under two conditions: high iconicity and low iconicity. Four students with autism or pervasive developmental disorders between the ages of six and nine years participated. Results indicated that students learned to request desired objects under both conditions, lending further support for the effectiveness of PECS. There was little to no difference, however, in the effectiveness and efficiency of requesting between the two conditions during Phases I and II of PECS training. Thus learners do not benefit from symbols that bear more resemblance with their referents during the first two phases of PECS instruction.

Section snippets

Participants

Four children between the ages of 6 and 10 with a diagnosis of autism or Pervasive Developmental Disorder (PDD) participated. A licensed psychologist, pediatrician, or neurologist diagnosed the children according to the criteria set forth by the Diagnostic and Statistical Manual: Fourth Edition (DSM-IV). Additionally, participants had to meet the following criteria: (a) have little to no functional speech (no more than 10 spoken words), (b) rely primarily on pre-linguistic means of

Results

Data were plotted graphically to examine the effectiveness and efficiency of symbol learning during three phases of PECS using Blissymbols and PCS. Daily probe results are presented in Fig. 1, and intervention results are reported in Fig. 2 (missing data points are a result of school absences). Specifically, the percentage of correct requests per session and the number of sessions to criterion for each phase of PECS instruction were recorded. All students achieved mastery in Phases I and II of

Discussion

This study adds to the current body of literature documenting the effectiveness of PECS instruction in teaching students with autism/PDD to request using graphic symbols (e.g., Ganz & Simpson, 2004; Tincani, 2004; Yoder and Stone, 2006a, Yoder and Stone, 2006b). The results of this study also showed that participants mastered Phases I and II of PECS with very little difference between the two experimental conditions: PCS and Blissymbols. Three students did not achieve mastery of Phase III

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Cited by (36)

Comparisons of intervention components within augmentative and alternative communication systems for individuals with developmental disabilities: A review of the literature
2013, Research in Developmental Disabilities
Citation Excerpt :
One study measuring maintenance also did not support an effect for symbol iconicity (Angermeier et al., 2008). Phase III data (i.e. requests involving discriminations between symbols) for both acquisition and maintenance were, however, inconclusive for a majority of participants in the Angermeier et al. (2008) study. In contrast, Koul and Schlosser (2004) provided suggestive evidence (limited by the number of IOA sessions and lack of treatment fidelity) that high iconicity symbols on an SGD were more likely to be receptively identified than low iconicity symbols.
Decisions regarding augmentative and alternative communication (AAC) for individuals with developmental disabilities (e.g. what AAC to use and how to teach a person to use a specific AAC modality) should involve consideration of different intervention component options. In an effort to elucidate such decisions and options, this review synthesized 14 studies, published between 2004 and 2012, comparing different AAC intervention components including different symbol sets, instructional strategies, or speech output within aided AAC systems, and different verbal operants within unaided AAC. Evidence supported the following: (a) different instructional strategies such as building motivation, using errorless learning, or adding video models to picture exchange interventions may improve the acquisition or rate of acquisition of picture exchange mands, (b) limited data supports training mimetic (imitated) or mand signs over tacts and (c) differences in symbol sets and speech output levels appeared to have little effect on AAC-based mand acquisition, but listener-based differences should be considered. These findings have implications for future research and clinical practice.
Comparative efficacy of the Picture Exchange Communication System (PECS) versus a speech-generating device: Effects on requesting skills
2013, Research in Autism Spectrum Disorders
Citation Excerpt :
Some literature suggests the degree of iconicity affects the learnability of the graphic symbol (Fuller, 1997; Goossens, 1983; Koul, Schlosser, & Sancibrian, 2001; Nail-Chiwetalu, 1991). Yet, Angermeier et al. (2008) found no differences when graphic symbol iconicity was assessed during PECS. Because it is not clear how much symbol iconicity affects PECS learning and given that participants in this study had difficulty discriminating between several picture symbols, it is possible that picture iconicity affected learning and should be investigated further.
An experimental, single-subject research study investigated the comparative efficacy of the Picture Exchange Communication System (PECS) versus a speech-generating device (SGD) in developing requesting skills for three elementary-age children with severe autism and little to no functional speech. Results demonstrated increases in requesting behavior for all participants across intervention phases with both augmentative and alternative communication (AAC) intervention strategies; however, difficulties were observed with picture discrimination. The Wilcoxon signed pair test did not reveal significant differences between PECS and the SGD for any participant. Findings suggest PECS and SGD are equally appropriate for developing initial requesting skills. Based on the current findings, successful implementation of either AAC strategy is achievable when appropriate instructional strategies are used.
Meta-analysis of PECS with individuals with ASD: Investigation of targeted versus non-targeted outcomes, participant characteristics, and implementation phase
2012, Research in Developmental Disabilities
Citation Excerpt :
PECS consists of six phases of progressively complex training, starting with exchanging a picture with a communicative partner in order to obtain a desired item (Frost & Bondy, 2002). In many cases, especially in individuals with severe disabilities, only the first three phases of PECS have been taught (e.g., Angermeier, Schlosser, Luiselli, Harrington, & Carter, 2008; Carre, Le Grice, Blampied, & Walker, 2009; Bondy & Frost, 1994). Teaching through phrase three teaches picture exchange and icon discrimination but does not include teaching phrases (e.g., I SEE, I WANT), adjectives, or discrimination by color, shape, or other features (see Frost & Bondy, 2002; Ganz, Simpson, et al., in press).
The Picture Exchange Communication System (PECS) is a widely used picture/icon aided augmentative communication system designed for learners with autism and other developmental disorders. This meta-analysis analyzes the extant empirical literature for PECS relative to targeted (functional communication) and non-targeted concomitant outcomes (behavior, social skills, and speech) for learners with autism, learners with autism and intellectual disabilities and those with autism and multiple disabilities. Effect size analyses were done using the Improvement Rate Difference method, an advanced metric. Effect sizes were independently analyzed for targeted and non-targeted outcomes, student age, learner disability, and number of phases in the PECS protocol acquired by learners. Results supported the judgment that PECS is a promising intervention method. Analysis also revealed that functional communication outcomes associated with the PECS protocol were most impacted, that preschool children and those with autism generally showed the strongest training effects, and that in general students who advanced through the most PECS protocol phases had the best outcomes.
An aggregate study of single-case research involving aided AAC: Participant characteristics of individuals with autism spectrum disorders
2011, Research in Autism Spectrum Disorders
Citation Excerpt :
Frea, Arnold, & Vittimberga (2001) implemented a picture exchange intervention that provided opportunities for a non-verbal 4 year old boy with autism to engage in choice-making to obtain preferred items, resulting in a reduction of aggressive behaviors. A variety of AAC interventions have also been implemented with elementary children (e.g., Angermeier, Schlosser, Luiselli, Harrington, & Carter, 2008; Buckley & Newchok, 2005; Schlosser, Blischak, Belfiore, Bartley, & Barnett, 1998). Tincani, Crozier, & Alazetta (2006) compared the use of sign language and PECS to increase the use of requesting behavior for two children with autism, ages 5 and 6.
Individuals with autism spectrum disorders (ASD) who cannot speak at all or not intelligibly are frequently taught to use aided augmentative and alternative communication (AAC). The majority of the research on the use of AAC with individuals with ASD has been single-case research studies. This investigation involved a meta-analysis of the single-case research on the use of aided AAC with individuals with autism spectrum disorders (ASD), investigating the differential impacts of AAC by participant characteristics. An effect size measure, the Improvement Rate Difference (IRD) was used to analyze 24 single-case studies. Two research questions were investigated concerning (a) the impact of AAC interventions on individuals diagnosed with subcategories of ASD and co-morbid conditions, and (b) the effects of AAC interventions on individuals in different age groups. Results indicated that participants with ASD and no additional diagnoses had better outcomes than others and that participants with ASD and developmental disabilities outperformed participants with ASD and multiple disabilities. Further, preschool-aged participants had better outcomes than elementary-aged and secondary-aged participants. Participants in all diagnostic categories and age ranges had moderate or better effects.
Effect of translucency on transparency and symbol learning for children with and without cerebral palsy
2011, Research in Developmental Disabilities
Based on the concept of iconicity, the iconicity hypothesis was emphasized for decades. The aims of this study were to explore the effect of translucency on transparency and symbol learning for children with and without cerebral palsy. Twenty children with cerebral palsy and forty typical peers participated in the study. Ten symbols with high translucency and ten with low translucency were used as experimental material. The results of transparency testing demonstrated the positive relationship between translucency and transparency. The effect of translucency on symbol learning was supported partially, all children with and without CP could learn the low translucent symbols only after two teaching sessions, or three sessions at most. The authors also provided some suggestions for further study based the results of this study.
Iconicity and ease of learning of the ARASAAC pictographic symbols
2018, Revista de Logopedia, Foniatria y Audiologia
Estudios previos han señalado la alta iconicidad de los signos pictográficos de ARASAAC, pero no existen datos que demuestren si esa mayor iconicidad está relacionada también con una mejor adquisición. Por tanto, este trabajo tiene como objetivo comparar la iconicidad y la facilidad de aprendizaje de los símbolos pictográficos de ARASAAC, SPC y Bliss en 24 menores (de edad entre 38 y 69 meses) diagnosticados con retraso del lenguaje, trastorno específico del lenguaje o trastorno del espectro autista.
El estudio se dividió en 4 sesiones: una evaluación inicial, 2 sesiones de entrenamiento y un seguimiento final. En cada sesión se presentó un total de 30 grupos de pictogramas correspondientes a nombres, verbos y adjetivos, y la tarea de los participantes era señalar el pictograma del grupo que correspondiera a una palabra presentada oralmente.
Los pictogramas de ARASAAC obtuvieron una mayor iconicidad que la de los símbolos SPC y Bliss, aunque el valor varió en función de la categoría gramatical. Igualmente, los símbolos de ARASAAC fueron los más fáciles de aprender y los que tuvieron mayor retención del aprendizaje después de una semana.
Estos hallazgos son coherentes con la hipótesis de transparencia, pues los símbolos con mayor iconicidad fueron los más fáciles de aprender en las fases iniciales y durante el seguimiento, lo que señala la superioridad del conjunto de pictogramas de ARASAAC frente a otros conjuntos empleados habitualmente, en términos de facilidad de aprendizaje.
Although previous studies have indicated the high iconicity of the ARASAAC pictographic symbols, currently there are no data that demonstrate whether this higher degree of iconicity is also related with a better acquisition. Therefore, this work is aimed at comparing the iconicity and ease of learning of the ARASAAC, PCS and Bliss pictographic symbols in a group of 24 children (aged from 38 to 69 months) diagnosed with language delay, specific language impairment or autism spectrum disorder.
The study was divided into 4 sessions: an initial assessment, 2 training sessions and a final follow-up. During each session, 30 groups of pictograms representing nouns, verbs and adjectives were presented, and the participant task was to point to the pictogram that corresponded to the meaning of a word presented orally.
Pictograms from the ARASAAC set obtained a higher iconicity compared to the PCS and Bliss symbols, although it varied across grammatical categories. Furthermore, the ARASAAC symbols were easier to learn and showed higher retention level after a week.
These findings are in accordance with the transparency hypothesis as symbols with higher iconicity were the easiest to learn at the beginning of the training sessions and during follow-up, which demonstrates the superiority of the ARASAAC pictogram set over other frequently used sets, in terms of ease of learning.

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Effects of iconicity on requesting with the Picture Exchange Communication System in children with autism spectrum disorder

Abstract

Section snippets

Participants

Results

Discussion

Brain and Language

Research in Developmental Disabilities

Diagnostic and statistical manual of mental disorders

Augmentative and alternative communication: Supporting children and adults with complex communication needs

The comparative translucency of initial lexical items represented in five graphic symbol systems and sets

Journal of Speech and Hearing Research

The picture exchange communication system

Behavior Modification

Using the picture exchange communication system (PECS) with children with autism: Assessment of PECS acquisition, speech, social-communicative behavior, and problem behavior

Journal of Applied Behavior Analysis

The Picture Exchange Communication System training manual

Initial study into the effects of translucency and complexity on the learning of Blissymbols by children and adults with normal cognitive abilities

Augmentative and Alternative Communication

Effects on communicative requesting and speech development of the picture exchange communication system in children with characteristics of autism

Journal of Autism and Developmental Disorders

Nonvocal language acquisition in adolescents with severe physical disabilities: Blissymbols versus iconic stimulus formats

Journal of Applied Behavior Analysis

Effects of symbol, referent, and instructional variables on the acquisition of aided and unaided symbols by individuals with autism spectrum disorders

Focus on Autism and Other Developmental Disabilities

Visual symbol acquisition by students with autism

Exceptionality

The role of iconicity in augmentative and alternative communication symbol learning

Augmentative and alternative communication: A handbook of principles and practices