Spurwink’s Therapeutic Preschool program believes that all children have different and unique needs and learning styles, and that incorporating techniques from a variety of strategies and intervention approaches to individualize programming is the most effective way to meet a child where they are at. In June of 2021, the Preschool educators attended a 2-day training on PECS (Picture Exchange Communication System), funded with support of the United Way of Southern Maine. PECS is an evidence-based augmentative communication system that teaches functional communication for learners with developmental challenges, leading to independent communication. After the training, the team reviewed each students’ opportunity to learn PECS, and built in many more opportunities to practice using PECS within the classroom routine. Their goal was not only for students to learn to request preferred items, but also to vary the reasons why and what the students would need to communicate for throughout the day. Educators created several new icons for students’ individual books, as well as classroom activities so the materials would be ready in bulk when needed throughout the day. This new adaptation had a significant impact for one student in particular.
Richard is a student that started with the program in July of 2020. When he started the program, he was completely non-verbal and used mostly maladaptive behaviors to get his needs met (climbing to access what he wants or pushing adults out of his way or toward what he wants without regard to safety). This led to very frequent communication breakdowns and a high level of frustration and “tantrum” behaviors. Many months were spent on Richard adjusting to being in a learning environment and separating from his mother, building trusting relationships with staff, learning to accept physical supports/prompting in his learning and to attend to adults and visuals presented. By spring of 2021, Richard was attending to pictures for about 10 preferred items and was able to exchange a single picture icon to get what he wanted when the book with the icon on the cover was placed in front of him on the table. He sometimes required hand over hand assistance for the first exchange in the sequence but had progressed to responding to a gestural prompt (adult pointing to the picture) to exchange more independently to continue to get the material during a learning session. This progress took a considerable number of structured trials, repetition, and reinforcement to obtain.
After 3-4 weeks, Richard was able to exchange nearly 30 icons with minimal to moderate support (not full physical assistance) to get his needs met at a variety of times during the day. Over the course of the next 6 months, Richard really took off with his use of PECS. He now has 6 pages of icons in his PECS book that he can independently search for and retrieve when he wants them (a total of about 60-75 icons). Richard has become very invested in his PECS book and has discovered the value in communicating. He has learned to travel to his book when he needed to communicate after trials of the book being systematically moved further away. Richard is now able to travel across the classroom to seek out his book. Richard also learned to carry his book with him consistently when going outside of the classroom, as he understands that he might want to communicate something outside of the classroom.
At this point in time, Richard is now able to put 3-5 picture icons on a sentence strip to make a request, answer a question or comment upon his environment. Richard uses colors and other adjectives to be more specific with his requests. Richard has even been able to be creative with the icons he does have when there is not a picture for what he wants. For example, he will put the icons “I “, “want”, “blue” and “yellow” when he sees the box of the Cariboo game on the shelf, which is blue and yellow box. Richard has also learned how to ask for multiple of something in one try. In an activity with colored blocks recently, the children were requesting the colors they wanted as they progressed in their building a specific figure. Richard looked at the model and made his sentence strip with the six colors he would need and the block icon all at once! Richard’s growth in functional communication has transitioned to progress in other areas as well. He is now able to stop himself before climbing unsafely, grabbing materials, or pushing others out of the way. He accepts “no” more readily after his want or need is validated and is not using physical or maladaptive behaviors to get his needs met. PECS use has also transitioned into the home environment and improved the quality of interactions with family, response time in getting his needs met and general safety within that environment.
Funding from the United Way of Southern Maine makes this kind of success possible for hundreds of preschool students and families throughout York County. Thank you, United Way of Southern Maine!