The Paper

Annotated Bibliography

Interrogative Question: Can the Picture Exchange Communication System (PECS) help to decrease stress in parents who are struggling to communicate with their non-verbal children?

autism spectrum disorders in minimally verbal children (Protocol). Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD012324. DOI: 10.1002/14651858.CD012324.

This article focuses on the communication interventions for children who are diagnosed with autism and have minimal language repertoire. Research seek to evaluate how effective are the interventions based on communication with children who are minimally verbal. Using three different approaches for the intervention such as communication based intervention, augmentative and alternative communication, and a combined phase of communication. The randomized controlled trial was used to see what outcome the intervention has.

The primarily tools were spoken words, PECS, anxiety that can derive from child, and parents stress. Using a cluster-RCTs will help do randomize the data to participants. The results indicated a statistical significance in the groups and it was discuss by the researchers that if children are not able to communicate properly with family members, than stress can arise (Brignel, 2016).

The article focuses on children who have minimal language repertoire and need help to acquire language and or find a way to communicate. This research can help with my LSQ as researchers have found that children with limited language repertoire have problems with communication in which can cause stress, anxiety, and family problems.

2. Carr, D., & Felce, J. (2007). "Brief report: Increase in production of spoken words in

some children with autism after PECS teaching to phase III". Journal of Autism and Developmental Disorders, 37(4), 780-7. doi: 10.1007/s10803-006-0204-0

Increasing the verbal repertoire of children diagnose with autism using PECS was the focus of this research article. Evaluating the early phases of PECS, in this study, 24 participants who had not being trained to used PECS at all participated (Carr and Felce, 2007). There was a PECS group and a control group. IOA data was gather for the words that were elicited using PECS. A within-subjects design was used to measure the difference between a treatment group and no treatment. It was discussed that the children who were taught to elicit responses using PECS made more responses than those who did not use it. Two of the participants were non-verbal and learn to elicit verbal response as well as using PECS to exchange words. Carr et al., (2007) discussed that the research elaborated in previous finding of PECS and children learning to use it after eliciting responses.

The article by (Carr and Felce, 2007) will help my LSQ by highlighting the effectiveness of using PECS to children who are non-verbal. As discussed in the article, two participants were non-verbal prior to being introduced in PECS and afterwards learned to elicit verbal responses as well as use PECS. Parents who are properly trained to use PECS can benefit from using it and decrease the stress factors that arise from not being able to communicate effectively. The content of this article can benefit as a source.

*This article is older than five years, but the content can benefit to input knowledge of the benefits of teaching non-verbal children how to elicit vocal and or form sentences using PECS, thus, learning to communicate.

3. Chaabane, D. B. B., Alber-Morgan, S. R., & DeBar, R. M. (2009). THE EFFECTS OF

PARENT-IMPLEMENTED PECS TRAINING ON IMPROVISATION OF MANDS BY CHILDREN WITH AUTISM. Journal of Applied Behavior Analysis, 42(3), 671–677. doi.org/10.1901/jaba.2009.42-671

Chaanane, Alber-Morgan, and DeBar (2009) researched on the effects of parent implementing PECS to their children diagnosed with autism. Participants had been pre-trained to use PECS and sessions were conducted in the participants home. Highly reinforcing items were utilized to pair the requests with PECS. A multiple baseline design across categories design was used. Parents performance, mands, generalization, and novel items were analyzed for this research. Parents conducted intervention and training to their children using PECS. Each preferred item was placed next to the corresponding visual card to teach the child to request using the visual card. During baseline, none of the participants were able to emit responses, but during intervention phase there was a high increase in the responses. Results suggested that parents can train children to communicate with them using PECS to request for the desired items even when the items are novel to the child.

This research helps my LSQ because it discusses the effects of parents learning how to use PECS and implement PECS with their children. This can help to effectively learn to communicate. The study also demonstrated that in fact parents when trained properly can learn effective ways of communication. The content is what will help construct the basis of my project.

*This article is older than five years, but it supports the theme of my paper and how effective PECS can be to decrease stress and learn new ways to communicate with their child who has limited language repertoire.

4. Greenberg, A. L., Tomaino, M. E., & Charlop, M. H. (2014). Adapting the picture

exchange communication system to elicit vocalizations in children with autism.

Journal of Developmental and Physical Disabilities, 26(1), 35-51.

doi:10.1007/s10882-013-9344-2

Greenberg, Tomaino, and Charlop (2014) conducted two studies to deepen the knowledge of PECS training in children with limited language repertoire. The research question was if children with autism can be taught to use PECS and pair it with vocalizations. Setting of intervention included tangible items. The design used in this study was a multiple baseline across participants design. Data was taken on vocalizations, PECS, IOA, and time delay. Findings of this study were that children were able to elicit vocalizations to request for items and non-verbal children can learn to pair PECS and vocalizations when taught properly. Findings on this research concluded that children can learn to use PECS and will not be dependent solely on this method for vocalizations (Greenberg et al., 2014). The content in this qualitative article, can help demonstrate the importance and utility of parents learning to use PECS to decrease their stress levels.

5. Flippin, M., Reszka, S., & Watson, L. R. (2010). Effectiveness of the picture exchange

communication system (PECS) on communication and speech for children with

autism spectrum disorders: A meta-analysis. American Journal of Speech - Language Pathology (Online), 19(2), 178-195.

This article evaluated the effectiveness of PECS on increasing the communication and speech of children who are diagnosed with autism. Flippin, Reszka, and Watson (2010) discussed that they wanted to evaluate the affects that PECS has in increasing language and communication. A systematic review of literature and findings on PECS were analyzed. A total of eight experiments using PECS were evaluated and all used a single-subject design. The vocalizations, approximations to sounds, utterances, spontaneous speech, requesting, and initiating the usage of PECS was examined. Based on the evaluation, it was determined that PECS does in fact help to increase language repertoire, and helps to increase language. Although, it was noted that PECS has not established enough evidence base. It was noted that typically during phase 5 of pecs, children begin to have a form of speech outcomes.

This article will help answer my LSQ because its content is useful to use and discuss what previous findings have demonstrated with the usage of PECS and with children diagnose with autism. Language, vocalizations, and attempts to vocalize have been observed when using PECS.

*This article is older than five years, but I decided to use it because there has been so much controversy with using PECS over the years. This article has enough data gathered from other articles that helps to prove the effectiveness of PECS regardless of the limited evidence-based research.

(2012). Teaching children with autism to engage in peer-directed mands using a picture exchange communication system. Journal of Applied Behavior Analysis, 45(2), 425. doi:10.1901/jaba.2012.45-425

Peer-directed requests using preferred items and PECS were examined. The participants were two non-vocal children diagnosed with autism. Participants were trained to use PECS prior to participating in this research. Peers were utilized to help elicit requests using PECS. IOA data was gathered on the number of mands, social interactions, differential reinforcement, and following peer directed mands. A multiple baseline reversal design was utilized for this research. The results of this research concluded that the participants were able to make mand requests using PECS after being trained to do so without any prompting. It was discussed by Paden et al., (2012) discussed the importance of training children prior to using PECS. One of the limitations was not doing maintenance of PECS. This research article and its content will help my LSQ to dispute the effectiveness of using PECS. Parents can benefit from it and learn to communicate with their child.

I chose this article because it has clear evidence of how PECS works when its paired with a peer. This can help answer my LSQ question because parents could be trained to be a peer to practice and teach how to use PECS with their child. The content of this article useful as a resource that demonstrates the effectiveness of learning to mand.

*This article is older than 5 years. I decided to use it as it analyzes the importance of teaching children to mand using PECS and how effective this tool is to communicate with others.

M.(2016). Parental stress and ASD: Relationship with autism symptom severity,

IQ, and resilience. Focus on Autism and Other Developmental Disabilities, 31(4), 300-311.doi:10.1177/1088357615583471

Fernandez, Tarraga and Navarro (2016) wanted to analyze the stress levels of parents who have children diagnose with autism compare to those who have atypical children. 84 families who participated in this study and using personal questionnaires PSI tool, RS scale used to see the adaptation of people, and other intelligence test were used to gather the data. A MANOVA and SPSS were used to compare the stress levels of parents with c atypical children and those parents with children diagnose with autism. The results suggested that parents stress levels with children diagnose with ASD were much higher than those who had atypical children Cerezuela et al., (2016). It was also discussed that family stressors not having enough resources to help out their children get the adequate services increases the stress. The researchers also found that the severity of ASD also contributes to higher stress levels.

This quantitative article has a lot of information on the stress levels that parents with children diagnosed with autism have. This research can help answer my LSQ because it uses theoretical frame work to help measure the levels of stress and its content contributes to the overall aspect of parents having higher stress levels and the challenges that parents can have when they are not able to communicate properly.

8. Parenting stress and psychological functioning among mothers of preschool children with

autism and developmental delay. (2009). Autism : The International Journal of Research and Practice, 13(4), 375–387. doi.org/10.1177/1362361309105658

Parent stress levels who have children in preschool diagnose with autism is being examined in this research article. Primarily, the researchers wanted to further explore the characteristics of the child and the adaptive functioning skills and what causes it has on the parents stress levels. A comparison of children with developmental delay and those diagnose with autism was examined. This longitudinal study gathered paid participants (parents) to share clinical information as well as the recruitment of their children at the facility. Several of assessment scales were utilized. All participants were same age, race, and non-verbal. Using a T-test to analyze data, and findings suggested that parents with children with ASD had a higher mean compare to others. Stress and psychological distress was also higher. In addition, it was found that parents of children with ASD have higher levels of parenting stress and lower daily living skills.

This particular article follows a theoretical model and it basis of its findings on previous findings. This research can help answer my LSQ because it provides information on the different stressors that can affect families with children diagnose with autism.

*This article is older than 5 years, but it provides great information on factors related to the parents stress when they have children diagnosed with autism. It is a longitudinal study in which participants were long evaluated and it is useful for its content and method.

9. Rivard, M., Terroux, A., Parent-Boursier, C., & Mercier, C. (2014). Determinants of stress in parents of children with autism spectrum disorders. Journal Of Autism And Developmental Disorders, 44(7), 1609-1620. doi:10.1007/s10803-013-2028z

Rivard, Terrouz, Bousier, and Mercier (2014) conducted research analyzing the stressors that parents experienced when they have a child going through the early intervention program. Participants for this study were 118 mothers and 118 fathers and their stress levels, stressors, and predicting variables that might increase stress were analyzed (Rivard et al., 2014). Intellectual functioning, adaptive behaviors, severity of symptom’s of ASD, and parental stress were the variables analyzed using a t-test, parental questionnaire, and CARS questionnaire. The results of this research were that parents who have children with ASD have higher levels of stress and that parents have higher stress levels due to their role as parents rather than there child’s diagnosis. The fathers reported higher stress levels than mothers did. Parents also demonstrated higher stress levels when their children have severe ASD. lower IQ, and not knowing when services and intervention will begin.

I chose this article because it researches the stress levels across both genders of parents who have children diagnosed with autism. This can help me answer my LSQ because it identifies possible stressors that parents undergo when they have a child diagnosed with ASD and do not know what to do or expect to help them. Although my LSQ primarily focuses on the parents stress levels when they have a child diagnose with ASD and do not know how to communicate with them, this article also serves as a guide to see many other stressors that might be co-occurring at the same time. The theory content is why I chose this article for. I thought it’s a helpful yet informative research.

communication system: Communicative outcomes for young children with disabilities. Topics in Early Childhood Special Education, 18(3), 144.

This is an evaluation of PECS in two different studies conducted with children who were delayed in their communication skills (Schwartz, Garfinkle, and Bauer 1998). The first study used participants that used acquisition of PECS and the second group was evaluated using PECS over the course of a year during different school activities. The setting of the intervention was inside the children’s classroom and data was collected in all interactions of the classroom. PECS training was administered to each of the participants prior to the intervention. They were taught all of the faces of PECS and how to form sentences. Once the children were taught all faces, they started to use the PECS with peers across all school time activities. The results in this research concluded that when the children are trained properly, they were all able to use PECS with peer and adults (Schwartz et al., 1998).

I chose this article to help answer my LSQ question because it focuses on the effectiveness of PECS to teach children language and learn a new way to communicate with others. The content of this article will help me to provide insight information of why parents would benefit from using PECS to help communicate with their children and decrease the stress levels caused by not being able to communicate.

*This article is older than five years, but its valuable to my research since it discusses how children learned to communicate with other using PECS.

Reference

Brignell A, Song H, Zhu J, Suo C, Lu D, Morgan AT. Communication intervention for

autism spectrum disorders in minimally verbal children (Protocol). Cochrane Database of

Systematic Reviews 2016, Issue 8. Art. No.: CD012324. DOI: 10.1002/14651858.CD012324.

Carr, D., & Felce, J. (2007). "Brief report: Increase in production of spoken words in

some children with autism after PECS teaching to phase III". Journal of Autism and Developmental Disorders, 37(4), 780-7. doi: 10.1007/s10803-006-0204-0

Chaabane, D. B. B., Alber-Morgan, S. R., & DeBar, R. M. (2009). THE EFFECTS OF

PARENT-IMPLEMENTED PECS TRAINING ON IMPROVISATION OF MANDS BY

CHILDREN WITH AUTISM. Journal of Applied Behavior Analysis, 42(3), 671–677.

doi.org/10.1901/jaba.2009.42-671

Greenberg, A. L., Tomaino, M. E., & Charlop, M. H. (2014). Adapting the picture

exchange communication system to elicit vocalizations in children with autism.

Journal of Developmental and Physical Disabilities, 26(1), 35-51.

doi:10.1007/s10882-013-9344-2

Flippin, M., Reszka, S., & Watson, L. R. (2010). Effectiveness of the picture exchange

communication system (PECS) on communication and speech for children with

autism spectrum disorders: A meta-analysis. American Journal of Speech - Language Pathology (Online), 19(2), 178-195.

Paden, A. R., Kodak, T., Fisher, W. W., Gawley-Bullington, E. M., & Bouxsein, K. J.

(2012). Teaching children with autism to engage in peer-directed mands using a picture exchange communication system. Journal of Applied Behavior Analysis, 45(2), 425. doi:10.1901/jaba.2012.45-425

Pastor-Cerezuela, G., Fernández-Andrés, M. I., Tárraga-Mínguez, R., & Navarro-Peña, J.

M.(2016). Parental stress and ASD: Relationship with autism symptom severity,

IQ, and resilience. Focus on Autism and Other Developmental Disabilities, 31(4), 300-311.doi:10.1177/1088357615583471

Parenting stress and psychological functioning among mothers of preschool children with

autism and developmental delay. (2009). Autism : The International Journal of Research and Practice, 13(4), 375–387. doi.org/10.1177/1362361309105658

Rivard, M., Terroux, A., Parent-Boursier, C., & Mercier, C. (2014). Determinants of stress in parents of children with autism spectrum disorders. Journal Of Autism And Developmental Disorders, 44(7), 1609-1620. doi:10.1007/s10803-013-2028z

Schwartz, I. S., Garfinkle, A. N., & Bauer, J. (1998). The picture exchange

communication system: Communicative outcomes for young children with disabilities. Topics in Early Childhood Special Education, 18(3), 144.