What PECS is Really For | www.agentsofspeech.com/micro
Ming explains PECS, a communication system that teaches kids to initiate requests by exchanging pictures. It works best around age 3 or 4 and focuses on building the concept of communication itself, not just symbol recognition. PECS differs from gesture-based or iPad approaches in how it structures that learning.
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Okay, so today we're going to talk about what PEX is and what is about and why you should pay attention or why you shouldn't pay attention to it. So what PEX is, what it stands for is picture exchange Communication System. Okay. And this thing has been, this thing, I mean, the system has been around for quite a long time now. And I would say that for someone to use PECS properly, to learn about PECs, that person should go to lesson. Okay. As you would know for a professional to actually, you wouldn't know for a professional to get certified, certified with PECS, it takes, I don't know, like 2000 USD at the very least to actually get the certificate or to be educated about it. Yeah. So to have someone who knows PECS would be a great asset to, for, you know, if, if they were to teach your child. Right, and that's true. But first of all, we need to think about what PECS is about. So PECS is a part of a whole umbrella term for what we call aac, right? If you guys know about it, which is alternative augmentative communication, meaning anything that doesn't use speech as a way to communicate is aac. Okay. So if you remember the late Stephen Hawkins, he would use his eye tracking thing to type out alphabets and write books that are volumes and volumes long. I'm not sure anyone has ever finished those books. That is called an AAC too. Okay, so why does your child need AAC or in particular PECs? So children who are on the spectrum are always pretty much quite often being recommended to use pecs. And the reason for that is because it's a structured thing. It's a structured activity system that helps the child acquire some what we call pre linguistic skills. Skills. All right, so pre linguistic skills, you don't need to be too scared about what it is or like it sounds too crazy. It's just basically some stuff that you need to know before you start talking. And we talked about this last week as well, a little bit, but I feel like a lot of you, a lot of you guys are asking, oh, does AAC packs or does like an iPad? You know, like, I don't know, like a communication device will help a child start talking or not. And the answer is it depends. Right? So if you're using a PECS or aac, I would say your child needs to be a little bit older. So what is older? So at least four to five. Why? Because when you're two to three or you're three to four, you're still trying Our best to teach speech as much as possible. Right. Are there times that we are going to do pecs at like 3 years old plus yeah, of course. Really we do. Don't get me wrong. And that is up to the discretion of your speech therapist or your ABA therapist or your pediatrician, not pediatrician, your developmental psychologist, whatever. Okay. A professional will tell you, ah, this kid needs pecs. Right. So are there cases that pecs will harm your child in any way? I don't really think so. Okay. PECS is a way of using pictures to communicate, obviously. But the whole crust, the thing about pecs itself is that it teaches a child how to initiate a communication. As we were talking about last week. Right, so, so what is this initiating part? Is it important? Is it anything? Yes, it's very important. First of all, it's super important. And does it warrant you to learn pecs and learn everything and print everything out and laminate it and put it in a book and then buy a book or whatever, Buy Velcro and all that stuff? Well, yeah, I think so. I think so. In the beginning, why we're using pex is for children who don't really have motivation to talk to you. Right? So we want to use, we want to use pecs to teach them to initiate, to communicate with you. I'm sorry, if you can see me, I'm looking here and looking here. That's because this is IG and this is YouTube and Facebook. But anyways. So why do you want your child to learn how to initiate communication? Well, first of all, your child is already initiating communication with you. He's already trying to talk to you in some way or another, right. So one of the ways that children talk to you might be unconventional ways. What is a conventional way is that they talk, I don't know, they signal you, they use a gesture, so on. Right. But some children, when they want to talk to you, they use ways that are not really socially acceptable, such as screaming, shouting, crying, whatever, kicking you, biting you, using the head to head. But you like when I was my first ever student with headbutt me in my stomach just to get my attention, right? And obviously, you know, the ABA way is to ignore any attention seeking behavior. So at the end of the day, when I was younger, I didn't know better and I just kept on getting head butt on the stomach for no particular reason. But I digress. I was talking about how to initiate communication. So if they already know, then why teach them? And that's because we need to give them a very Predictable way for the child to talk to you, to start a conversation with you. Right? So that's why pecs is great. Pecs is great is because now there is a structured way that a child can start a conversation with you telling you exactly what they want. So if you're dealing with children who are non verbal and have a lot of tantrums when they can get their message across, then packs is a good one. Is a good one. But the thing about PACs here is that a lot of people, a lot of therapists actually, and a lot of teachers, they put the emphasis of pecs inside of how many cards, how many specific messages they can send with cards, right? There's a lot of oh, I want to pee, I want whatever. And then you make sentences like I want an underscore something or give me whatever or I eat whatever. Like these kind of what we call carrier phrases that they use to build sentences in pecs so that it justifies, I feel like what's happening is that especially in Asia, because, you know, pecs is something that Asian parents do not want because it means that, oh, you're giving up on speech. It's besides the point. It's not about that. But sometimes when we're trying to compensate, especially younger therapists who feel like we, oh no, I don't know if this will actually, as a parent, you wouldn't know. But as someone who has been in the field and looking at other therapists, I will see that they are trying to compensate for thinking, oh no, I've done it, I've jumped on pecs and I want to make sure that I can show the mom that this works. Therefore I'm going to do a lot of sentences or whatever. But the real point of text is that they can initiate correctly with you, meaning they can take up the card, shove it into your hand. Even if you're not looking, you're not trying to attempt them, you're not doing anything to get your attention. That's the good way to get your attention. Not by, I don't know, screaming, shouting or whatever. A lot of times when I see a pack session is that the, the person is, maybe the caregiver is trying very hard to get their attention. Like, you know, like, and take up the. I don't know what, what people use for pex, right? Maybe it's the phone, maybe it's snack or whatever. But then they do a lot of stuff. They ask the person, they ask the kid to look over here, over here and all that stuff. But that's besides the point. The main goal of pecs, the main goal is that you're teaching them a different way to communicate. So the whole stage one of pecs. All right, and a huge disclaimer here. I haven't been on a PECS workshop just yet. Okay. The pandemic hit. I was supposed to go to Singapore to relearn a little bit of that. I was supervised by someone who has, I don't know, PECs level whatever. I don't stage whatever. But, you know, I was mentored directly by that person and she was very strict about it. That's why I had to remember the whole book. So, you know, I don't want to think about it. It was very tough on me. But if she hadn't had done so, I wouldn't have been able to speak to you right now about packs. Okay. So grateful for her. So what happened was, what happens in stage one is that you want the child to take the card on the table and shove it into your hand. Okay, why do you want that? So basically, when the child can do that, it means that they understand by giving you the card to get what they want, not by any other means. Therefore, when they have this means to use it, to use that. So some children will imitate whatever you say, whatever you do to get what they want. That's the means to the end. Where in PECs, you're teaching them to use picture exchanging as a means to an end. Right. So when they learn that there's a means to an end to the pecs, then the next stage is to use that structure that means to an end to teach more content. This is where you teach them a pre linguistic skill, what we call matching. Right. Or being able to identify a difference in different pictures. So usually when they can take the emphasis should be 100% on them being automatic taking the card and giving it to you to get something they want. Even if you're not looking, you're not enticing them with snacks or floundering with your phone or whatever you don't want that you want them to from the heart. Suddenly out of nowhere, they just want to and just give it to you. Then you know, you can move on to stage two. Many people just think that, ah, as long as I tempt them and then they give me a card, then we're done with stage one. Not really. You want them to out of just suddenly think about that reward and just give it to you and get what they want. And this is very important. This needs to happen at home. It cannot happen at the clinic because at the clinic, you know, you can. They're already, they're already conditioned to, to think, I'm gonna, I'm gonna do this. I'm. I'm here to give cards, I'm here to get rewards and so on. And therefore it's easy for the child to perform. But I want. What you need to do, if you really do pecs, is that you need him or her, probably him most of the time, and you want them to go him, go, go to that place with the card and give it to you. Okay. And then you can talk about teaching more words and so on and so forth. Okay. Okay. So why do you need it? Or why do you need it? And so on. We talk about why. We talked about how to do it kind of. Obviously you still need a professional to help you out along the way. Right? So if you already know what text is, then, you know, you're already down a rabbit hole. Okay. And obviously this kind of topic wouldn't get a lot of people, but you know, on agents of speech, we talk about stuff that are helping those parents, especially those mothers who want to learn more. So if you're here, then great. Hallelujah. Anyways, so does your child need it or not? There are lots of arguments about pecs. There are people saying that and showing me real evidence that I've seen with my real eyes in Hong Kong. Right. There's a huge advocate for pecs who works with children on the spectrum. And they would start off using pecs to teach these pre linguistic skills and then move on to speech. And it works. It does work. I've seen it. And that's why I would say nine times out of 10, if you know what you're doing, does a therapist know what you're doing? And if they, if the therapist says that for this child, it's fair to use pecs as a way to teach them something to communicate in the beginning stages. Then go for it. Go for it. Right. Even if they're around three, would I say that your child would need it by around 2 to 3? No. Start pecs after 3. There's reasons for it just because it's more manageable. All right. And the attention span is a little longer and you can make them sit for a little longer and they want stuff from you for a little longer. Okay, so how about if I got. The whole reason why this sparked this conversation is because last week someone asked me about whether a 2 year old would benefit from AAC like, like using an iPad App or whatever. Like, teach me to talk, talk for me or whatever. A pro low to go or something, if you know what I'm talking about. You know what I'm talking about. If you don't know, then you don't know. Right? So I was saying, no, if your child is below three, I would say that you need to try all we can to see if we can get them to imitate sounds, to get them to get them to imitate actions, sounds, see what their repertoire is, see what sounds they have already, what sounds they can have. If it's a problem about, like, a speech, then, you know, we need to focus on getting more sounds. If it's a problem with language, then we need to focus on teaching them more things. Okay? And last week we were talking about matching as a, as a therapy thing. Now, I've seen it many times, because in ABA back then, I did a lot of matching with a lot of children. I'm talking about. I'm. I was a master of matching. I'm not even joking. I was telling you guys, right? Back in the day, when I was in aba, all my female colleagues would get sick, right? And I would shoulder most of the cases. I don't know why there were other people available. Whatever. It was a chance for me to learn. But the thing about matching is that how do you generalize it towards real speech? And why would you want to use it in the long run? It doesn't really help much other than if you're building towards pecs and you're building compliance, that's all. Would I say that you guys need pecs? No, not really. Before three, don't even think about it. Your child is not on the spectrum. Is not n o t not on the spectrum. Then PECs will be only reserved for children who are deemed nonverbal. And we've talked about this before. Non verbal, there's a lot of meanings, I mean, a lot of definitions. That's what I mean for non verbal. Okay. But there is a place where we call them pre verbal and then non verbal. Pre verbal. That means like we're thinking, oh, they're yet to speak. We don't know if they will speak yet. And then non verbal is where we deem them kind of difficult to use speech sounds as a mode to communicate, not saying that they cannot communicate. Right. So where do I draw the line? It's difficult. It's hard. It's a decision with the parents and me and maybe another professional that has been working with them or something. And we talk about okay, what are you like, what are the parents concerns? Are you okay with using AAC as a middle step? Right. This conversation should always be here. If you have, if you go to a therapy center, they don't talk to you about it and then they suddenly just force packs on you. Then obviously there's something wrong with their, with their. I don't know, there's something wrong. You gotta have a conversation, a professional one, about, are we doing this? Do you want to do this? Is this something you want to do? Are you on board? Because if you're on board, you need to help me out. Right. So there's a lot of these things you got to talk about first before you jump in. Okay, so we see a question here on Instagram. Obviously you can't see, so it's Sassitharan. Sorry if I'm getting your name wrong. Says is bl is babbler. Babbling. Right, so babbling considered preverbal. Yes, babbling is considered preverbal. Preverbal is more like how I would say proverbal is. I would. Personally, Personally. Right. I don't know. There's definitions are changing every day, you know, so. And even definitions of autism, definition of as, I know adhd, definitions of, you know, intellectual disorder, they're all changing all the time. But preverbal, I think, I think, okay, don't take my word for it. Although, you know, I don't want to have you guys go out and say, ah, this speech therapist Ming said this is not proverbial. Whatever. It's different everywhere. First of all, I want to get this out there. Okay? It's different everywhere. Whether you're in, I don't know, you're in Korea, Japan, I don't know, usa, uk. They all have kind of different ways of defining anything. So preverbal is, I would say is any child between like three and a half or below. And you can see, you can physically see that they still have, they still have a full set of developed skills that are from. That are developmentally normal. Meaning they're step by step. Right. They're. They're still hitting some foundations. They're not missing a bunch of stuff. And you would think that, oh, by. They're just delayed in terms of language. That's why they haven't been able to say anything yet. Right. That's pretty verbal. Whereas non verbal usually means that a child is physically incapable of making sound. Physically incapable of creating coherent, understandable speech sounds. That's non verbal. That's why I said non, because they're not able to. Right. Whereas pre is like. You can see that it's coming. There are a set of skills. They can. They can babble, they can say certain sounds, certain words, but they haven't linked the word to meanings. Therefore, that's why they're pre verbal. They're not yet verbal. Okay, so maybe that will help you a little bit. So I would say that we don't use. Sorry, I'm going to close that. We don't use pets for pre verbal children, for sure. Okay? But in cases where if it's a. What we call a asd, Autism spectrum disorder, then we will consider it for reasons that. It's a pragmatic. It's a pragmatic thing. It's. It's. It's more of a. What's that called? It's more of a social interaction thing that I don't know how to. How to use it. So someone asked on Instagram, right? They say, can we see the example of pecs and how to use it? Well, we're not here to talk about how to use it. I mean, as I said, if we want to learn how to use it, then try to do it. You know, Try to get a professional to do it with you. Number one, an example of pex is. I don't have one around here, okay? It's downstairs, and I don't want to go down right now. I'm sorry about that. But what I mean is, I don't know your situation. Sometimes I tell parents something and they feel like they got to do it after I say it. And it's very easy to link and think, ah, that's for my child. And you try to do it. But what I mean is, Juliana, right, is that, hey, man, you gotta. You gotta tell me more about your kid. Gotta. You gotta do more research. Whether you want it or not, you gotta ask more professionals. You gotta ask around, ask other parents, ask other moms about whether this is for your child or not. There's no use in studying something that is not helpful for a child. Okay? I've seen it many times that moms will take courses about. Take courses about what? Courses about many different things, like oral massage, when the child can speak already. They take courses about, I don't know, sensory integration when the child is. Obviously not. Doesn't have any sensory issues. So I see this all the time. So I know that you want the best for a kid, but, you know, my best advice is that you go to. If you're on Facebook, then great, you can go to our Facebook group, inside Facebook group and ask there. Okay. And ask. Describe your child, ask other moms and search inside for a lot of different things. Or you could just join our agentsofspeech.com micro the micro course. Right. And there are loads of things that will go through for you. Like we go through a lot of FAQ basically frequently asked questions in semi detail so that I can get you on the right mindset and we can move forward from there and you can ask better questions. Right. So I'm sorry, I don't have an example of pecs. I don't want to show you anything. I just want to tell you if this, this whole life is for that. If someone asks you about oh I want the therapist say I want to do pecs. At least you have a little idea what it's about. On a conceptual level is that to teach a child to learn how to actually start a conversation with you using pictures and then when they have that they can use it to learn new words, new sounds, new new content, new pictures and identify the speech sound into the ear to choose the correct one and give it to you. Right. And that's working on a bunch of things and working on matching, working on word identification, learning how to slowly moving from pictures to drawing, learning about abstractness and so on. These are all things that text will help your child with, maybe even sentence building at the end of the day. Okay, so that's probably it for tonight guys. I just wanted to get this out of the way and I'll be open to some questions. All right, so for ig adult really know how to scroll back up guys. Oh, I see it now. Let me check. No one asked questions, right? If you need then just tell me. All right, just put it here. And I see that on Facebook someone has put a question as from Koyan. Yay. Okay. During preverbal stage 33 months. Well, children tend to sound a single word, but it's not repeatedly or consistently. How could the parent help him to repeat? Is more snack practice session or the only way observe the kid to be in good mood once wake up. Good sleep tends to self babble even midnight. Okay, so Ku Yen talks about snack practices from the micro course. If you don't know, then you know, join it and take a look. No, it's not the only way Ku Yen, but a lot of times why we, why I in particular because I know you guys very well is because a lot of techniques take a lot of patience and you will not see any results. Okay, the snack one is the Fastest, I want you to give you a quick win so that you feel like I can do this. Let me continue. All right. And there are times where like you, Ku Yan, that, you know, sometimes it doesn't work that fast. Okay. For example, last time, if you seen the first ever parent who I showed to the outside world that I've been working on with, she could only get to imitation in four months. Right? So there are other ways to babble. There's a lot of stuff you can do. So first of all, one of the ones that we talk about a lot, I mean, we as in therapists, not an agent of speech because we don't really teach that. So one of them is called sound play, right? Sound play. What? Sound play is basically you play with toys that have some sort of like for instance, like an ambulance. That sounds right. When you do sound play, you go be boo be. And you keep on doing it even if your child doesn't repeat. The thing is go Yan, you're always thinking about how you can help him talk. That's the problem here. You know, there's some, I don't know. Whenever a parent wants the child to repeat or talk, there is a sort of feeling that a child gets and he's gonna be like, I know you want me to repeat. I know what you are trying to do. I don't get why I should do it. You know, you get that kind of feeling and that's when parents will say, oh, they're too lazy. They don't know. They, they don't understand it. Only when they're good mood, bad mood, they don't want to. Right? But you're not supposed to try to make them repeat. You're only supposed to make them repeat if you have something of value in your hands. That's hence the snack practice session, right? So you can do a lot more sound play with him. But when you're doing sound play, you're creating sounds that are about of his level. So in Babel there are two levels, right? One is just mono babbling, which is like that. Okay. And then there's reduplicated babbling. I'm throwing jargons at you. But what it means is just it goes babi babu or mambu or whatever or people. This kind of like. You get what I mean? Reduplicating, meaning it will duplicate itself in a different pattern. It might be ma babi or something. So there are two stages? Most probably. Actually there are loads of stages if you really want to dig into it. But I don't even remember myself. Okay, so why. If you want. You don't want. You want him to repeat and be consistently, then you have to do it yourself. You know, you. You have to be the person who is creating those sounds and making it fun. And we call that sound play. All right. Yeah. Yeah. If you're doing it, then keep on doing. There's. There's not much I can say to you, Koyan. Sometimes. And that's because you need to have patience. This stuff doesn't just magically work. I mean, if you bring him to a speech therapist, it might magically work. And that's because, you know, people have got like years of experience just handling children. So you have to be patient about your own. What's that called? Your. Your own ability. Okay. Sometimes it's not the child. You have to be patient. Alrighty. So, Mohuden. Sorry if I'm getting your name wrong again. Start babbling suddenly and continue the whole a. The whole day. H3. Is it certain development? Yeah. I mean, if he starts babbling and he keeps on doing it, then obviously it's verbal development. Right? All right. Hey. Why? Bing. Hello. I was the one who asked AAC last week. Yes, you did. There's a bunch more, actually. You sparked a conversation. So should I be concerned about my child's ABA therapist because they insisted to use AC instead of gesture? It says too difficult to teach my 2 gesture because they require strong motor skill. And there any type of sign of asl. Yeah, no one told. No one tells. I mean, like, I don't want to say that your therapist is wrong. But. There's a but. Right. Obviously. Because, you know, whenever you're teaching like a gesture, it doesn't need to be 100 correct. It doesn't need to be spot on. Right. And you think about aac, hey, what. What kind of AC are they talking about? Like, are they talking about packs? Are they talking about iPad? Anyone who is telling a 2.5 year old, 2 1/2 year old kid to press buttons on the iPad to tell you what they want? I don't know, man. It doesn't sound natural to me. It doesn't sound whatever. And I've seen your kid. If your child is on the spectrum and they have a plan, for instance, they have a plan to tell you to use pecs to teach certain sounds or. Or words, then I think, fair enough, go for it. Right? But at the same time, what's, you know, like, if I don't get it. So how hard is it to teach a very gross Motor gesture. Okay. I mean wiping. You've seen it as well, right? We were inside of the, in the membership that we have, by the way, Closed guys, not open. Okay. Remember that if you were on one of the calls, which I remember that you were. Okay. There was a kid who obviously had motor issues and couldn't do the open gesture correctly. Right. So he would go like that. Even that's acceptable, you know, because the mom understands it. Right. Doesn't matter. Gestures are great. Gestures are cool because later on you can use it for other things such as cueing speech in a very naturalistic way. Okay. I would say what requires more motor skills, Right. Pressing buttons every time, holding a big iPad. Does that require a big strong motor? I think so. I would never do it for a two year old. Okay. Even if they were on the spectrum, I would only start at 3. For obvious reasons. For their reasons, actually. But you know, like if, if they do have a plan, then let them go for it and that's it. Probably. I don't know what to say. You know, sometimes I feel like ABA is a hit or a miss. You know, I started off as an ABA therapist too, but I moved on from it. And at the same time I still use the practices I used back then to a large extent. But at the same time you cannot. I don't know what to say. I don't want to sound like I'm discouraging people from going to aba because it's great. It really is a good thing. A lot of one of my students who are in the teenage years, they are one in their adult years would say ABA is great. You know, it helped me a lot to understand, gave me a lot of direct and straightforward to the point and structured environment for me to learn and grow. But at the same time there are many stories about, you know, aba, so on and so forth and we've done a live about this videos about this before as well. Well, right, so don't worry, you can go back and take a look. So ybing for me to give you an answer here is that I would always try gestures. Okay. But the thing about pecs or AAC is that you need to be on board with the therapist. If they're doing it, you need to do it at home and use at home or else your child's not going to benefit from it. So there's no way in unless you change therapist. Right. But there's no way in trying to go against what they, they're telling you. So what I'm telling you here is that either be 100% on board or don't be on board. Okay? And you say yes 100% or hell no. Okay? So that's up to you. That's not up to anyone to decide. That's not up to me to decide either. And we're not even going to go into many types of sign languages. And remember what I said just now? Aac, gestures, all of these. What we're doing is teaching pre linguistic skills, teaching him or her how to use a different way to initiate communication. I don't care if the sign language is wrong. They're thinking about many types of sign languages. Remember when I said text, many focus on the number of tiles on the, the freaking iPad. That that's not even the point. That they're not supposed to care about how many pictures, how many words you're teaching through aac. That's not the point. The point is to teach the child how to communicate with you. I don't care how many. Like if there's one picture, I think it's fine. You know, if there's one picture in text, I think it's fine. If gestures, you only have two to three, that's fine. Don't focus on the quality, the quantity, focus on the quality. Remember when we were having our coaching call session, right? When your child stopped and hold up her hand, she was waiting. We were, we taught her something. We taught her to wait and be patient and to use a gesture, open palm to get what she wants. Once she knew that, she would stop and she would listen to you and you can teach more stuff. So your starting point at home should be like that. And if the therapists are teaching in the beginning, if you see, okay, I'll tell you how to see if someone knows how to use the AAC or not. If you open their app or the pecs and it's a two and a half year old child who doesn't know how to talk and doesn't know how to use the ac. If you open it and you see that there's like five or six different pictures or maybe a whole page of tiles, then you know, get the hell out. You know, get out. You know, how is anyone going to use an AAC with so many buttons on it and you're trying to teach them how to use a system, is that crazy or not? Right? That's why. That's why. Especially to Kuyan, right? That's why I tell you guys, when you're starting to teach gestures, teach one, only one gesture at one time. Because you're not teaching that gesture. You're teaching the concept of using the gesture, right? You're not teaching them. Oh, I have this one. I have this one. I have that one. So many. Oh, they can't do the fine motor. Oh, no. Then we should skip to, like, using ac. That's not the point. You need to teach the concept of communication. All right, cool. All right, so I've stopped rambling. Maybe the last four minutes was the most valuable part of the whole live. But thanks, Wiping, for sparking this conversation. All right, this is what we need to do. All right? Remember? Yeah, Take a look. Why? Being see if they know what they're doing. All right, so for everyone here, everyone who's watching, for people who haven't used. Like, for children who haven't used a single word yet, remember, you need to teach their concept of how to communicate. Not the words, not how many gestures, not how many pictures they can take, not how many they can press, not how many they can identify. Okay. I'm sure that you know that a lot of children who are on the spectrum will be able to sing songs, recite movies, whatever. Okay. Recite nursery rhymes, all that kind of jazz. And at the end of the day, it's not about that. They have the content. They don't know how to link it and use it with you. That's the problem. That's what we're solving with text and gestures and whatnot. Okay? So that's all for tonight. Thanks, guys. Thanks for tuning in. I am on Instagram and also YouTube and Facebook at the very same time. That's why I'm looking two ways. But anyways, that's all. Thanks and have a good night.
