Scientific Institute I.R.C.C.S. Eugenio Medea, Regional Branch of Ostuni, Brindisi Department of Neurorehabilitation 2, Child Psychiatry, Brindisi, Italy.
Int J Lang Commun Disord. 2012 Sep-Oct;47(5):609-17. doi: 10.1111/j.1460-6984.2012.00172.x. Epub 2012 Jul 18.
The Picture Exchange Communication System (PECS) is a common treatment choice for non-verbal children with autism. However, little empirical evidence is available on the usefulness of PECS in treating social-communication impairments in autism.
To test the effects of PECS on social-communicative skills in children with autism, concurrently taking into account standardized psychometric data, standardized functional assessment of adaptive behaviour, and information on social-communicative variables coded in an unstructured setting.
METHODS & PROCEDURES: Eighteen preschool children (mean age = 38.78 months) were assigned to two intervention approaches, i.e. PECS and Conventional Language Therapy (CLT). Both PECS (Phases I-IV) and CLT were delivered three times per week, in 30-min sessions, for 6 months. Outcome measures were the following: Autism Diagnostic Observation Schedule (ADOS) domain scores for Communication and Reciprocal Social Interaction; Language and Personal-Social subscales of the Griffiths' Mental Developmental Scales (GMDS); Communication and Social Abilities domains of the Vineland Adaptive Behavior Scales (VABS); and several social-communicative variables coded in an unstructured setting.
OUTCOMES & RESULTS: Results demonstrated that the two groups did not differ at Time 1 (pre-treatment assessment), whereas at Time 2 (post-test) the PECS group showed a significant improvement with respect to the CLT group on the VABS social domain score and on almost all the social-communicative abilities coded in the unstructured setting (i.e. joint attention, request, initiation, cooperative play, but not eye contact).
CONCLUSIONS & IMPLICATIONS: These findings showed that PECS intervention (Phases I-IV) can improve social-communicative skills in children with autism. This improvement is especially evident in standardized measures of adaptive behaviour and measures derived from the observation of children in an unstructured setting.
图片交换沟通系统（PECS）是一种常见的自闭症非言语儿童治疗选择。然而，关于 PECS 在自闭症的社交沟通障碍治疗中的有效性，几乎没有实证证据。
测试 PECS 对自闭症儿童社交沟通技能的影响，同时考虑标准化心理计量数据、标准化适应行为功能评估以及在非结构化环境中编码的社交沟通变量信息。
将 18 名学龄前儿童（平均年龄=38.78 个月）分为两种干预方式，即 PECS 和常规语言疗法（CLT）。PECS（阶段 I-IV）和 CLT 均每周进行 3 次，每次 30 分钟，共进行 6 个月。结果测量包括以下内容：自闭症诊断观察量表（ADOS）的沟通和互惠社会互动领域得分；格里菲斯精神发育量表（GMDS）的语言和个人-社会子量表；适应行为量表（VABS）的沟通和社会能力领域得分；以及在非结构化环境中编码的几个社交沟通变量。
结果表明，两组在时间 1（治疗前评估）时没有差异，而在时间 2（后测）时，PECS 组在 VABS 社会领域得分和几乎所有在非结构化环境中编码的社交沟通能力方面（即共同注意力、请求、发起、合作游戏，但不包括眼神接触）均优于 CLT 组。
这些发现表明，PECS 干预（阶段 I-IV）可以改善自闭症儿童的社交沟通技能。这种改善在标准化适应行为测量和从非结构化环境中观察儿童得出的测量中尤为明显。
