The Picture Exchange Communication System (PECS) was specifically designed to help young autistic children to make requests for important needs. PECS is widely used in special schools, but there is limited research to show its effectiveness. Even fewer studies have been carried out at home, despite this being the most important environment for developing communication skills.

Vicky Slonims and her team will conduct a randomised trial over 18 weeks, comparing children using PECS at home with those not using PECS.

The need for the project

Communication is essential for social and emotional development. Those who do not develop language are at risk of developing emotional and behavioural problems. Research shows that once minimally verbal children reach school age, they show very little improvement in speech or communication skills. It is not a surprise that research in this area is a top priority for families.

We are looking at PECS because previous research has been promising but quite limited. Most quality PECS research has been conducted by trained professionals in clinics or school, not at home. Home however is where children spend a significant proportion of their time and where unstructured, unprompted communication happens. It is valuable for a child to learn to communicate in this more natural environment - this is why in this study we are testing PECS at home with parents.

The research process

64 young children aged between two and seven years of age will take part in the study. 32 children will use PECS, 32 will not. Parents in the PECS group will be taught how to use the system with their child.

To understand how effective PECS is, a few things will be measured:

• Parents will record requests made using PECS in an app. They will also record requests made by other means (e.g. speech, gestures etc) and behaviour that may indicate a request e.g. a child attempting to open the fridge door.
• The children will wear a small body camera. This will provide extra information about the communication used by the child.

Parents will also be asked about how they found the study and the guidance given, and therapists will rate how well the parent understood and carried out the PECS stages and will carry out interviews with parents involved in the project.

How this project is making a difference

This project will tell us whether this method of PECS is easy for parents to use at home with their young children and whether it improves the child's communication skills. The results will go into a report which will help inform future research. If successful, the team plan to seek funding for a larger scale study. This research could be turned into resources for parents and professionals or an early intervention service for parents of young children. The aim of this work is to find an effective therapy that can be used early in a child's life to improve their longterm communication skills.