The Picture Exchange Communication System (PECS) was designed to help young autistic children to make requests for their needs. PECS is widely used in specialist 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.

Professor Vicky Slonims and her team ran a feasibility trial comparing children using PECS at home with those not using PECS. 

Most quality PECS research has been run in clinics or schools. However, it is valuable for a child to learn to communicate in their natural environment, their home.

By testing PECS, Vicky and her team helped parents understand their children’s needs better, supporting better wellbeing and mental health. The focus is not to change the child’s actions, but to help parents respond in the best way to meet their child’s needs.

The researchers recruited 33 families with children aged 2 to 7 to take part. Half of these families used PECS, while the others did not. 

When children made requests using PECs, their parents recorded them in an app. They also recorded requests made by other means, such as gestures or actions that indicated a request. For example, attempting to open the fridge door. 

Vicky and her colleagues asked the parents how they found PECS and its guidance.

Therapists rated how well parents understood and carried out the PECS stages. They also interviewed parents involved in the project.

The research aimed to understand if it is feasible to offer PECS at home. The team showed that it is feasible and acceptable to run a home-based randomised controlled trial of PECS at home. 

Recruitment for the study happened during the peak of the COVID pandemic, so they had fewer participants than planned. However, of the families recruited, 92% of families completed the follow-up at four weeks, showing good retention. 

The team also identified several barriers to using PECs at home, which they can consider in future research.

The team tested using a small body camera to provide extra information about their communication methods. However, they found it produced poor-quality images and couldn't reliably stay on children's clothing. 

The overall aim was not to measure the effectiveness of using at-home PECs. However, tentative early findings showed the PECs group performed better than the control group, both at the end of the intervention and during follow-up four weeks later. This indicates that a trial could be of value.

Through the research, Vicky and her colleagues also identified several ways to improve the intervention, which they could test in larger-scale research.

After promising results from the trial, the team plans 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. Ultimately, this research could help children with higher support needs communicate their needs and help their parents understand them better.