title: Social-communicative effects of the Picture Exchange Communication System (PECS) in autism spectrum disorders.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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
  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.
  
  
  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
  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.
authors.affiliation: Scientific Institute I.R.C.C.S. Eugenio Medea, Regional Branch of Ostuni, Brindisi Department of Neurorehabilitation 2, Child Psychiatry, Brindisi, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Lerna
authors.forename: Dalila
authors.initials: D
authors.lastname: Esposito
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Conson
authors.forename: Luigi
authors.initials: L
authors.lastname: Russo
authors.forename: Angelo
authors.initials: A
authors.lastname: Massagli
mesh_terms: D000223:Adaptation, Psychological; D002659:Child Development Disorders, Pervasive / Q000534:rehabilitation*; D002675:Child, Preschool; D003142:Communication; D003143:Communication Devices for People with Disabilities; D005260:Female; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D007558:Italy; D007805:Language Development Disorders / Q000534:rehabilitation*; D007808:Language Therapy / Q000379:methods*; D008297:Male; D015999:Multivariate Analysis; D012919:Social Behavior