Evaluating the Effects of Picture Exchange Communication System® (PECS®) Mediator Training Via Telehealth Using Behavioural Skills Training and General Case Training

Abstract

The Picture Exchange Communication System® (PECS®) is often used by children diagnosed with autism spectrum disorder (ASD) as a means of functional communication. Although there is extensive research indicating that PECS is an evidence-based intervention for children with ASD (e.g., Wong et al., 2015), little is known about how best to train parents to support their child’s PECS use. Of those studies that do explore parent training approaches, few measure the caregiver’s fidelity implementing PECS or explore whether parents generalize or maintain skills post-training. Similarly, little is known about how to train parents to implement PECS via telehealth. The purpose of the current study was to bridge the gap between PECS and telehealth research and to explore strategies to help parents support their child’s PECS use at home. One father-mother dyad was recruited. The father was the primary training recipient (i.e., parent trainee). The mother participated in training sessions as the role play partner (i.e., surrogate parent). Researchers used behavioural skills training (BST) to teach target PECS skills and applied strategies of general case training (GCT) to actively program for generalized behaviour change. A multiple baseline design across skills was used to monitor the father’s fidelity during mediator training sessions and a multiple probe design was embedded to monitor both the father’s and mother’s fidelity in the natural environment with their child. Results demonstrated that the parent trainee acquired PECS skills within the training setting. However, parents did not reliably demonstrate all of the PECS skills in the generalization setting during follow-up.