Effects of the Picture Exchange Communication System (PECS) on Maladaptive Behavior in Children with Autism Spectrum Disorders (ASD): A Review of the Literature

This paper provides an overview of the literature investigating the functional relationship between the use of the Picture Exchange Communication System (PECS) and maladaptive behavior (i.e., aggression, tantrums) in individuals with autism spectrum disorders (ASD). Digital searches were conducted to identify single subject design studies published between 1994 and 2012. While nine studies were identified, only three explicitly addressed the collateral effects of PECS training on reduction of maladaptive behavior. Of the seven participants across these three studies, four demonstrated an inverse relationship between PECS exchange and reduction of maladaptive behavior. Results are promising in terms of functional communication. However, the authors suggest caution due to limited number of publications to date. Effects of the Picture Exchange Communication System (PECS) on Maladaptive Behavior in Children with Autism Spectrum Disorders (ASD): A Review of the Literature Autism Spectrum Disorders (ASD) have been characterized by impairments or delays in social interaction, communication, and restrictive or repetitive behaviors (American Psychiatric Association, 2004). More recently, the Diagnostic Statistical Manual, fifth edition (American Psychiatric Association, 2013) collapsed these three domains into social communication/interactions and restricted/repetitive behaviors. By virtue of diagnostic criteria, individuals with ASD possess challenges in the area of communication, which may be described as compromised in the ability to send, receive, or process symbols (American Speech-Languagehearing Association, 1993). Language is a symbolic system (Bloomfield, 1914). Having stated the aforementioned, one may consider effective communication as communication which is efficiently conveyed across individuals and environments, without need for repair (i.e., functional speech). While the specific percentage of individuals with ASD who are effective communicators is uncertain, it is estimated that up to 50% of individuals with ASD are not functional communicators (National Research Council, 2001; Centers for Disease Control and Prevention, 2007). Mirenda (2003) described a functional communicator as one who can generalize communication across people and settings over time. Children with ASD, who may not demonstrated functional communication, may instead engage in maladaptive behavior (e.g., tantrums, self-injury or aggression) as a method of communication (van der Meer & Rispoli, 2010). When such behaviors are observed, clinicians may utilize Functional Communication