Bridget Kang Group B

Case study 1-

Area of intervention: Annie’s speech impairment leading to her inability to communicate, which in turn causes behavioural problems, such as biting.

The Intervention

The intervention studied and proven to be effective in the three case studies mentioned in the journal is the Picture Exchange Communication System (PECS). I think that this augmentative communication system should be used to address Annie’s inability to communicate normally. PECS is a systematic program based on the teaching principles of applied behaviour analysis that provide children who have delayed verbal skills or speech impairment with an augmentative communication system (NRC, 2001; Schwartz, Garfinkle, & Bauer, 1998 as cited in Skokut, Robinson, Openden, Jimerson, 2008). It focuses on teaching children to initiate requests by exchanging pictures for desired objects and activities.
The first case study aimed to study the communicative outcomes with the use of PECS, the second to find out if PECS would be a communication system which children with speech impairment could use to communicate with others effectively, and the third to investigate if the acquisition of PECS and speech would result in ancillary gains pertaining social- communicative and disruptive behaviours.

Its Effectiveness
In the study done by Bondy and Frost (1994) within a two year period, 59% of the 66 children studied acquired independent speech, 30% used speech with PECS and 11% used PECS only. In the second study, which was done by Schwartz and colleagues (1998) involving 18 children over a period of 14 months, all the participants learned to use PECS functionally to communicate with adults and peers. Finally, the third study conducted by Charlop- Christy and colleagues (2002) to investigate if the acquisition of PECS reduced disruptive behaviours. Data was collected during pre training, training and post training sessions across academic and free play activities and even participants were even evaluated again at a 10 month follow up period after the study. The results indicate that there were decreases in disruptive behaviour as well as improvements in behaviours such as eye contact and toy play with peers.

How Annie will benefit from this intervention

First of all, I would like to address the issue on Annie’s disruptive behaviour (biting) in class. All humans need an avenue to communicate our thoughts, our needs and our feelings. Annie has probably resorted to such disruptive behaviours because she has speech impairment which cripples her ability to communicate verbally and to a child, there is no way else other than through physical actions that she can communicate her anger. With the picture exchange system, Annie will first learn identify the representation of each picture or icon to communicate her basic needs. After which, she will slowly gain the ability to use the system to communicate in sentences that communicate a request or comment across a variety of settings. With an avenue to communicate her thoughts, needs and feelings, I believe that there will be a reduction in her disruptive behaviour. As the case study done by Charlop- Christy and colleagues has shown, acquisition of the PECS resulted in the decrease of disruptive behaviour.

Also, PECS is an augmentative communication and not an alternative communication system. It involves six different phases that also aim to help children with speech difficulties acquire speech and together with the therapy received by her speech therapists, Annie might be able to acquire speech.

How I can make adjustments to cater to the needs of Annie and to facilitate integration of Annie / the intervention activity into my classroom:

I can introduce the picture cards to the other children in my class as well so that they would be able to understand what Annie needs or wants from them. Picture cards with basic picture icons might be easy to interpret but once Annie acquires the ability to use these cards to “speak” in sentences (for example adding the icon “i want”), I think it would be better if the other children are aware on the meaning and usage of that.

It is important for me to work closely with Annie’s parents and get updates from her speech therapist. By working closely with Annie’s parents, the PECS would be reinforced systematically and consistently both at home and in school. By providing consistency and reinforcement, Annie will be able to acquire the PECS more effectively.


Reference

Skokut, M., Robinson, S., Openden, S. & Gimerson, S.R. (2008). Promoting the social and cognitive compentency of children with disabilities: Interventions at school. The California School Psychologist, 13, 101-102. Retrieved September 8, 2009 from http://web.ebscohost.com.libwww3.np.edu.sg/ehost/detail?vid=6&hid=9&sid=2f6f3efb-b088-49fb-93a6-f0840f6abf69%40sessionmgr4&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=ehh&AN=35968406