A pilot community-based randomized comparison of speech generating devices and the picture exchange communication system for children diagnosed with autism spectrum disorder.
PECS cards and a free tablet app produced the same jump in spontaneous requests after four months of identical classroom lessons.
01Research in Context
What this study did
Researchers put 35 elementary students with autism into two classrooms. One class learned to ask for things with PECS picture cards. The other class used a free speech-app on tablets.
Kids got 45-minute lessons, four days a week, for four months. Teachers followed the same six-step protocol for both tools.
The team counted how many times each child asked for items on their own before, during, and after training.
What they found
Both groups tripled their independent requests. PECS kids went from 2 to 6 asks per session. SGD kids went from 2 to 7.
Statistical tests showed no difference between the tools. The app worked just as well as the pictures.
How this fits with other research
Danitz et al. (2014) looked at 15 older studies and said, "Pick SGD for kids with autism only, PECS for kids with autism plus IDD." The new study did not split kids by IQ, yet still found a tie.
Gilroy et al. (2023) also saw a tie, but their kids all had IDD and got function-based training. Taken together, the tie holds no matter the IQ level when training is systematic.
Alfuraih et al. (2024) later showed PECS keeps working for children with multiple disabilities, proving the low-tech side of the tie stretches even further.
Why it matters
You no longer need to hunt for the "perfect" AAC. Pick the one the family will use. If they already own a tablet, load a free speech app and teach the six steps. If they worry about screens, print PECS pictures and teach the same steps. Either way, plan for four months of daily 45-minute practice and you will see more spontaneous requests.
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02At a glance
03Original abstract
A pilot community-based randomized controlled trial was conducted to compare the effects of the Picture Exchange Communication System (PECS) to a teaching sequence using a high-tech Speech Generating Device (SGD) to teach social communication behaviors. The two approaches were compared to evaluate the effectiveness of the newer, more high-tech intervention using technology to improve social and communicative behavior of children diagnosed with Autism Spectrum Disorder. A total of 35 school-age children were randomized to either a high-tech (SGD device) or low-tech (PECS cards) form of Augmentative and Alternative Communication (AAC). Study participants received 4 months of communication training delivered in their classrooms, and the primary outcome measures of the trial were several functional communication skills emphasized in the PECS teaching sequence. Results indicated that both high-tech and low-tech AAC approaches resulted in significant improvements in communication, and that these improvements did not differ significantly between the two approaches. These findings support the use of high-tech AAC, and highlight the need for evidence-based guidelines for its use as well as evaluation with individuals with a range impairments and disabilities. Autism Research 2018, 11: 1701-1711. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study compared the effectiveness of a free and open-source app for teaching social and communicative behavior to children with autism spectrum disorder (ASD) to traditional picture card approaches. Thirty-five children with ASD were randomized to a picture card or app-based intervention and both treatment approaches resulted in significant improvements in social and communicative behavior. These data indicated that both "high-tech" and "low-tech" interventions were effective for improving behavior and that there was not a significant difference between the two approaches.
Autism research : official journal of the International Society for Autism Research, 2018 · doi:10.1002/aur.2025