Using an adapted form of the picture exchange communication system to increase independent requesting in deafblind adults with learning disabilities.

Three deafblind adults with learning disabilities lived in a group home.

Staff wanted them to ask for things on their own.

The team made PECS cards bigger and added raised lines so the adults could feel them.

They taught Phase I through Phase III of PECS using a multiple-baseline design.

Each adult learned to pick a card, hand it over, and get the item they wanted.

Training took place in their day room and kitchen.

Staff used prompts and fading to help them learn.

All three adults learned to ask for items without help.

They used the adapted cards to request snacks, drinks, and activities.

The skill worked in new places and with new staff.

No one needed physical help after training ended.

The adults kept using the cards weeks later.

If you work with adults who can't see or hear well, try enlarging and texturing their PECS cards.

The raised lines let them find the right card by touch.

You can teach Phase III PECS even with severe sensory loss.

Start with items they really want, like favorite snacks.

Use their daily routines as teaching moments.