an actual scenario and apply your learning. Use the guiding questions
Johnson is a 5-year-old boy with autism. He has difficulty communicating
with his peers and frequently fails to respond when people speak
to him. Tommy never initiates conversations and rarely makes eye
contact with other individuals. Periodically, Tommy becomes upset
and loses his temper throughout the school day. Tommy is not the
only person with autism in his family. His older brother, Matthew,
exhibits some signs of autism, including certain repetitive behaviors,
difficulty with social skills, and behavioral problems. Despite
these barriers, Mathew has been successfully integrated into a general
was placed in a special education class at Springfield Elementary
School at the beginning of September.
Mrs. Penny, Tommy’s teacher, has been unable to find effective teaching
strategies to work with Tommy. He rarely listens to Mrs. Penny and
has difficulty interacting with the six other students in his class.
At home, Mr. and Mrs. Johnson have noticed that Tommy loses his
temper more frequently since their move to Springfield last year.
They have learned that the methods that helped
Matthew change his behavior do not seem to be effective with Tommy.
In order to reassess the strategies for working with Tommy, Mrs.
Penny scheduled an IEP team meeting.
the IEP team meeting, Mr. and Mrs. Johnson explained how their son
Matthew once had a teacher who used social
stories to help decrease Matthew’s anxiety and tantrums
during recess. Although the Johnsons were impressed with this strategy,
they were unsure whether social stories could help Tommy change
his behavior in the classroom. Mrs. Penny agreed that social stories
would not be the appropriate approach, since Tommy has not yet developed
the appropriate language skills for social stories to be effective.
Although Tommy occasionally repeats words from a story, he never
seems to understand the story.
Penny suggested using Ivar Lovaas’s intensive
behavioral treatment as an intervention strategy.
The Johnsons had heard of the Lovaas method but expressed
some reservations about using this approach with their son.
Although the Lovaas method provides intensive
one-on-one contact with a therapist, this strategy seemed
to provide little interaction with peers. The Johnsons felt that
Tommy needed to develop better social skills to relate to other
young people. They were primarily concerned with Tommy’s socialization.
IEP team decided that the primary goal was to help Tommy learn to
communicate better. Over the past year, the Johnsons had tried sign
language with Tommy, but this strategy did not seem to be any more
effective than teaching him direct speech. Tommy was capable of
imitating signs, but never initiated signed speech on his own. The
Johnsons were also concerned that even if Tommy did learn signs,
his peers would not necessarily understand these signs. Imitation
strategies also seemed to be relatively ineffective for Tommy. Although
Tommy was capable of repeating language, he never did this consistently.
He rarely looked at his trainer’s face and usually could not sit
still long enough to focus on language skills. The Johnsons also
felt that teaching Tommy to communicate by using imitation would
take a very long time. They hoped for an approach that would help
Tommy communicate better immediately.
IEP team selected a picture system approach designed by Pyramid
Educational Consultants, called the Picture Exchange Communication
This approach seemed most appropriate for Tommy because it encourages
children to be the communication initiators. PECS concentrates on
each child’s interests, instead of forcing a child to focus on objects
that do not appeal to him. The Johnsons also liked the idea of using
pictures to help Tommy communicate, since both his brothers and
his peers would be able to understand these signs. The Johnsons
hoped that PECS would allow Jamie, their third son, to have a more
important role in communicating with his younger brother. In addition,
PECS seemed suitable for Tommy because he would be able to begin
using pictures immediately to help him communicate. When the Johnsons
learned that PECS did not require an extensive training period,
they were ready to begin using PECS with Tommy immediately.
main goal was for Tommy to begin initiating communication on his
own so that he could establish better relationships with his peers
and feel less frustrated during daily interactions with other people.
Mr. and Mrs. Johnson both decided to receive PECS training. The
plan was to have Tommy work initially with a PECS specialist for
several days after school, and then to encourage Tommy to use PECS
at school during the day and at home at night. During Tommy’s first
few training sessions, Mrs. Johnson observed the training so that
she would feel more comfortable working with Tommy. Mr. and Mrs.
Johnson planned to familiarize their two older sons, Matthew and
Jamie with this approach so that they could both begin using PECS
with Tommy as well.
two specialists working with Tommy spent most of the first session
determining Tommy’s "likes and dislikes." Before the next
session, they made pictures of these desired objects on little squares
backed with Velcro. During the next few training sessions, they
worked with Tommy on Phase 1 of PECS, which they called the Physical
Exchange. Mrs. Johnson watched as one of the specialists, who called
herself the communicative partner, tried to attract Tommy’s attention
with a cup of water (one of Tommy’s desired objects). When Tommy
reached for the cup, the second specialist, the physical prompter,
helped Tommy pick up the picture of the cup of water and hand this
picture to the communicative partner. When the communicative partner
received the picture from Tommy, she gave him the cup and said to
him: "Oh, you want the cup." Once Tommy became familiar
with this routine, the two specialists switched roles and worked
with Tommy in different environments to introduce some variety to
one week, Tommy was ready for Phase 2 of the training, Expanding
Spontaneity. During these sessions, one of the specialists placed
herself farther away from Tommy. She encouraged Tommy to move toward
her to give her the picture of a desired object (a ball in one session).
When Tommy handed her the picture of the ball, she praised him by
saying, "Great job, Tommy. You want the ball!" and quickly
gave him the ball to play with. At first, the physical prompter
helped Tommy move toward the communicative partner. However, over
time, the physical prompter was phased out of the training. As Tommy
progressed through the training, one of the specialists gave him
his own communication book. During each session, the specialist
would place one picture with velcro on the outside of the book and
wait for Tommy to peel off the picture and hand it to her before
giving him the desired object.
month, Tommy complete Phase 3 of PECS, called discrimination
training. This phase was most difficult for Tommy. He needed
to learn to choose between pictures of different objects. At first,
the specialist started with one picture of a desired object and
one picture of a non-preferred object. When Tommy handed her a picture,
she would give him the object he requested. Initially, Tommy had
a hard time distinguishing between the two pictures. The specialist
made the pictures slightly bigger with brighter colors to enhance
the visual components. Eventually Tommy was able to distinguish
between the pictures. Presently, Tommy is working on Phase 4 of
PECS, Sentence Structure, at home and at Springfield Elementary
School. He is learning to use simple sequences of pictures on Velcro
sentence strips to make requests.
Johnsons are very pleased with Tommy’s progress with PECS. Tommy
now has a way to communicate with and to request things from other
people. The Johnsons feel that their two older sons are beginning
to establish better relationships with Tommy. Even Jamie seems to
enjoy using the PECS communication book with his younger brother.
Mrs. Penny reported that Tommy throws fewer tantrums and seems calmer
during the school day. She also noticed that Tommy has started to
use the communication book with the other six students in his class.
Tommy is slowly learning to use some speech with his PECS training.
Mrs. Penny feels that she has more time to work with the other children
now that she does not have to constantly focus on Tommy’s tantrums.
Although Tommy has a long way to go, the Johnsons feel that he has
made huge strides with PECS.
IEP team plans to meet again in another month to discuss Tommy’s
progress and to establish new goals for him. In the future, Mrs.
Penny hopes to begin implementing the University of North Carolina
at Chapel Hill’s TEACCH
strategies into her classroom. She already uses several of these
classroom strategies, which seem to work well with Tommy. In particular,
she has established a very structured environment in her classroom,
where Tommy is familiar with his daily routine. Mrs. Penny tries
to focus on visual aspects of each lesson when she is working with
Tommy, since he has not fully developed his verbal skills. Tommy
seems to be most successful when he has to focus on only one topic
at a time. Mrs. Penny plans to work collaboratively with the Johnsons
to help Tommy continue to develop his social skills and speech.
might the IEP team choose to improve Tommy’s communication skills,
rather than focusing on his social/behavioral skills as their
else can be done to help Tommy develop his communication skills?
were Tommy’s brothers, Jamie and Matthew, affected by the Johnson’s
choice of PECS as the appropriate intervention method?
that Tommy has a means of communicating his needs to others, what
should the IEP team establish as Tommy’s next goal?