#025: Where to Start with Communication Intervention with Lori Frost

Lori Frost is a traditionally trained speech-language pathologist who has spent most of her 40-year career in public schools working with preschool and elementary kids. She met Dr. Andy Bondy when she was working in the Delaware Autism Program and that’s when she began learning about applied behavior analysis. This fundamentally changed her practice and made her more aware of what was leading to good outcomes and what was leading to poorer outcomes for the students she worked with.

When she was working with Dr. Bondy in the Delaware Autism Program, they were helping a little boy who was non-speaking. They tried a range of things including speech imitation, sign language, and picture point systems but he made little progress. When he wasn’t able to communicate, he displayed challenging behaviors. It was only when Lori presented individual pictures carefully selected to be of interest to the child, let him touch the picture, and pass it to his communication partner, thus doing something very overtly to communicate, that he made progress. This was the beginning of PECS or the Pyramid Educational Consultants in 1992 where it grew to have 6 phases in its protocol, offices in 15 countries and made the manual available in 16 languages.

The long-term goal for the kids is to be as independent as possible and independence is only possible if you initiate, so teaching the kids to initiate communication is the first skill taught in the PECS protocol. The starting point always has to be tailored to each student’s likes and the things they enjoy. It can take time to figure this out. 

If kids start with PECS at the right time, they usually transition to a speech-generating device quite easily. This normally coincides with phase 4 of the PECS protocol when the kids have mastered the following skills:

• Initiation
• Picture discrimination 
• Able to make some picture sentences

Even after this transition, PECS remains a useful backup for when technology fails or is misplaced or forgotten. PECS has great results with younger kids. Around 80% of kids who are six and younger who are on PECS for nine months to a year start to talk.

Lori’s most important advice for parents or professionals supporting autistic kids is to listen to the kids and be guided by their wants and needs. 

What's Inside:

• How PECS began.
• How PECS has grown.
• The importance of initiation of communication
• How useful are speech-generating devices as communication tools?
• When should speech-generating devices be introduced?