Procedural integrity and social validity issues in parent use of the Picture Exchange Communication System (PECS) in naturalistic settings

While recent reviews of the Picture Exchange Communication System (PECS) research have provided support for the efficacy of PECS, they have also identified the need for future research to examine the long term maintenance of skills acquired through PECS training, as well as the social validity and procedural integrity of the intervention as used in practice (Flippin, Reszka, & Watson, 2010; S. L. Hart & Banda, 2010; Preston & Carter, 2009; Sulzer-Azaroff, Hoffman, Horton, Bondy, & Frost, 2009; Tincani & Devis, 2011). The aim of the present study was to examine the social validity and procedural integrity of parent implemented PECS in naturalistic settings, utilising three approaches: an analysis of YouTube videos, an internet survey, and a long-term follow-up. Results demonstrated a high rate of observed and reported procedural errors in parent’s implementation of PECS with their children in naturalistic settings and limited long-term maintenance of skills acquired through PECS training, despite parents indicating that they feel overwhelmingly positive about the PECS program, including the program’s effectiveness and ease of implementation. These results contribute to a better understanding of parents’ use of PECS with their children in naturalistic settings and highlight the contextual variables that are likely to affect the maintenance of gains acquired through PECS training. Further implications of these results are discussed.