Telehealth Picture Exchange Communication System Caregiver Training: A Multi-Site Community Evaluation

A large body of evidence has established the Picture Exchange Communication System (PECS) as an evidence-based practice to support communication development for children diagnosed with autism spectrum disorder (ASD). Although PECS involves a manualized teaching protocol, there is not a corresponding systematic approach to caregiver PECS training. Caregivers play an integral role in children's communication skill development, therefore strategies to engage and train caregivers to support their child's PECS use are critical. The purpose of the present study was to explore caregiver PECS teaching integrity and child PECS implementation accuracy following participation in a manualized caregiver PECS training program (i.e., the PECSperts Caregiver Training Package). This study was conducted as part of a multi-site community research project and used a quasi-experimental design with non-random group assignment. A total of 18 caregiver-child dyads participated (treatment group, n = 11; waitlist comparison group, n = 7). Results indicate that caregiver PECS teaching integrity and child PECS implementation accuracy increased significantly for members of the treatment group, with a large effect size. Caregiver participants reported high levels of satisfaction with the training. Results were generally maintained at one- and three-month follow ups. Results suggest that the PECSperts Caregiver Training Package is an ecologically valid, time- and cost-efficient approach to caregiver training that supports caregiver PECS treatment integrity and child PECS implementation accuracy. Although further research is required, the findings provide emerging support for PECSperts as a promising approach to community-based, caregiver and child PECS training.