PECS vs. iPad for autism spectrum disorder treatment

PECS VS. iPAD FOR AUTISM

Autism spectrum disorder (ASD) has come to be known as one of the more afflicting and damaging mental disorders that affect people around the world, particularly when it comes to the youth. As the understanding of the disorder increases, so do the types and forms of therapies and tools that can be used to combat and treat the disorder. While more traditional interventions like pharmacological and traditional therapy methods are still quite common and pervasive when it comes to the normal treatment courses, there has been the emergence of solutions in particular as a means to assist or create a therapeutic environment for children with autism. A technology-based solution for autism treatment and assistance is the iPad, a product of Apple Corporation. A non-technology solution that is prolifically and commonly used is known as the Picture Exchange Communication System (PECS). What follows in this report is a literature review that speaks about those two methods as it pertains to treatment of patients with Autism Spectrum Disorder.

PECS vs. iPad for Autism

As noted in the abstract, the use of iPads and the Picture Exchange Communication System (PECS) have both emerged as treatment vehicles to assist both treatment facilitators as well as the autism spectrum disorder patients themselves when it comes to treatment of and coping with autism. This document will include a literature review of ten scholarly sources that cover PECS, iPads or both as it relates to the treatment and assistance for patients with Autism Spectrum Disorder (ASD). There will be a discussion of key terms as well as the literature review itself which shall be divided by the key themes and topics involved. A conclusion and summary will end this document along with a recitation of the scholarly sources used for this report. While technology is a not a fix-all and while both the iPad and PECS have their upsides and downsides when it comes to providing effective treatment for Autism Spectrum Disorder, the two technologies can certainly be tools that can make treatment much more effective and much more quickly when it is wielded effectively and properly.

Apple iPad/Technological Solutions

When it comes to the Apple iPad, there is certainly a large number of proponents that tout its efficacy and performance when it comes to helping autism-stricken children. Boyd, Hart-Barnett and More (2015) note that the advent and emergence of mobile technology has introduced a new communication medium and opportunity for students that are diagnosed with autism spectrum disorder. There is a significant amount of customization that is allowed for with the iPad and the use of the iPad solution, as opposed to systems like PECS, offers a much less stigmatizing and humiliating means to get treatment but yet still allows for therapeutic treatment and progress to take place. However, Boyd and his colleagues do caution that the research about the efficacy of the iPad and similar solutions is not always keeping up with the emergence of the technologies and software suites being used. With that being said, Boyd notes that the quality and performance of intervention can be measured using several different yardsticks including the ability to customize the solution, the motor skills that are needed to operate the system, the resources and time that are needed for the intervention in question, the research or evidence-based practices that support the intervention in question and the cost of the specific device or application that is being used (Boyd, Hart-Barnett & More, 2015).

Another study that focused on the iPad in particular was offered by Cumming, Strnadova and Singh in 2014. The study related to developmentally disabled students at a private high school in Sydney, Australia. There was a collection of data that stemmed from observations of those developmentally disabled students using iPads as a treatment intervention for their disorders. An inductive content analysis approach was used to assess the outcomes. One thing that was discovered is that the learning subjects that were previously not engaging and enrapturing for students became much more interesting and fun for the kids involved once the iPad was used as a vehicle. However, there were some problems with the iPad use overall as many teachers were not well-versed on the technology and there were concerns about fairness due to the autism-stricken children getting to use the iPads but other students were not (Cumming, Strnadova & Singh, 2014).

Fletcher-Watson (2013) looked at the broader subject of computer-assisted learning for children and people in general with Autism Spectrum Disorder. Fletcher-Watson echoed the prior source when she notes that personalization and customization is a critical factor when it comes to technology-based interventions. Non-technology interventions may not be as flashy and "sexy" as systems like the iPad. However, those non-technology interventions are uniquely and specifically designed to treat autism and thus they should not be eschewed if they are effective. On the other hand, technology allows for much easier customization and user-friendly ability to make changes and this would probably make technology the wiser course to use for treatment so long as the underpinning foundations and frameworks for the iPad software in question is designed and crafted properly (Fletcher-Watson, 2013).

Another important to study to focus on related specifically to iPads as a way to treat and assist students with autism. As published in February 2014, research Amy Price covered a pilot study that occurred at Oakstone Academy. The study aimed to reveal the overall role that was played by the use of interactive books that were rendered on iPad rather than using physical copies of books and other materials. The study was eventually expanded to include all of the schools six hundred students. The upside touted by Price is that while the costs can be daunting to some, the applications and options that exist when it comes to the iPad are far superior to just about anything else when used and approached in the right way. The logistics of paying for such technology and sharing the devices when there are more kids than devices can create some issues. However, the effort to manage those challenges is worth it if the proper choice sand methodologies are used (Price, 2014).

PECS System

Even if the PECS system is not technology-driven like the iPad obviously is, its efficacy and performance over time is touted quite often. However, the verdict of PECS being the best or even a decent intervention for Autism Spectrum Disorder is by no means unanimous or overwhelming. This is made clear in many scholarly articles including the study done by Flippin, Reszka and Watson as published in May of 2010. To prove their point, the researchers used eight single-subject experiments with a total of eighteen participants. In total, there were three group studies. There were just less than one hundred PECS participants and there were sixty-five that were using another intervention or they were in the control group. Per the results, it was found that PECS is "promising" but that it is not quite at the point where it can be called an evidence-based solution that is beyond reproach. The authors of the study did not say this casually or based on fleeting research as the research in question was done with a very specific method and they also did a literature review spanning from 1994 to 2009 (Flippin, Reszka & Watson, 2010).

Another study that focused on PECS in particular was the one done by Tincani and Devis in 2011. Similar to the Flippin treatise, there was a group of single participants and their performance before, during and after the use of the PECS system was assessed. Unlike Flippin, the results for PECS interventions aws found to be positive. The term that Tincani and Devis used was "moderately effective." Further, they found that recorded learning sessions that included the vocalizations of autism spectrum disorder patients seemed to reveal that speech was actively facilitated by the PECS system (Tincani & Devis, 2011).

Technology & Non-Technology Compared

One research study in particular that was covered as part of this literature review specifically compared the efficacy of the iPad as an autism intervention with an picture-based system like PECS. It was found that the Apple iPad was mixed in its efficacy as compared to picture-based system. In some instances, the iPad was superior to the picture-based system. However, in other instances there was a not a discernible difference between the outcomes realized between the technology-based and picture card-based solution (Flores et al., 2012).

Teacher Knowledge

As can be easily inferred from the brief talk about teacher knowledge in the relevant terms directory of this report, the amount of knowledge that a teacher does or does not have regarding technology and how to wield it has a demonstrable effect on the results that are rendered from the use of said technology. For example, the results of the Flores study just discussed could be more of a function of whether the teachers knew how to wield and use the iPad tool rather than whether or not the iPad is a superior tool in general. This is a relevant question because many assert that people who use technology-based interventions yet falter are simply not using it right. For example, Hart and More (2013) did a compare and contrast of a learning environment, only it was with teachers rather than autism patients. Rather than using something as complex as an iPad, they compared a learning environment where only reading of material was done to a situation where there narrated Microsoft PowerPoint slides. It was found that the PowerPoint solution was easily superior when the two were compared and contrasted (Hart & More, 2013).

Spence very much echoes the clarion call of Hart and More when it is noted in her work that non-verbal autism patients in particular need to be handled and molded in a very particular way and that the knowledge and methods of teachers and administrators is a huge part of doing that well (Spence, 2014). The work of Tunney and Ryan (2012) followed much the same thought pattern. Those two specifically focused on where "iDevices" could help teaching assistants. Yet again, the common theme was that the familiarity and adeptness that the teaching personnel have with the device has a direct correlation to how well they wield and use the devices in practice.

Conclusion

In the end, it is clear that both PECS and iPads (not to mention other technology-based solutions) can all be useful in their own ways when it comes to creating and facilitating interventions for autism spectrum disorder. The potential tradeoff with technology is that the training and knowledge of teachers and administrators can be either a plus or a liability depending on the situation. However, the customizability and Apple-based support (not to mention the applications for the same) are very intriguing and they seem to make the Apple iPad system a very worth investment. That all being said, not all school systems will have the resources and funds to make use of the iPad. However, that is not a huge problem as the PECS system is still ostensibly effective in its own way. Even so, it would be extremely beneficial for governments and parents to make the investment in technology as that is the direction that society and education is clearly heading in over the coming years and decades.