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PECS Phase I Student

The documents contain data collection forms for assessing a student's progress through the Picture Exchange Communication System (PECS). The forms track behaviors like picking up items, reaching, releasing items, and distances traveled during sessions. Data is collected on prompts needed, independence level, and responses to preferred versus non-preferred items to evaluate the student's developing communication skills using the PECS system.

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oanhsquirrel
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100% found this document useful (1 vote)
298 views

PECS Phase I Student

The documents contain data collection forms for assessing a student's progress through the Picture Exchange Communication System (PECS). The forms track behaviors like picking up items, reaching, releasing items, and distances traveled during sessions. Data is collected on prompts needed, independence level, and responses to preferred versus non-preferred items to evaluate the student's developing communication skills using the PECS system.

Uploaded by

oanhsquirrel
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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PECS Phase I

Student:_________________________
Staff Date Activity Item Pick-Up Reach Release Open Hand
Initials
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No
FP PP + FP PP + FP PP + YES No

KEY:

FP = Full Physical Prompt


PP = Partial Physical Prompt
+ = Independent
YES = The open hand is still visible
NO = The open hand has been faded

PECS Phase II
Student:___________________________________

Staff Date Activity Item Dist. to CP +/- Dist. to Book +/-


Initials
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -
0-3 3-6 6-9 >9 + - 0-3 3-6 6-9 >9 + -

KEY:
Circle the approximate distance traveled
Distances are listed in feet
+ = moved the indicated distance independently
- = needed assistance from the physical prompter or required the backstep error correction procedure

PECS Phase IIIA (preferred vs. non-preferred or contextually irrelevant)


Student:__________________________________

Staff Initials Date Activity Preferred Item Non-Preferred Item Performance


+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -

KEY : Effective “Switches: Effective non-preferred items

+ = correct performance __________________ _______________________


- = incorrect performance __________________ _______________________
__________________ _______________________
__________________ _______________________
__________________ _______________________
__________________ _______________________

PECS Phase IIIB (preferred vs. preferred)

Staff Initials Date Activity Preferred Item Preferred Item Performance


+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -

KEY: Effective “Switches”

+ = correct performance ______________________


- = incorrect performance ______________________
______________________
______________________
______________________

PECS Phase IIIB (3-Way)

Staff Date Activity Preferred Item Preferred Item Preferred Item Performance
Initials
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
KEY: Effective “Switches”

+ = correct performance _______________________


- = incorrect performance _______________________
_______________________
_______________________
_______________________

PECS Phase IIIB (4-Way)

Staff Date Activity Preferred Preferred Preferred Preferred Performance


Initials Item Item Item Item
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -

KEY: Effective “Switches”

+ = correct performance _______________________


- = incorrect performance _______________________
_______________________
_______________________
_______________________

PECS Phase IIIB (5-Way)

Staff Date Activity Preferred Preferred Preferred Preferred Preferred Performance


Initials Item Item Item Item Item
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -
+ -

KEY: Effective: “Switches”

+ = correct performance ___________________


- = incorrect performance ___________________
___________________
___________________
___________________

PECS Phase IV

Staff Date Activity Item Drops Drops icon Removes Exchange Comments
Initials Sentence for item strip
Starter
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G +

KEY: Note:

FP = Full physical prompt Since Phase IV is taught using backward


PP = Partial physical prompt chaining, you should see +s in the far right
G = Gesture column first, and then the far right two
+ = independent columns, etc. until all columns are +s

PECS Phase IV with Correspondence Checks


Student:_________________________ Date:____________________

Staff Activity Item Drops Drops icon Removes Exchange Correspondence Check
Initials Sentence for item strip performance (icon for
Starter the item)
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + + -

KEY: Note:
FP = Full physical prompt Since Phase IV is taught using backward
PP = Partial physical prompt chaining, you should see +s in the far right
G = Gesture column first, and then the far right two
+ = independent columns, etc. until all columns are +s

PECS Phase IV with attributes


Student:_________________________ Date:____________________

Staff Activity Item Drops Drops Drops icon Removes Exchange


Initials Sentence Attribute for item strip
Starter Icon
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G +

KEY: Note:
FP = Full physical prompt Since Phase IV is taught using backward
PP = Partial physical prompt chaining, you should see +s in the far right
G = Gesture column first, and then the far right two
+ = independent columns, etc. until all columns are +s

PECS Phase IV (attributes) with Correspondence Checks


Student:_________________________ Date:____________________

Staff Activity Item Drops Drops Drops Removes Exchange Correspondence


Initials Sentence Attribute icon for strip Check
Starter icon item performance
(attribute icon)
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -
FP PP G + FP PP G + FP PP G + FP PP G + FP PP G + + -

KEY: Note:
FP = Full physical prompt Since Phase IV is taught using backward
PP = Partial physical prompt chaining, you should see +s in the far right
G = Gesture column first, and then the far right two
+ = independent columns, etc. until all columns are +s

Phase V

Student:_____________________________

Staff Date Activity Item Pause interval Did the student


Initials (seconds) “beat” the prompt?
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO
0 1 2 3 4 5 YES NO

KEY:

Yes = student responded to the question BEFORE a prompt was given


No = student needed the prompt to the sentence starter
Phase IV and V tracking form within the same activity

Student: ___________________ Date: ______________________


Staff Activity Item Phase IV or V If Phase V, form of the question
Initials
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V
IV V

Key:

IV = Request was spontaneous


V = Student requested in response to a question
Phase VI

Student: _______________________ Date: ___________________

Staff Activity Item Sentence Pause interval Did the student beat the prompt?
Initials starter used (seconds)
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No
0 1 2 3 4 5 Yes No

Key:

Yes = student responded to the question BEFORE a prompt was given


No = student needed the prompt to the sentence starter

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