A child using PECS consistently initiates requests but struggles to differentiate between similar items (e.g., 'juice' vs. 'water'). What strategy is MOST crucial to address this?

The MOST crucial strategy to address a child using PECS (Picture Exchange Communication System) who consistently initiates requests but struggles to differentiate between similar items like 'juice' and 'water' is systematic discrimination training. PECS is a communication system that teaches children with communication difficulties to initiate communication by exchanging pictures for desired items or activities. 'Systematic discrimination training' means intentionally and repeatedly teaching the child to distinguish between similar items by controlling the environment and providing clear, consistent cues. The core issue here is that the child has learned to request *something*, but hasn't yet developed the ability to precisely specify *what* they want. This is a common progression in PECS implementation; initial success often involves requesting broadly, and more refined discrimination develops later.

To implement systematic discrimination training, begin by presenting both the 'juice' and 'water' pictures simultaneously. Initially, you might hold both pictures up and say, “Juice?” and “Water?” clearly, emphasizing the words. Then, only present the 'juice' picture. If the child gives you the 'juice' picture, immediately provide juice and enthusiastic praise. If the child gives you the 'water' picture, *do not* give juice or water. Instead, gently take the 'water' picture back, say “Not water,” and immediately present both pictures again, repeating the clear verbal labels. This process is repeated consistently. The key is to only reward the correct choice (the 'juice' picture when juice is offered) and to consistently correct incorrect choices (the 'water' picture) without providing the requested item.

This controlled presentation and consistent reinforcement (giving the reward only for the correct choice) helps the child learn the distinct features associated with each picture. Over time, gradually reduce the verbal prompts. For example, after repeated successful exchanges, you might simply present the 'juice' picture and wait for the child to exchange it. As the child’s accuracy increases, introduce distractions or present the pictures in different locations to ensure the discrimination is robust. This systematic approach, focusing on controlled exposure and consistent reinforcement, is far more effective than simply repeatedly offering juice and water and hoping the child eventually learns the difference. It directly addresses the child’s difficulty in differentiating between similar items, a critical step in advancing their communication skills within the PECS system.