Clinician-Perceived Bridges and Barriers to Parental Implementation of Picture Exchange Communication System (PECS): An evaluation.

Picture Exchange Communication System (PECS) is an augmentative and alternative communicative system that improves communication and decreases problem behaviors in children with Developmental Disabilities and Autism. The mediator model is a validated approach that clinicians use to train parents to perform evidence-based interventions. Parental non-adherence to treatment recommendations is a documented problem. This qualitative study investigated clinician-perceived factors that influence parental adherence to PECS recommendations. Three focus groups (n=8) were conducted with Speech Language Pathologists and Behavior Therapists experienced in providing parents with PECS recommendations. Constant comparison analysis was used. In general, clinicians believed that PECS was complex to implement. Thirty-one bridges were identified to overcome complexity. Twenty-two barriers and 6 other factors also impacted parental adherence. Strategies to address these factors were proposed based on a review of the literature. Future research will be performed to validate these findings using parents and a larger sample size.

Cardboard Box from Pascall Chocolate Animals of London

The box contained the chocolate elephant.

Samuel DeVeaux Woodruff's Pewter Match Box

This pewter hinged flip-top box is 9 cm x 7 cm and has a 2 cm depth. It contains lit and unlit matches. It is worn and slightly dented.

Tin box "Waldmeister zur Bowle, Woodruff"

Tin box with the title “Waldmeister zur Bowle, Woodruff” on it, 10 cm x 16 cm. The box is from Julius Schade and Co., German Army and Navy Contractors, Leipzig-Lindenau, Germany. This box contains dried woodruff leaves. Accompanying this box of woodruff is a handwritten recipe for woodruff brew, n.d.

Chart of bill of timber in bridges, culverts, cattle-guard and roadways, signed by S.D. Woodruff

Chart of bill of timber in bridges, culverts, cattle-guard and roadways, signed by S.D. Woodruff, Oct. 18, 1855.