Picture Exchange Communication and Picture Schedules

My son has grown increasingly frustrated and has begun throwing tantrums every time we need to change what we're doing. In therapy, they call this transition. Even though we give him verbal preparation that we're going to take a bath in fifteen minutes or we're going to go out shopping in ten minutes, and remind him as the time gets closer and give specific information like we're going to get on your coat and your shoes, he gets very upset. This is a new behavior, and it has been difficult to deal with. Almost always, I am able to stay very calm and tell him that I understand that he is upset, but this is what we need to do. Unfortunately, it also leads to me physically doing things for him, and sometimes pulling him places or carrying him, because I do not want to teach him that tantrum=getting what he wants. However, I am sure that a lot of his tantrum has to do with his delays, and I try to be very understanding as well. Firm but gentle, I suppose, is what I try to be. It's so hard to tell with a non verbal child with global developmental delays how much of what they're doing is behavioral and how much is part of their learning disability. I have handled this by treating him like a normally developing child, expecting good behavior from him and using warnings, simple language (saying look at me, listen, and then asking if he understands as per his therapists' and teachers' instructions to me), and then time outs if non-compliance continues. Generally, three strikes and he's in time out. I also try to be extremely consistent so that any threats I make, I follow through on when I say I will, and I only threaten to do things that I will actually do...take a toy away, make him walk instead of ride in the little supermarket cart car, etc.

My son only says two words or so, and he's nearly four, so he has MUCH greater communication needs. We have been working on sign language, but he's slow to catch on with signs, and his physical limitations prevent him from making the signs clear, which sometimes just creates even more frustration because even if we know what he's saying, his teachers may not, and even we can't always tell what he's trying to tell us.

The newest augmentative communication device we're going to start is called PEX or PECS which is picture exchange. You put a bunch of pictures out on a board with velcro, and he brings you the picture of what he wants or needs. We've tried this in the past, and again, he was slow to catch on, and it was difficult to figure out which pictures to use. However, now that he's been doing it in school, it should be easier to carry over to home. It would be so nice to be able to have him tell me what he did in school since he doesn't even answer yes and no questions most of the time. Also, we're hoping that putting up a picture schedule will help him to be more aware of what's coming up next, and hopefully, this will ease some of his apprehensions and frustrations and the tantrums will stop. I would even love if we could use it to ask where a boo boo is...if he's in pain, or something hurts, or he's sick, maybe he could tell us what's wrong then.

Has anyone else ever used either of these systems or something else that worked well? I'd love to read about it if you have.