Picture Exchange Communication System (PECS)

Introduction to PECS: A Transformative Communication Tool

The Picture Exchange Communication System (PECS) stands as a groundbreaking augmentative and alternative communication (AAC) system specifically designed to assist individuals with limited or no verbal communication. Developed in 1985 at the Delaware Autism Program by Dr. Andy Bondy and Lori Frost, PECS utilizes visual symbols—such as picture cards, photographs, or tangible symbols—to teach users to communicate their needs, wants, and thoughts effectively. With its foundation rooted in applied behavior analysis (ABA) principles, PECS aims to foster spontaneous, functional, and independent communication, especially for individuals on the autism spectrum, young children, and those with developmental or traumatic brain injuries. Its effectiveness is validated by over 240 research articles, highlighting its role in reducing problematic behaviors, promoting social interaction, and supporting speech development.

Understanding the Development and Theoretical Foundations of PECS

What is the Picture Exchange Communication System (PECS) and its purpose?

The Picture Exchange Communication System (PECS) is an augmentative and alternative communication tool designed to help individuals, particularly autistic children and those with developmental delays or traumatic brain injury, develop functional communication skills. It uses visual symbols, such as picture cards, to teach users to exchange images for objects or actions, enabling them to express wants, needs, and thoughts effectively.

PECS is based on principles of Applied Behaviour Analysis (ABA) and involves structured teaching in phases, starting from simple exchanges to constructing short sentences. It can be implemented as a short-term or long-term communication aid and is typically used daily with support from trained professionals, parents, or teachers.

Overall, PECS aims to enhance communication independence, support speech development, and improve social interactions for individuals with communication challenges.

What is the development history and theoretical background of PECS?

PECS was developed in 1985 at the Delaware Autism Program by Lori Frost and Andy Bondy. Its creation responded to the need for a systematic, evidence-based communication method for children with autism who are non-verbal or have limited speech. The system was designed to provide a practical, accessible way for these individuals to initiate and develop communication skills.

Theoretical roots of PECS are firmly grounded in Applied Behaviour Analysis (ABA), a scientific approach that uses reinforcement to increase desirable behaviors. PECS employs ABA principles such as shaping, differential reinforcement, and stimulus control transfer to progressively teach communication. Its structured phases guide the learner from the initial exchange of simple pictures to constructing sentences and engaging in social commenting.

Research has consistently demonstrated that PECS does not impede speech development; on the contrary, it often facilitates verbal language growth. It effectively promotes requesting behaviors, which are foundational for social interaction and further language acquisition.

The implementation of PECS involves training for therapists, educators, and parents, emphasizing consistent reinforcement and naturalistic teaching environments. Such training ensures fidelity of implementation, which is critical for the program’s success.

In summary, PECS’s development was driven by empirical needs within autism intervention, rooted in behaviourist theories, and backed by extensive research supporting its effectiveness in fostering functional communication skills in individuals with autism and related developmental disabilities.

The Structured Phases of PECS: Building Blocks for Effective Communication

What are the phases of PECS and their functions?

PECS, or the Picture Exchange Communication System, is structured into six carefully designed phases. Each phase serves a specific purpose to gradually develop a child's ability to communicate effectively.

Phase 1: How to Communicate This initial stage teaches individuals to exchange a single picture of an desired item with a communication partner. The goal is for the learner to make simple requests independently, fostering motivation and initiating interaction.

Phase 2: Distance and Persistence Here, the focus shifts to generalizing the requesting skill across different settings, distances, and with various people. It encourages persistence and reinforces the learner’s ability to seek out communication in different situations.

Phase 3: Picture Discrimination In this phase, learners learn to discriminate between two or more pictures or symbols to correctly select the item they want. This skill builds their understanding of symbols and improves their decision-making capabilities.

Phase 4: Sentence Structure The learner begins constructing simple sentences, usually by combining a sentence strip with the phrase 'I want' and the picture of the desired item. This phase introduces basic syntax and promotes more expressive requests.

Phase 5: Responsive Requesting (Answering Questions) At this stage, individuals are taught to respond to questions like 'What do you want?' Using their symbol system, they learn to make detailed requests, adding specificity to their communication.

Phase 6: Commenting The final phase involves teaching learners to comment on their environment or experiences, such as responding to 'What do you see?' or 'What do you hear?' with sentences starting with 'I see,' 'I hear,' etc. This promotes social engagement and enriches conversational skills.

Functions and skills taught in each phase

Each phase steadily builds on the previous one, promoting self-initiated communication and social interaction. The system emphasizes:

• Requesting objects or activities
• Discriminating between different symbols
• Constructing meaningful sentences
• Responding appropriately to questions
• Engaging in social commenting

Progression from simple requesting to social commenting

Starting with basic requesting (Phase 1), learners progress to more complex communication functions such as responding to questions (Phase 5) and making comments (Phase 6). This progression supports the development of spontaneous, functional, and social communication skills necessary for everyday interactions. Each step encourages independence, confidence, and the ability to initiate and respond within social contexts, which are crucial for meaningful interactions and social participation.

Practical Implementation of PECS in Real-Life Settings

How is PECS implemented and used in practice?

PECS, or the Picture Exchange Communication System, is a systematic approach to teaching functional communication primarily used with individuals with autism and other developmental disabilities who have limited or no verbal speech. Its implementation begins with structured teaching sessions where the individual is introduced to exchanging simple picture cards to request desired items or activities. Initially, the focus is on one-to-one exchanges—such as handing a picture of a cookie to a communication partner to indicate a desire for that item.

As the learner gains confidence, the process advances through six phases, gradually increasing in complexity. Children move from exchanging single pictures to constructing simple sentences by selecting pictures on a sentence strip, such as "I want" plus the item. They also learn to respond appropriately to questions like "What do you want?" and to make social comments, such as "I see the car."

Implementation involves reinforcement strategies, where successful communication acts are rewarded to encourage continued use. Teachers, therapists, and parents play vital roles in this phase. They reinforce communication, provide prompts when necessary, and create naturalistic settings that support spontaneous use of PECS.

Proper training for caregivers and professionals is essential to ensure consistency and effectiveness. Sessions often begin with workshop-style training led by qualified practitioners, such as certified speech-language pathologists or by organizations like Pyramid Educational Consultants. They teach participants how to set up PECS materials, use prompting, and reinforce communication efforts.

PECS is flexible and can be used across various environments, including classrooms, therapy rooms, and at home. Its portability—using a portable communication book or board—allows individuals to initiate communication in different settings, promoting independence and social interaction.

Over time, as users become more proficient, they typically develop greater independence in requesting, commenting, and responding, which can support their overall language development. PECS can also be integrated with other AAC tools like speech-generating devices to broaden communication options.

Role of training for caregivers and professionals

For PECS to be successful, comprehensive training for caregivers, teachers, and therapy providers is crucial. Training usually involves a two-day workshop where participants learn the six-phase protocol, techniques for prompting and reinforcement, and strategies for creating naturalistic teaching opportunities.

Beyond initial training, ongoing support and coaching help practitioners refine their skills, address behavioral challenges, and adapt PECS strategies to individual needs. Certification programs offered by Pyramid Educational Consultants ensure that implementers meet professional standards and are equipped with current best practices.

Well-trained caregivers and professionals are better able to create motivating environments, transfer skills across settings, and facilitate generalization of communication skills beyond training sessions.

Use of PECS in classroom, therapy, and home environments

PECS is widely applicable across different settings. In classrooms, teachers incorporate PECS into daily routines, encouraging students to initiate requests during activities such as snack time, play, or learning sessions. Visual schedules andPECS boards can support participation and reduce frustration.

In therapy settings, speech-language pathologists and other specialists use PECS to systematically teach communication, often combining it with other interventions. Therapy sessions focus on building core requesting skills, expanding vocabulary, and developing sentence structure.

At home, parents and caregivers utilize PECS to promote communication during routine activities—mealtimes, shopping trips, or leisure activities. They often adapt the materials for use in various locations and contexts, fostering consistency and natural use.

Effective integration of PECS in these environments promotes generalization, meaning the individual increasingly initiates communication independently and appropriately across settings.

Benefits and Evidence Supporting PECS for Communication Development

What are the benefits and effectiveness of PECS for individuals with communication challenges?

PECS, or the Picture Exchange Communication System, is recognized as a prominent augmentative communication method, especially effective for individuals with autism and other communication difficulties. It enables users to communicate by exchanging picture cards for desired items, actions, or information, laying a foundation for more complex language skills.

One of the primary benefits of PECS is its ability to foster functional communication. It teaches individuals to initiate requests, make social comments, and respond to questions, fostering independence and reducing frustration caused by communication barriers. Research shows that early stages of PECS significantly improve requesting and social behaviors, encouraging children to seek out communication opportunities actively.

In addition to improving requesting and social skills, PECS has been linked with positive changes in speech development. Studies indicate that while PECS does not hinder speech growth, it can facilitate verbal skills, especially when integrated with other therapies. Many children who adopt PECS begin to develop spontaneous speech, with some achieving verbal communication as their primary mode.

PECS also impacts problematic behaviors that often stem from communication frustration, such as tantrums or aggression. By providing a means to express needs and desires clearly, PECS reduces the likelihood of challenging behaviors and supports a more positive social environment.

Impact on speech development and reduction of problematic behaviors

Research demonstrates that PECS can be instrumental in developing verbal language. For many children, PECS serves as a bridge toward speech, especially in early intervention. The structured phases of PECS—beginning with requesting and advancing toward commenting and answering questions—help build receptive and expressive language components.

Moreover, PECS's emphasis on initiation encourages social interaction, which fosters language use and social engagement. The system’s visual nature aligns with the preferences of many individuals with autism, facilitating motivation and learning.

Furthermore, PECS is effective in decreasing behaviors related to frustration and communication breakdown. As individuals learn to express their needs through pictures, they experience less stress and exhibit fewer disruptive behaviors.

Research studies and outcomes

A plethora of research supports PECS as an evidence-based practice. Over 240 scientific articles detail its effectiveness in improving communication, social interaction, and reducing problematic behaviors. Studies from the Delaware Autism Program and others worldwide consistently show small to moderate gains in communicative responses.

In particular, the research underscores that PECS is most successful when all six phases are implemented, especially among preschool and elementary-aged children. It has been found to predominantly enhance functional communication skills, notably requesting and commenting.

Meta-analyses reveal that PECS contributes to small but meaningful improvements in speech, though gains can vary based on individual characteristics and the phase of intervention. Some studies indicate limited effects on speech for individuals with more severe impairments or when only certain phases are used.

Implementation fidelity is crucial: formal training and adherence to the protocol lead to better outcomes. Certification programs for practitioners and parents help ensure high-quality implementation.

In summary, PECS stands out as a widely supported, practical, and adaptable system that effectively boosts communication, social engagement, and reduces challenging behaviors among individuals with communication challenges.

This comprehensive research backing underscores PECS's vital role in supporting individuals with communication difficulties, making it a cornerstone of early intervention strategies.

Research Evidence and Case Studies Supporting PECS Use

What research evidence supports the use of PECS and its outcomes?

Extensive research supports the effectiveness of the Picture Exchange Communication System (PECS) in enhancing communication skills among individuals with autism and related developmental disabilities. Studies conducted at the Delaware Autistic Program, where PECS was first implemented, revealed that approximately 76% of users acquire speech as either their primary or supplementary communication mode. This notable statistic underscores PECS's capacity to promote verbal language development, especially when introduced at early stages.

Numerous empirical investigations and meta-analyses have documented consistent improvements in requesting behaviors—an essential aspect of functional communication. For instance, research shows that individuals trained with PECS frequently develop the ability to initiate requests independently, which in turn increases their participation in social interactions. These findings are further supported by observational studies that report greater social approach and engagement with peers and caregivers.

In addition to behavioral gains, evidence indicates that PECS can contribute positively to speech production. Some studies show small to moderate increases in verbal output, especially when the protocol is applied comprehensively across all six phases. Interestingly, about 76% of children who used PECS transitioned to using speech as their primary mode of communication, either alone or alongside other systems.

Meta-analyses, such as the one reviewing multiple single-subject and group studies, emphasize that PECS can be a practical intervention delivering tangible benefits in communication, social skills, and reducing maladaptive behaviors like tantrums caused by frustration. These studies highlight that the intervention is most effective when tailored to the individual’s needs and when all phases are systematically implemented.

Despite the positive outcomes, the research also points out limitations. For example, some findings suggest that gains in speech and generalization to new settings may not always be sustained over time without ongoing support. Variability in individual response indicates that PECS’s success depends on factors such as the child's initial communication level, cognitive abilities, and the quality of implementation.

Overall, the body of evidence positions PECS as an evidence-based practice for promoting communication and social interaction among individuals with autism, although continued research is needed to refine protocols, optimize speech outcomes, and explore long-term effects.

Outcomes related to speech, social, and behavioral improvements

Limitations and areas needing further study

While PECS has demonstrated significant benefits, some limitations are recognized. Gains in speech are often small and may not always generalize to all environments without additional support. Long-term maintenance of communication skills can vary, emphasizing the importance of ongoing intervention. Moreover, individual differences can influence outcomes—some learners may respond more robustly than others.

There is also a need for further research exploring how variables such as early intervention timing, age at implementation, or additional therapies affect PECS outcomes. Recent studies suggest that earlier and consistent implementation across multiple settings enhances generalization and maintenance.

Emerging research calls for detailed investigations into how PECS can be integrated with other augmentative and alternative communication (AAC) strategies or speech therapies. Larger, controlled studies could better delineate which populations benefit most and how to optimize protocols for maximal speech and social gains.

In conclusion, current research provides strong support for PECS as a valuable communication tool. However, optimizing its application depends on continued empirical evaluation, especially concerning long-term effects and integration with broader intervention frameworks.

Implementing PECS: Certification, Resources, and Practical Tips

Are there certification, training, and resources available for PECS?

Yes, a comprehensive range of certification programs, training opportunities, and resources are accessible for those interested in implementing PECS effectively. The Pyramid Educational Consultants, the only organization officially certified to provide PECS training, offers structured certification paths to ensure high-quality implementation.

The certification process includes three levels: Level 1 Certified Implementer (PCI-1), Level 2 Certified Implementer (PCI-2), and Certified Manager (PCM). Practitioners who complete levels 1 and 2 have attended professional training workshops and gained practical experience, enabling them to apply PECS with accuracy and confidence. Those seeking managerial roles or to oversee PECS programs within organizations can pursue the PCM certification after fulfilling additional training and experience requirements.

Training workshops are typically intensive two-day sessions that focus on the six phases of PECS, ensuring that practitioners understand how to teach each stage effectively. These workshops often include live demonstrations, role-plays, and hands-on practice. After training, practitioners can access ongoing support and updates through the Pyramid approach resources.

For parents, teachers, and caregivers, introductory workshops are available to help support their child's or student's communication development. These basic workshops usually cost around $440 for parents and $695 for professionals (as of 2024). They provide foundational knowledge about PECS principles and practical implementation strategies.

In addition to formal training, a multitude of resources are readily available. Free downloadable PECS symbols, manuals, and visual aids can be accessed through official websites and affiliated organizations. These resources help maintain consistency and facilitate portability, as PECS books are made to be portable for use in various settings—home, school, or community.

Moreover, many organizations and online platforms offer supplementary materials, including guides on phase-specific teaching, troubleshooting tips, and activity ideas. Support from trained therapists and the PECS therapy team is also available to ensure practitioners are confident in their implementation.

In summary, certification programs by Pyramid Educational Consultants, accessible training workshops, and a wealth of resources—ranging from visual symbols to manuals—support the widespread and effective use of PECS, helping children and adults communicate more independently.

Comparative Analysis: PECS Versus Other Communication Interventions and Devices

How does PECS compare with other communication interventions or devices?

PECS, or Picture Exchange Communication System, is distinct from many alternative communication methods due to its focus on teaching individuals to initiate communication by physically exchanging pictures. This manual system is designed to help individuals with limited or no speech develop functional communication skills through a structured, step-by-step protocol.

Compared to speech-generating devices (SGDs), PECS is a low-tech, cost-effective approach that relies on tangible picture symbols instead of electronic technology. While SGDs can produce digitized or synthesized speech, offering users verbal outputs upon activation, PECS teaches users to express their needs and thoughts via visual symbols in a systematic way.

Other therapies, such as traditional behavioral interventions aimed at modifying behavior or enhancing speech production, may emphasize imitation, vocalizations, or complex language teaching. However, PECS prioritizes spontaneous, self-initiated communication, which can act as a foundation for later speech development.

PECS is versatile: it can serve as a temporary platform to encourage requesting behaviors or as a long-term communication system for individuals with diverse disabilities, including developmental delays, autism spectrum disorder, and traumatic brain injuries.

Because of its structured phases—from requesting simple items to constructing sentences and commenting—PECS nurtures independence in communication and can be effectively used in various environments such as home, school, and community settings.

In essence, PECS differs from other communication interventions primarily in its simplicity, focus on initiating communication, and adaptability. It complements more complex or technologically advanced strategies, creating a comprehensive support network that enhances individual communication outcomes across different contexts.

Advantages of PECS in Various Settings

PECS offers numerous benefits that make it suitable for a wide range of environments. Its portability and low cost allow practitioners and caregivers to implement it easily in homes, classrooms, and community locations.

The visual nature of PECS is particularly advantageous for children and adults who prefer visual stimuli or have difficulty processing verbal information. This approach can motivate communication, promoting social interaction and learning.

In educational settings, PECS can reduce challenging behaviors linked to communication frustration, such as tantrums or avoidance. Its structured phases help in systematically building communication skills that are foundational for social and academic development.

In community settings, PECS enables users to express needs in public or unfamiliar environments, increasing independence and confidence.

PECS's emphasis on initiation of communication supports social acceptance and inclusion, fostering meaningful relationships beyond the classroom or home.

Complementary Use with Other Interventions

While PECS provides an effective foundation for requesting and commenting, it can be combined with other therapies to maximize communication development.

For instance, integrating PECS with speech therapy can facilitate verbal language emergence. Some users may progress from picture exchanges to vocalizations or verbal speech, especially when supported by additional modeling and reinforcement.

Technology-based interventions, like SGDs, may be used alongside PECS to provide verbal prompts or models, reinforcing the connection between visual symbols and spoken language.

Behavioral and social skills training can further enhance the use of PECS, encouraging more natural interactions and generalization across different settings.

Overall, PECS is highly adaptable and can act as an entry point or an adjunct to other communication and behavioral strategies, creating a personalized approach suited to individual needs and strengths.

Summing Up the Promise of PECS

The Picture Exchange Communication System (PECS) has established itself as a vital and evidence-based approach to enhancing communication among individuals with autism, developmental disabilities, and other speech challenges. Its systematic phases, grounded in ABA principles, facilitate the development of requesting, commenting, and social interaction skills, promoting greater independence and social engagement. Research consistently supports PECS’s effectiveness in improving functional communication and reducing challenging behaviors, with many users advancing to verbal speech. Implemented worldwide, PECS is accessible through certified training, resources, and ongoing support, making it a practical tool for educators, therapists, and families alike. While it works best when tailored to individual needs and complemented with other interventions, PECS remains a cornerstone in AAC strategies, empowering individuals to connect, learn, and participate more fully in their communities.

References

• PECS®: An Evidence-Based Practice
• The Picture Exchange Communication System (PECS)
• Picture Exchange Communication System (PECS)
• The picture exchange communication system - PubMed
• Picture Exchange Communication System - Wikipedia
• Exploring the Use of the Picture Exchange Communication System ...
• Effectiveness of the Picture Exchange Communication System ...
• Get PECS® Certified - Pyramid Educational Consultants