Picture Exchange Communication System (PECS)

Picture Exchange Communication System (PECS) is a form of augmentative and alternative communication. It is typically used as an aid in communication for children with autism and other special needs. The system has been used with a variety of ages including preschoolers, adolescents and adults who have a wide array of communicative, cognitive and physical difficulties.

What is it?

A picture exchange communication system (PECS) is a form of  communication that uses pictures instead of words to help children communicate. PECS was designed especially for children with autism who have delays in speech development.

When first learning to use PECS, the child is given a set of pictures of favourite foods or toys. When the child wants one of these items, he gives the picture to a communication partner(a parent, therapist, caregiver, or even another child). The communication partner then hands the child the food or toy. This exchange reinforces communication.

PECS can also be used to make comments about things seen or heard in the environment. For example, a child might see an airplane overhead, and hand a picture of an airplane to his or her parent. As the child begins to understand the usefulness of communication, the hope is that he will then begin to use natural speech.

What's it like?

A child can be trained in PECS by a parent, caregiver, or therapist who has learned about the method. An applied behaviour analysis approach is used, in which prompts are given to guide the picture exchange. Further, in the early phases of PECS training, the child chooses a picture of a desired food, and receives the food in exchange for the picture. Getting the food is the positive reinforcement for using the picture to communicate.

What is the theory behind it?

The direct reinforcement that comes from immediately getting what you want is the key to PECS. Without having to use spoken words, a child is able to turn an inner desire into an external reward. It is thought that tangible rewards are more reinforcing to children with autism than social rewards, at least during the first steps of communication learning.

PECS may also help improve social interactions in children with autism. Because the child is in charge of approaching the communication partner, the child learns how to make the first move. For children with autism, approaching another person socially can be difficult. However, in this case, the child is not expected to speak, so the initial approach may be less intimidating.

Does it work?

There are several well-designed research studies showing the usefulness of PECS. In one study of 18 preschool children with language delays, some of whom were diagnosed with autism, PECS generalized across communication partners and environments. These children were able to use PECS to communicate throughout their school days, not just during the training sessions. Further, almost half of these children stopped using PECS and started using natural speech within a year.

One parent commented that "PECS turned on the light for communication" in her child.  

Overall, the evidence supports the use of PECS as a tool for developing natural communication in children with autism, especially when it is taught before the child is six years old.

Is it harmful?

There are no known negative effects of PECS. Some parents have been concerned that their child will become dependent on PECS and not move on to develop natural speech. However, this view is not supported by research studies. In fact, there is evidence that children with autism who have learned to use PECS develop speech more quickly than those who have not been trained in PECS.

Cost

The materials used in PECS are relatively inexpensive. A binder for storing PECS pictures can be made from a 3-ring binder. A Velcro strip is attached to the front cover to hold the picture(s) currently being used. Each picture can be drawn by a parent, cut out of a magazine, or made from an actual photograph of the object glued onto a card. A Velcro strip can be placed on the back of each picture to hold it in place on the front cover of the binder when it is being used.

PECS is designed to teach functional communication with an initial focus on spontaneity. It has been and continues to be implemented in a variety of settings (home, school, community) so users have the skills to communicate their wants and needs. PECS does not require complex or expensive materials since it uses picture symbols as the modality.