Picture Exchange Communication System (PECS)

Description:, PECS is a methodology that uses pictures and other symbols to develop a functional communication system for individuals with autism spectrum disorder (ASD) based upon the principles of applied behavior analysis (ABA). In the early stages of training, PECS teaches students to exchange a picture of a desired item for the actual item.  Next steps in training include teaching expansion of vocabulary, including attributes (e.g., “big”, “red”) and commenting (e.g., “I like swinging”).

Research Summary: Studies show that PECS is effective in teaching communication skills that involve single words or short phrases, and that these communication skills may generalize to everyday settings. Ongoing consultation from an expert in PECS is likely to improve outcomes for children with autism spectrum disorders who receive this intervention.

Recommendations:  PECS is a viable option as an intervention for teaching functional communication skills to children with ASD who have limited or no communication skills, or have difficulty initiating or expanding vocabulary. To increase the utility of this intervention, an important area for future research is to investigate PECS procedures for promoting initiation of communication and acquisition of complex, flexible language.

Selected References:

Selected scientific studies:

Alissa L. Greenberg, A. L., Tomaino, J.A.E., and Charlop, M. H. (2012). Assessing Generalization of the Picture Exchange Communication System in Children with Autism. Journal of Developmental and Physical Disabilities, 24, 539–558. doi: 10.1007/s10882-012-9288-y

Chaabane, D., Alber-Morgan, S., & DeBar, R. (2009). The effects of parent-implemented PECS training on improvisation of mands by children with autism. Journal of Applied Behavior Analysis, 42, 671-677.

Howlin, P., Gordon, R. K., Pasco, G., Wade, G., & Charman, T. (2007). The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: A pragmatic, group randomised controlled trial. Journal of Child Psychology & Psychiatry, 48, 473-481.

Follow-up study:

Schreibman, L., & Stahmer, A. C. (2014). A randomized trial comparison of the effects of verbal and pictorial naturalistic communication strategies on spoken language for young children with autism. Journal of Autism and Developmental Disorders, 44(5), 1244-1251.

Gordon, K., Pasco, G., McElduff, F., Wade, A., Howlin, P., & Charman, T. (2011). A communication-based intervention for nonverbal children with autism: what changes? Who benefits? Journal of Consulting and Clinical Psychology, 79, 447-457.

Yoder, P., & Stone, W. L. (2006). Randomized comparison of two communication interventions for preschoolers with autism. Journal of Consulting and Clinical Psychology, 74, 426-425.

Systematic reviews of scientific studies:

Flippin, M., Reszka, S., & Watson, L.R. (2010). Effectiveness of the Picture Exchange Communication System (PECS) on communication and speech for children with autism spectrum disorders: A meta-analysis. American Journal of Speech-Language Pathology, 19, 179-185.

Maglione, M. A., Gans, D., Das, L., Timbie, J., & Kasari, C. (2012). Nonmedical interventions for children with ASD: Recommended guidelines and further research needs. Pediatrics, 130, S169-S178.

Tien, K-C. (2008). Effectiveness of the Picture Exchange Communication System as a functional communication intervention for individuals with Autism Spectrum Disorders: A practice-based research synthesis. Education and Training in Developmental Disabilities, 43, 61-76.

Tincani, M. & Devis, K. (2010). Quantitative synthesis and component analysis of single-participant studies on the Picture Exchange Communication System. Remediation and Special Education (Online First), 1-13.

For additional information:

Bondy, A. & Frost, L. (2001). The Picture Exchange Communication System. Behavior Modification, 25, 725-744.

Related articles:

Generalization of PECS

The effectiveness of the picture exchange communication system (PECS) on communication and speech for children with autism spectrum disorders: A meta-analysis