Picture Exchange Communication Systems (PECS)

What is the Picture Exchange Communication System (PECS)?

The Picture Exchange Communication System (PECS) is an augmentative and alternative communication (AAC) system (i.e. a communication method other than speech) that involves the physical exchange of pictures to communicate with another person for the purpose of requesting or commenting. It was originally developed for use with preschool children with autism spectrum disorder and other related developmental disabilities. These children had not developed useful language and they did not initiate communication with others. Over time, PECS has been used with individuals of many ages and with diverse abilities.

PECS is used to provide a child with an alternative way of communicating if they have not yet developed speech. It can also be used to teach a child how to initiate communication with another person. The child first learns to request for highly desirable items and then expands this for commenting and sentence formulation. The child is taught to make their request by handing an exchange card representing what they want, to an adult who is holding the desired item. PECS is taught in six phases. Some children will master each phase quite quickly, while others may never reach Phase 6. What is important is to begin!

Why is the Picture Exchange Communication System (PECS) important?

PECS enables a child to communicate effectively with other people. It is particularly useful for children who are non-verbal, have limited or unclear speech and/or do not use a functional communication system in the home/preschool/school environment. PECS has been successful with individuals of all ages demonstrating a variety of communicative, cognitive and physical difficulties. Some learners using PECS will also develop speech.

What are the building blocks necessary to develop the Picture Exchange Communication System (PECS)?

• Interpersonal interaction: a child must ‘want’ to communicate with others.
• Eye sight: Good eye sight.
• Mobility and controlled movement in the arms and hands.
• Motivation: Motivated to request items.
• Planning and sequencing: The sequential multi-step task/activity performance to achieve a well-defined result.
• Executive functioning: Higher order reasoning and thinking skills.
• Receptive (understanding) language: Comprehension of language.
• Problem solving: The identification of a challenge, including what the challenge is, what strategies could be used to overcome it, and the subsequent performance to overcome it.

How can you tell if my child has problems learning the Picture Exchange Communication System (PECS)?

If a child has difficulties learning PECS they might:

• Not be motivated to request items.
• Be resistant to hand-over-hand prompting/guidance.
• Get frustrated when they can’t get their message across.
• Struggle to maintain attention to task.
• Be unable to match physical objects to a picture of the item.

What other problems can occur when a child has difficulties learning the Picture Exchange Communication System (PECS)?

When a child has difficulties learning PECS, they might also have difficulties with:

• Receptive (understanding) language: Comprehension of language.
• Expressive (using) language: The use of language through speech, sign or alternative forms of communication to communicate wants, needs, thoughts and ideas.
• Articulation: Clarity of speech sounds and spoken language.
• Imitation
• Working memory: The ability to temporarily retain and manipulate information involved in language comprehension, reasoning, and learning new information; and to update this information as change occurs.
• Fine motor skills: Finger and hand skills.
• Planning and sequencing: The sequential multi-step task/activity performance to achieve a well-defined result.
• Social skills: Determined by the ability to engage in reciprocal interaction with others (either verbally or non-verbally), to compromise with others, and be able to recognize and follow social norms.
• Behaviour

What can be done to improve learning the Picture Exchange Communication System (PECS)?

• Motivation: Discover items that are highly interesting and motivating to your child so that they want to request them.
• Aversion: Find items that your child really does not like so that when learning how to discriminate between items they have something that is not appealing to request.
• Decrease sensitivity to touch: Decreasing the child’s resistance to being touched by seeing an Occupational Therapist to work on sensory processing issues.
• Photos: Use photos of items instead of line drawings so the picture used for requesting is easier for your child to recognise.
• Real objects: Use real objects in miniature form of the items they wish to request so that it is easier for your child to recognise the item they wish to request.

 What activities can help improve the Picture Exchange Communication System (PECS)?

• Out of reach: Put a desired item/object up high (but still in the child’s sight) so that your child has to make a request.
• Sabotage: Only complete part of an activity so that the child has to make a request for it to be completed (e.g. get the bath ready but forget to have the bubbles or their favourite bath toys).
• Short episodes: Only allow your child to engage for a short period in an activity so that they have to make a request for the activity to continue (e.g. turn on a video or song and then turn it off after a short while).
• Play: Start to play with a toy and wait to see if the child asks for the toy so that they can have a turn.
• Snack time: During snack time, encourage the child to make a choice about what they would like to eat and drink or the colour cup/plate they would like to use.
• Books: When reading books, take it in turns to comment about pictures in the story using the picture sentence strip (e.g. I see a car, I see a bird).
• Objects: Place a variety of items in a bag/pillow case. Take it in turns to pull out an item and say what you have using the picture sentence strip (e.g. I have a ball).

Why should I seek therapy for my child to develop the Picture Exchange Communication System (PECS)?

Therapeutic intervention to help a child master PECS is important because:

• PECS is an explicitly learned process and to master correctly needs to be taught by someone trained in the process.
• Learning PECS can help to reduce the high levels of frustration often experienced by a child who can’t express their wants and needs.
• PECS helps a child to learn how to initiate interactions with others and understand the cause and effect nature of communicating (i.e. you do something and you get something in return).
• To teach a child the process of applying the use of pictures to help develop more extensive expressive language by improving word order in sentences using pictures (e.g. using pictures to teach a child to say “Can I please have….” rather than “I can have please”).

If left untreated what can  difficulties learning the Picture Exchange Communication System (PECS) lead to?

When children with difficulties learning PECS, they might also have difficulties with:

• Behavioural difficulties as a child’s frustration levels increase because they are unable to express their wants and needs.
• Social isolation as a child is unable to communicate with their peers and may resort to other unwanted behaviours, such as pushing or hitting to try and get other people’s attention.
• Coping in the academic environment as a child may be unable to participate in activities due to a lack of expressive language.

What type of therapy is recommended to help teach the Picture Exchange Communication System (PECS)?

If your child has difficulties with learning PECS, it is recommended they consult a Speech Therapist.

If there are multiple areas of concern (i.e. beyond just PECS) both Occupational Therapy and Speech Therapy may be recommended to address the functional areas of concern. This is the benefit of choosing Kid Sense which provides both Occupational Therapy and Speech Therapy.