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At a glance: Picture Exchange Communication System (PECS)
Type of therapy
Therapy-based
The claim
Improves social skills and communication
Suitable for
People with ASD
Research rating
Find out more about this rating system in our FAQs.
Some research shows positive effects, more research needed.
Time
Estimate of the total time for family in hours per week and duration.
10-20 Because it is a method of communication, this therapy involves daily use.
Cost
Estimate of cost to family per session/item or week.
$30-120 Initial cost of PECS training is high ($330). Ongoing costs are low.
Visit the Autism Service Pathfinder to browse Service Providers information.

About this intervention

What is it?
Based on the principles of ABA (Applied Behaviour Analysis), Picture Exchange Communication System (PECS) is a way for people with autism to communicate without relying on speech. Instead, they use cards that feature pictures, symbols, words or photographs which represent tasks, actions or objects.

Who is it for?
PECS can be used for any individual with autism. No age limit is specified, but research has focused on children. This therapy is also suitable for anyone who has a problem with spoken language, including those with developmental delay, Down syndrome, communication disorder and traumatic brain injury.

What is it used for?
PECS provides an alternative means of communication for people without spoken language skills. It can also add to these people’s existing skills.

By using a system of picture cards, people with autism can learn to make requests, have their needs met, make comments and answer other people’s questions.

Where does it come from?
PECS was developed in the United States in 1985, as part of the Delaware Autism Program. In 1992, two leading autism researchers co-founded Pyramid Educational Consultants, an international consortium of PECS training centres.

What is the idea behind it?
PECS is based on ‘learning theory’, which proposes that learning occurs because of the consequences of a particular behaviour and the events that lead up to it. If a behaviour leads to something a person wants, that behaviour will continue to occur. If the behaviour doesn’t result in what that person wants, it’s unlikely to reoccur.

In PECS, when a child uses an appropriate card, they’re rewarded with the desired object or action. Supporters of PECS suggest that this reinforces the child’s behaviour. In turn, it increases the likelihood that the child will continue to use the cards for communicating needs and desires.

What does it involve?
Because it’s a method of communication, PECS is taught and used on a daily basis.

To begin with, the child’s preferences for things like food and toys are identified. The child is then taught to exchange pictures of these items for the actual items.

Later on, the cards may be used to make requests, to ask and answer questions, or for more advanced tasks, like making comments.

Cost considerations
PECS training workshops are available through Pyramid Educational Consultants.

In 2011, the two-day PECS basic training workshop costs $660 for professionals and $363 for parents. The workshop fee includes a copy of the PECS Training Manual with Data Forms CD, which contains information to guide parents and practitioners implementing the system.

Resources for creating PECS cards are also available for purchase from Pyramid Educational Consultants. Some resources are also offered free online (see Links, below).

Does it work?
Some research has shown positive effects from this therapy, but more high-quality studies are needed. There isn’t strong evidence that this therapy prevents language development.

Who practises this method?
Many speech pathologists, occupational therapists, psychologists, physiotherapists, social workers, parents and teachers have been trained in PECS. You can ask whether a professional has experience with PECS when making an appointment.

Parent education, training, support and involvement
It’s recommended that parents complete a two-day PECS basic workshop before beginning PECS with their child. Even if parents are taking their child to a professional to learn PECS, they’re still encouraged to complete the training so they can practice PECS with their child at home.

After completing this training, parents are often able to implement PECS at home independently. Additional training and support is offered if parents require more assistance.

Parents can also be involved in expanding the PECS card library as their child’s needs and interests develop.

Where can I find a practitioner?
Contact the autism association in your state and ask them to recommend a service or practitioner. Many health professionals have completed training in PECS. Pyramid Educational Consultants is the only organisation certified to train people in the PECS system. To find a certified PECS practitioner, you can contact Pyramid Educational Consultants on (03) 9314 5374.

 
 
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  • Last Updated 09-11-2011
  • Last Reviewed 07-09-2012
  • 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.

    Mastergeorge, A.M., Rogers, S.J., Corbett, B.A., & Solomon, M. (2003). Nonmedical interventions for autism spectrum disorders. In S. Ozonoff, S.J. Rogers, & R.L. Hendren (Eds.), Autism spectrum disorders: A research review for practitioners (pp. 133-160). Washington, DC.: American Psychiatric Publishing.

    National Autism Center (2009). National Standards Report – Addressing the need for evidence-based practice guidelines for Autism Spectrum Disorders. Massachusetts: National Autism Center.

    Roberts, J.M.A., & Prior, M. (2006). A review of the research to identify the most effective models of practice in early intervention for children with autism spectrum disorders. Australian Government Department of Health and Ageing, Australia.

    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.