Picture Exchange Communication System and Autism Ranking:

Key Features

The Picture Exchange Communication System (PECS) is a form of augmentative and alternative communication in which a child is taught to communicate with an adult by giving them a card with a picture on it.

The adult begins by teaching the child to exchange a picture of an item he wants. For example, if the child wants a drink, he will give a picture of 'drink' to the adult who will then give him a drink.

The adult will then teach the child progressively more difficult skills, such as using pictures to make whole sentences or to express preferences.

The child's preferences for items like food and toys are assessed. The child is then taught to exchange picture cards (usually symbols) for the items he likes.

At first, two trainers are needed so that the child can be prompted to exchange the symbol for the items he wants. The first trainer sits or stands in front of the child, holding the desired item without speaking at all. The second trainer sits or stands behind the child and physically prompts him to pick up the picture and hand it to the first trainer, naming it as it is handed over. The first trainer then hands the desired item to the child. Once the child learns to make the exchange spontaneously, the second trainer is no longer needed.

PECS involves six distinct phases of training, during which the child gradually becomes independent of adult prompting and learns that communication is a two way process which can achieve desired needs.

• Phase 1: Performs the basic exchange with a wide range of pictures
• Phase 2: Persists in getting an adult's or peer's attention and in moving across increasing distances
• Phase 3: Discriminates between a number of pictures in an array
• Phase 4: Forms sentences using pictures
• Phase 5: Answers questions using pictures
• Phase 6: Expands on previously mastered interactions

Frost and Bondy recommend continuing training within each phase until the child has reached 80% or greater proficiency for a minimum of three days before moving onto the next phase.

They suggest that once an individual has mastered PECS and is able to spontaneously and successfully approach others, it may be appropriate to introduce a pointing system or a voice output communication device.

They recommend that, rather than attempting to force the individual to speak, adults should demonstrate appropriate speech. They also note that some individuals may start to speak spontaneously.

Picture symbols can also be used to introduce the idea of choice. For example a child may learn to choose between different symbols to show which food he wants to eat or what toys he would like to play with.

Picture symbols can also be used to make the environment seem more organised and predictable. For example, they can be used with timetables or schedules to show what is supposed to happen when during the day - which can reduce stress and anxiety.

Updated

17 Jun 2022

Last Review

01 Sep 2017

Next Review

01 Dec 2023