PECs

The Picture Exchange Communication System (PECs) is a systematic way to teach a child how to communicate with someone else by handing them a picture of what they want.  PECs is a type of augmentative and alternative communication (AAC) 

The PECs Phases 

1. How to Communicate:

In the first phase of PECS, the child will learn that if they hand an adult a picture, they will get what they want in return.  For this phase, there is one adult in front of the child who is holding what the child wants, and another adult behind the child guiding the child’s hand and arm to help him pick up the picture and give it to the first adult.  Like I said before, this is a very specific program with very specific instructions.  Each adult in this situation has an important role and has instructions on what to do.  For the first phase, the child only has one picture in front of him.  He’s not choosing the picture he wants from a selection, he’s just practicing the idea of handing a picture and getting what he wants.

2. Distance and Persistence:

In this phase of PECS, the child is taught to be more persistent with his communication attempts.  Some of the time, the picture will be moved farther away from the child and he’ll have to go get it.  In other attempts, the picture will be right next to the child but the person who is holding what he wants will start walking away.  The child learns that he needs to be persistent to communicate and can’t give up.

3. Picture Discrimination:

At this point in the program, the child will be given two pictures to choose from.  The child must find the picture that he wants and give that to the adult.  Typically, the second picture is something that the child does not want so that he understands that he really does need to look at the pictures.  Just like the other stages, this stage describes different roles for each of the two adults and shows you exactly what to do to help the child learn how to choose the correct picture.

4. Sentence Structure:

At this point, the program teaches the child how to form a simple sentence.  The picture choices are placed on the front of a notebook with Velcro along with a picture that says “I want”.  There is also a separate strip of Velcro that detaches from the book.  The child is required to place the “I want” picture on the strip along with the picture of what they want.  When the child takes that strip and hands it to the adult, the child is helped to point at each picture as the adult says the words out loud.  At this point, I have seen some children with autism begin to speak the message along with the adult.  That’s not the case for all children, but I definitely have seen some success with this for some children.

Attributes and Language Expansion:

Though not necessarily a true phase, there is also training on how to help a child use adjectives and other words to expand his sentences at this point.

5. Answering Questions:

This phase teaches the child how to answer the question “what do you want” using the PECS notebook and pictures.  For the children that I have used with PECS, I have not often had one get this far.  Typically, the child either starts talking or we have tried a different AAC system, such as a speech output device, and had success with that.  That’s not to say that you can’t continue with this program, that’s just what I’ve done in the past.

6. Commenting:

This phase teaches the child to comment in response to a question.  For example, you may ask “what do you see?” and the child replies with “I see ___”.