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This article reviews the progress of a group of children 19 months after being introduced to PECS which was reported in Special Children 1999. The group have progressed from using 3-5 word sentences incorporating attributes to spontaneously requesting and commenting both with and without PECS. As speech developed the teacher continued to use PECS as a framework for teaching further communicative functions and a range of curriculum subjects. The familiar framework enabled the assimilation of new concepts and ideas more easily, and they were able to ask and respond to a range of questions. They progressed to more advanced requesting and commenting lessons and used the conjunction ‘and' and the indefinite article ‘a' within 13 word sentences. There was increasing evidence of generalisation as the taught structures were used spontaneously at home, which underlines the importance of ensuring the same vocabulary is available in all environments. Gradually, the children were observed using commenting spontaneously both with and without PECS, and the skill extended into narrative and description. The author used PECS right across the day, which enabled language to be integrated with the social and environmental context and enabled the mapping of language onto experiences. The development of functional communication impacted on reducing contextually inappropriate behaviours. In fact it also raised the question of whose behaviour changed the most, the children's or the staff? Staff found that by using PECS they could eliminate prompts, allow time to observe, facilitate children to respond and self-correct, and as a result peer interaction and independence was able to develop.

This study investigated the effects of introducing the Picture Exchange Communication System (PECS) on the frequency of requesting and commenting and the length of verbal utterances of two children with autism spectrum disorder (ASD) who presented with some spoken language, but limited use of language in communicative exchanges. A mixed research design was used, including a quantitative component — a single-subject multiple-baseline design (MBD) across three behaviours, repeated with two participants — and a qualitative component. Data was collected in the PECS pre-training, training, post-training and follow-up stages, in both structured and unstructured settings. The quantitative data was visually represented and analysed to determine the effectiveness of the PECS. The qualitative component investigated the impact of the PECS on other areas (e.g. communication profile, speech complexity and pragmatic skills), and included parent and educator perspectives. Both participants benefited from the introduction of PECS. The findings indicated highly effective treatment for requesting and mixed results for commenting and length of verbal utterances. There were considerable increases in intentional communicative acts (ICAs) for both participants, with marked increases in requesting (function) and the development of forms of communication (from augmentation of speech with pictures to speech only utterances). Clinical, educational and research implications were raised.

We examined the effects of the Picture Exchange Communication System (PECS; Frost & Bondy, 2002) on the manding (requesting) and speech development of school-aged children with autism. In study 1, two participants, Damian and Bob, were taught PECS within a delayed multiple baseline design. Both participants demonstrated increased levels of manding after implementation of PECS. Only Damian demonstrated any measurable speech during study 1. His speech development occurred primarily during phase IV of PECS. Because of the positive relationship between Phase IV and increased speech for Damian, study 2 was conducted to confirm a functional relationship between phase IV procedures and speech development for an additional participant. Carl received phase IV training procedures in two conditions, administered in an ABAB design. In condition A, no reinforcement was provided for vocalization; in condition B, reinforcement was provided for vocalization after a delay of 3-to 5s. The vocal reinforcement procedures in phase B differentially increased Carl's speech. Results are discussed in terms of research on augmentative and alternative communication and speech development for children with autism.

The passage of the Individuals with Disabilities Education Act of 1990 mandated the provision of interventions for young children with autism spectrum disorders (ASD) under the age of 3 years. Although Strain, McGee, and Kohler (2001) suggested that children with autism benefit from inclusive programming, inclusive early intervention programs are rare. In the current study, the authors used a quasi-experimental design to analyze the outcomes for 20 young children with ASD in an inclusive program for children under age 3. Both outcomes on standardized assessments and functional outcomes were compared at program entry and exit. Significant increases in standard scores were found for the standardized assessments from intake to exit, with 37% of the children functioning in the typical range at exit, compared to 11% at entry. Significant improvements in performance on functional measures were also seen. At intake, 50% of the study participants had no functional communication skills, whereas at exit, 90% used a functional communication system. Social and play behaviors also increased substantially. Use of augmentative communication systems and a combination of research-based programming are discussed. (NOTE: see pages 76-77 in particular re: PECS-“Two of the children on the PECS system began to use spoken language consistently, and they discontinued use of the PECS system. The use of an augmentative system thus did not appear to impair the acquisition of spoken language for these children, as has been previously suggested (McGee et al., 1999).

Presently there is no consensus on the specific behavioral treatment of choice for targeting language in young nonverbal children with autism. This randomized clinical trial compared the effectiveness of a verbally-based intervention, Pivotal Response Training (PRT) to a pictorially-based behavioral intervention, the Picture Exchange Communication System (PECS) on the acquisition of spoken language by young (2–4 years), nonverbal or minimally verbal (≤9 words) children with autism. Thirty-nine children were randomly assigned to either the PRT or PECS condition. Participants received on average 247 h of intervention across 23 weeks. Dependent measures included overall communication, expressive vocabulary, pictorial communication and parent satisfaction. Children in both intervention groups demonstrated increases in spoken language skills, with no significant difference between the two conditions. Seventy-eight percent of all children exited the program with more than 10 functional words. Parents were very satisfied with both programs but indicated PECS was more difficult to implement.

The purpose of this study was to analyze the impact of the implementation of the Picture Exchange Communication System (PECS) on the comprehension of instructions by children with Autism Spectrum Disorder (ASD).

The purpose of this study was to analyze the impact of the implementation of the Picture Exchange Communication System (PECS) on the comprehension of instructions by children with Autism Spectrum Disorder (ASD).

The Picture Exchange Communication System [PECS®) was first described in autism research literature in the early 1990s. Since that time, there have been almost 200 publications about the PECS protocol from countries around the world. The manualized PECS protocol has six key phases beginning with simple requests involving single icons, and building toward commenting, responding to other people's communication, and increased message length through picture combinations.1 We developed the protocol with very young children with autism spectrum disorder [ASDJ, but there are now publications involving adolescents and adults, as well as individuals with a wide variety of learning needs.

Autism Asperger's digest, 2003, Mar.-Apr., pp. 24-25, 31.

Behavioral Disorders, 44, 1-12. https://doi.org/10.1177/0198742918806925'>https://doi.org/10.1177/0198742918806925Abstract: Effective strategies to address communication and behavior challenges are critical in early intervention programs. The purpose of this study was to investigate the effects of the Picture Exchange Communication System (PECS) on vocal mands and aggressive behavior displayed by a child with autism in China. One 4-year-old boy with autism participated in this study. The experimental design was a multiple baseline across three settings. The PECS intervention involved the first three phases described in the PECS manual. The results indicated that PECS effectively increased vocal mands and decreased aggressive behavior maintained by access to preferred items in all three settings. The results also suggested that vocal mands were potentially controlled by pictures in the PECS book. One week following the completion of the intervention, the child maintained the PECS exchanges at a high level with increased vocal mands. His aggressive behavior remained at almost zero occurrences. Results of this study have important implications to early intervention educators working with children with autism. 

Picture Exchange Communication System is a common augmentative communication system used on children with Autism Spectrum Disorder (ASD), which is one of the categories of developmental problems in social interaction, communication and behavior patterns. The aim of this study is to see an increase in the utterance of the word by students with autism using PECS. This study is an action research using quantitative descriptive on data collection. Observations were implemented over a period of four weeks to see the effectiveness of PECS using cartoon picture cards and cards real pictures to enhance the utterance of two primary school autism students. From the result shown, the application of PECS successfully stimulates utterance among the students. This study is expected to enhance the communication and social interaction development of children with autism and other children who have difficulty mastering the language. 

Picture Exchange Communication Systems (PECS) is a form of augmentative and alternative communication (AAC) frequently used by individuals with autism spectrum disorder and intellectual disability when speech development is delayed or does not develop (Bondy and Frost 1994 in Focus on Autism and Other Developmental Disabilities, 9, 1–19; Sunberg and Partington 1998). Researchers have previously evaluated variations of PECS as a means for vocalization development (Ganz and Simpson 2004 in Journal of Autism and Developmental Disorders, 34, 395–409; Tincani et al. 2006 in Education and Training in Developmental Disabilities, 41, 177–184). The current study investigated delay to reinforcement and an increase in response effort when utilizing PECS on the development of intelligible word vocalizations with four elementary aged students. Three participants transitioned from primarily requesting using PECS at Phase IIIb to using independent vocalizations (i.e., spoken words). This research provides further evidence for the use of PECS not only as a tool for functional communication, but also as a resource for assisting individuals in the development of vocalizations with slight variations in the parameters of reinforcement including response effort and delay of reinforcement.

The author who is a teacher at Avalon Special School, Street, Somerset, introduced PECS to a class of 6, 4/5 year old children, with severe communication difficulties, and of whom 5 have autistic spectrum disorders. The work started mid-September 1998 and within weeks all children who were previously at a pre-verbal level, were verbalising, and now five months on are using spoken language to communicate spontaneously with and without the use of symbols/words.

The Picture Exchange Communication System (PECS) is a widely used intervention strategy designed to teach communication skills to children with developmental delays, including autism. The Picture Exchange Communication System incorporates the teaching of mand initiations that are thought to be pivotal response behaviours, and have been demonstrated to lead to generalised improvements in other nontargeted behaviours. The aim of the present study was to assess the acquisition of PECS with a 3-year-old boy with autism using the established PECS training program, and to evaluate concomitant changes in spoken language, social–communicative behaviours, and functional play. Results indicated that the participant rapidly acquired the criterion behaviours for Phases 1 to 3 of the PECS program. Although PECS exchanges were rarely observed in the generalization settings, clear increases were evident in verbal mands and other initiations in both home and kindergarten generalisation settings. Increases in spoken vocabulary and in the length of comprehensible spoken utterances in free-play were observed, as were gains in time spent in developmentally appropriate play. Implications of these results and directions for future research are discussed.

Little is known about the relationship between PECS training and vocalizations in children with limited verbal abilities (e.g., children who are unable to verbally imitate simple phrases). Study 1 used a multiple baseline design across children to examine the vocalizations of four children with autism during and after PECS training. At follow-up, three of the participants demonstrated higher frequencies of vocalizations than at baseline. Further, two of these participants used both PECS and vocalizations to mand at different times, but did not pair the two modalities. Study 2 was then conducted to determine if children with limited verbal abilities could be taught to pair PECS with spontaneous vocalizations using time-delay and verbal prompting procedures. By the end of Study 2, both participants made a spontaneous vocalization every time that they used PECS. Findings support the potential use of PECS as a component of a treatment package leading to verbal speech.

By definition children with autism spectrum disorders (ASD) experience difficulty understanding and using language. Accordingly, visual and picture-based strategies such as the Picture Exchange Communication System (PECS) show promise in ameliorating speech and language deficits. This study reports the results of a multiple baseline across participants investigating the implementation of the PECS with three preschool children with characteristics of ASD. The first four phases of PECS were taught to the participants: basic picture exchange, increasing distance use of PECS, discriminating among a variety of pictures, and communicating in sentences composed of pictures. Relative to the impact of PECS's implementation in providing the participants with a functional communication system, word approximations, and intelligible word and phrase use, results indicated that two of the three participants mastered PECS. However, participants did not significantly increase in use of word approximations and intelligible words.

Few studies on augmentative and alternative communication (AAC) systems have addressed the potential for such systems to impact word utterances in children with autism spectrum disorders (ASD). The Picture Exchange Communication System (PECS) is an AAC system designed specifically to minimize difficulties with communication skills experienced by individuals with ASD. The current study examined the role of PECS in improving the number of words spoken, increasing the complexity and length of phrases, and decreasing the non-word vocalizations of three young children with ASD and developmental delays (DD) with related characteristics. Participants were taught Phases 1–4 of PECS (i.e., picture exchange, increased distance, picture discrimination, and sentence construction). The results indicated that PECS was mastered rapidly by the participants and word utterances increased in number of words and complexity of grammar.

Purpose: The Picture Exchange Communication System (PECS) is a popular communication training program for young children with autism spectrum disorders (ASD). This metanalysis reviews the current empirical evidence for PECS in impacting communication and speech outcomes for children with ASD. Methods: A systematic review of the literature on PECS written between 1994 and June 2009 was conducted. Quality of scientific rigor was assessed and used as an inclusion criterion in computation of effect sizes. Effect sizes were aggregated separately for single subject and group studies for communication and speech outcomes. Results: Eight single-subject experiments (18 participants) and three group studies (95 PECS participants, 65 in other intervention/control) were included. Results indicated PECS is promising, but not as yet established evidenced-based intervention for facilitating communication for children with ASD ages 1–11 years. Small to moderate gains in communication were demonstrated following training. Gains in speech were small to negative. Conclusions: This metanalysis synthesizes gains in communication and relative lack of gains made in speech across the PECS literature for children with ASD. Concerns about maintenance and generalization are identified. Emerging evidence of potential pre-intervention child characteristics are discussed. Phase IV was identified as a possibly influential program characteristic for speech outcomes.

The picture exchange communication system (PECS) is an augmentative communication system frequently used with children with autism (Bondy & Frost, 1994; Siegel, 2000; Yamall, 2000). Despite its common clinical use, no well-controlled empirical investigations have been conducted to test the effectiveness of PECS. Using a multiple baseline design, the present study examined the acquisition of PECS with 3 children with autism. In addition, the study examined the effects of PECS training on the emergence of speech in play and academic settings. Ancillary measures of social-communicative behaviors and problem behaviors were recorded. Results indicated that all 3 children met the learning criterion for PECS and showed concomitant increases in verbal speech. Ancillary gains were associated with increases in social-communicative behaviors and decreases in problem behaviors. The results are discussed in terms of the provision of empirical support for PECS as well as the concomitant positive side effects of its use.

The context for this work was an evaluation study (Carr & Felce, under review) of the early phases of the Picture Exchange Communication System [PECS] (Frost & Bondy, 1994; 2002). This paper reports that 5 of 24 children who received 15 hours of PECS teaching towards Phase III over a period of 4-5 weeks, showed concomitant increases in speech production, either in initiating communication with staff or in responding, or both. No children in the PECS group demonstrated a decrease in spoken words after receiving PECS teaching. In the control group, only 1 of 17 children demonstrated a minimal increase and 4 of 17 children demonstrated a decrease in use of spoken words after a similar period without PECS teaching.

Research suggests that 25 to 61% of children with autism will use little or no functional speech to communicate. For these children, many speech-language pathologists will teach the use of the Picture Exchange Communication System (PECS). Studies have reported some children go on to develop functional speech after using PECS. What remains unclear is (i) which children will begin to use functional verbal abilities, and (ii) why this occurs for some and not others. The purposes of this study were to: (a) measure changes in speech production in children with autism after PECS use, and (b) explore whether these changes could be related to children's pre-intervention characteristics, including adaptive functioning, symbolic representation, motor imitation and receptive and expressive language skills. Three male children with autism spectrum disorder aged 2–3 years participated in this study, which followed a single-subject, changing-criterion design. At study outset, speech skills and pre-intervention characteristics were assessed. Parents were then trained to use PECS with their child during weekly clinic and home visits across a five-month period. Speech production data were collected during monthly probes and at post-intervention, then analyzed and compared to pre-intervention characteristics. Results showed changes to speech occurred for Participants 1 and 3. Comparison of pre-intervention characteristics revealed imitation as the only skill area that was different between children, with Participant 3 demonstrating higher motor and verbal imitation scores. These preliminary results suggest that stronger imitation skills may increase the likelihood that a child with autism will develop functional speech after PECS use.

A variety of strategies have been used to help children with autism acquire functional communication skills. The Picture Exchange Communication System (PECS) is a unique communication training program that was developed as a means of circumventing some shortcomings associated with these strategies. A description of the steps within PECS is provided. Long-term group data have indicated that a large proportion of children started on PECS as preschoolers acquire speech. Individual and group data supporting the use of PECS are provided. (http://www.proedinc.com)

The Picture Exchange Communication System (PECS) was developed as a means to teach children with autism and related developmental disabilities a rapidly acquired, self-initiating, functional communication system. Its theoretical roots combine principles from applied behavior analysis and guidelines established within the field of alternative and augmentative communication. This approach has several potential advantages relative to imitation-based strategies (both vocal and gestural) and symbol selection strategies. The system begins with the exchange of simple icons but rapidly builds “sentence” structure. The system also emphasizes developing the request function prior to developing responding to simple questions and commenting. The development of requesting with a sentence structure also permits the rapid development of attributes more traditionally taught within a receptive mode. The relationship between the introduction of PECS and various other behavioral issues (i.e., social approach and behavior management) as well as its relationship to the codevelopment of speech are reviewed.

The Picture Exchange Communication System (PECS) is an alternative/augmentative communication system that was developed to teach functional communication to children with limited speech. The approach is unique in that it teaches children to initiate communicative interactions within a social framework. This article describes the advantages to implementing PECS over traditional approaches. The PECS training protocol is described wherein children are taught to exchange a single picture for a desired item and eventually to construct picture-based sentences and use a variety of attributes in their requests. The relationship of PECS's implementation to the development of speech in previously non-vocal students is reviewed. (http://www.sagepub.com)