This paper examines the Picture Exchange Communication System (PECS) as a treatment approach for children with autism spectrum disorder. It begins by outlining autism's developmental characteristics and the range of available treatments, then describes PECS as an augmentative and alternative communication (AAC) method that uses images in place of speech. The paper details PECS's six progressive phases, from initiating basic exchanges to commenting on the environment. It compares PECS with related approaches such as TEACCH and Voice Output Communication Aids, and concludes by weighing the system's practical advantages — including ease of use and low material cost — against its disadvantages, such as training expenses and the ongoing demands placed on teachers and caregivers.
Autism is a developmental disorder affecting communication skills, caused by abnormalities in the brain or nervous system. Symptoms usually surface within the first three years of life. Treatments take the form of picture communication systems, medication, dietary interventions, and social interaction programs. Among these, the Picture Exchange Communication System (PECS) appears to be one of the most effective, operating through six structured phases. It carries both advantages and disadvantages that practitioners and families should carefully consider.
Autism is a developmental disorder involving the brain and communication skills (Kaneshiro & Zieve, 2012). The causes of this physical abnormality remain unknown, although genetic factors appear to play an important role. Language abnormalities among the relatives of autistic children are a commonly noted observation. Chromosomal and nervous system abnormalities have also been observed. Autism typically becomes evident within the first three years of life. Most autistic children experience difficulty with pretend play, social interactions, and both verbal and nonverbal communication (Kaneshiro & Zieve, 2012).
Successful treatment is focused on the child's specific needs (Kaneshiro & Zieve, 2012). Approaches include applied behavior analysis (ABA), Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH), medications, dietary changes, occupational therapy, physical therapy, and speech-language therapy. Visual aids are also found to be helpful. Alternative approaches have also been developed, among them the Picture Exchange Communication System (Kaneshiro & Zieve, 2012).
PECS is an augmentative and alternative communication (AAC) system that uses images instead of speech-based communication techniques, with the purpose of helping autistic children communicate (Prontes, 2012; PEC, 2012). The child hands a picture to a communication partner or teacher in exchange for the item the picture represents. It provides the child with a functional outlet for expressing what he or she would normally convey through speech. It can be introduced as early as age two to help the child initiate conversation and express needs to others. The observation is that the child's condition tends to improve as his or her ability to communicate increases.
Using this system allows the child to communicate about things already present in his or her actual environment. As an ABA-based approach, PECS enables careful monitoring and the use of positive reinforcement techniques necessary for teaching behavioral steps and practices (Prontes, 2012; PEC, 2012).
The first phase initiates the communication process (Prontes, 2012; PEC, 2012). The child is guided to select a picture from the table and hand it to the partner or teacher in order to receive the item represented. The teacher's physical guidance is gradually withdrawn.
The second phase teaches distance and persistence. A communication book is presented to the child with a picture displayed on the cover. The child locates the picture and brings it to the partner or teacher in exchange for the actual object.
The third phase teaches the child to discriminate between pictures or symbols. The child is shown a picture of a preferred item alongside a picture of a non-preferred object. He or she exchanges a picture and receives the corresponding actual item. If the child selects the preferred item, he or she receives an animated social reinforcement. If the child exchanges the non-preferred item instead, an error correction sequence is introduced. When the child successfully discriminates between items, correspondence checks are made to confirm that the child's choice matches his or her actual preference. Multiple desired items are then introduced, increasing the number of pictures presented.
The fourth phase begins incorporating sentence structure through a new visual prompt reading "I want," designed to teach the child to form simple sentences. A sentence strip is placed on the cover of the communication book. The child is guided to place the "I want" strip alongside the picture of the desired item, then remove and exchange the strip. The partner or teacher shows the strip to the child and reads the phrase aloud, after which the child receives the desired item.
The fifth phase teaches the child to answer direct questions such as "What do you want?" The child learns to respond appropriately to these prompts.
The sixth and final phase aims to build the child's capacity to comment. The child learns to communicate not only wants and needs but also observations about the surrounding environment. Strips reading "I see" and "I hear" are introduced one at a time on the communication board in a systematic manner (Prontes, 2012; PEC, 2012).
TEACCH is a statewide program developed in North Carolina (Kaneshiro & Zieve, 2012). It also uses pictures and other visual cues to help autistic children function independently and manage their environment. It aims to improve the child's adaptation and skills while addressing problems associated with the autism spectrum. Unlike PECS, TEACCH does not endeavor to bring the child to a specific level of development through treatment (Kaneshiro & Zieve, 2012).
Voice Output Communication Aids (VOCAs) represent another type of augmentative and alternative communication system (Research Autism, 2012). These devices are designed to help a child produce speech. The simplest type records a single pre-recorded message in digitized form, which plays when the child presses a button, switch, or key. More advanced versions use software that allows the child to form and combine words independently, producing new sounds as computerized synthetic speech (Research Autism, 2012). These systems differ substantially from the phase-based exchange structure used in PECS.
"PECS compared to TEACCH and voice output aids"
"Key benefits of PECS for children and caregivers"
"Costs, limitations, and ongoing demands of PECS"
You’re 65% through this paper. Sign up to read the remaining 3 sections.
Sign Up Now — Instant Access Already a member? Log inAlways verify citation format against your institution’s current style guide requirements.