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Treatments

Pictorial Exchange Communication System (PECS)

The Picture Exchange Communication System (PECS) is a type of augmentative alternative communication (AAC) originally developed for children with autism. The primary purpose of PECS is to teach individuals with autism to initiate communication. Individuals are taught to initiate by handing a picture to a communication partner in exchange for a desired item.

Why use PECS?

PECS allows individuals with autism to communicate by using pictures instead of, or in conjunction with, speech. PECS provides a functional outlet of expression for individuals who otherwise have difficulty communicating with others. It can be used, beginning as early as age two, to initiate conversation and to communicate wants or needs to another person and has also successfully been taught to adults with similar communication needs. Lastly, often times as individuals with autism increase their ability to communicate their behavior tends to lessen.

How does PECS work?

After being taught the phase six system, an individual using PECS chooses a picture from a variety of pictures available then gives the picture to a communication partner. Knowing the individual's request, the partner can then provide the desired item or fulfill a desired need.

The six phases of PECS:

Phase I. Purpose: To initiate communication
The individual with autism sees a desired item. He or she is physically guided by a prompter to pick up a picture of that item from the table and place it into the communication partner's hand in exchange for the desired item. Physical guidance by the prompter is faded as soon as possible.

Phase II. Purpose: To teach distance and persistence

A communication book is provided with one picture on the front of the book at a time. The individual with autism is taught to locate his/her communication book and travel to the communication partner to exchange a picture for the desired object.

Phase III. Purpose: To discriminate between pictures or symbols

The individual with autism is presented with a picture of a highly preferred item and a picture of a non-preferred item on his/her communication book. The individual exchanges a picture and receives the corresponding item. If the individual selects the preferred item then he/she is given the item with animated social reinforcement. If he/she exchanges the undesirable item then an error correction sequence is introduced. Once the individual begins to discriminate between the items, correspondence checks are completed to ensure that the individual's actions correspond to his or her requests. Discrimination training continues by added multiple desired items and increasing the number of pictures on the front of the book.

Phase IV. Purpose: To begin using sentence structure

The individual is introduced to a new icon "I want" to begin teaching the individual to use a sentence starter. A sentence strip is added to the front of the communication book and the individual learns to build and exchange the phrase by attaching the "I want" picture to the strip, attaching the picture of the desired item to the strip, removing the strip, and exchanging the strip. The communication partner then turns the strip toward the individual with autism and reads the phrase and provides the individual with the desired item.

Phase V. Purpose: To answer a direct question

The individual is taught to answer the question, "What do you want?"

Phase VI. Purpose: To begin to develop commenting

The individual learns to communicate more than just his or her wants and needs. He or she learns to comment about the environment. Icons such as "I see" and "I hear" are introduced one at a time on the communication board in a systematic fashion.

Resources

Book

Frost, L., & Bondy, A. (2002). The Picture Exchange Communication System Training Manual. Newark, DE: Pyramid Educational Products, Inc.

(From: http://www.autismspectrum.ilstu.edu/resources/factsheets/pictureexchange.shtml)
Autism Spectrum Institute at Illinois State University