Picture Exchange Communications System, PECS (pronounced PEX) is a system of communication that is typically used by individuals who are nonverbal or who have significant spoken communication problems. It also helps children who learn and think visually better communicate their ideas, needs and wishes when spoken language is problematic. For children with significant communication disorders or Autism, for example, PECS offers a viable solution to spoken language. Additionally, PECS has proven to help many children develop spoken language and does not merely substitute its system for more mainstream communication (Desch, Gaebler-Spira, & Disabilities, June 2008). PECS is helpful to the child who does not have the motor control to use sign language and serves as a readily usable means of communication in the home, at school and in the community at large. Even those not familiar with PECS can understand the images used by a child communicating with this system since the images are clear and universally understood. In many settings PECS has become a generic term for systems that use picture cards for communication; however, there is a trademarked system from which the name originated produced by Pyramid Educational Products that bears the name Picture Exchange Communication System (PECS).
These types of systems are available in many versions with some sets having a larger variety of images available. There are now many companies offering such communication aids. Systems are also produced in sets specific to certain ages and needs. For example, there are cards specific to toileting, foods and even specific occasions. Images are available in decks, typically laminated for easy handling and care. Some sets have Velcro backing and fasten onto communication boards or are filed in binders made specifically to hold them. Cards are similar to the ‘flash cards’ well known in educational settings and are typically designed with one clear and easily discernible image per card. Decks range from art and graphic renderings to photographs. In fact, many users of these systems develop their own sets of pictures by using images available via Internet or typical computer operating systems. There are downloadable communication images on free web sites, sites that charge fees and CDs. Some families use the ‘clip art’ option available on most personal home computers and many use digital photographs taken themselves and printed into do-it-yourself card systems. These communication systems typically require a volume of images and can be labor intensive to create. However, many families purchase key images and supplement with additional commercial sets or ones created themselves as the child grows and develops a broader vocabulary. There are many options available and can be easily researched online using the keywords “picture exchange communication”.
These communication systems help children learn and use effective ‘language’. They also promote vital interaction between the child and others. Typically, use of a picture exchange system will encourage the child’s independence (Howlin P, 2007). It also builds communication skills step by step in similar ways that spoken communication skills are built. Many children will go from use of picture exchange to spoken language because of the skills learned with these systems. The effectiveness of picture exchange systems is well researched and documented (Desch, Gaebler-Spira, & Disabilities, June 2008).
The picture exchange system progresses through phases of learning. The following are the six phases of learning within the picture exchange system. After being introduced to the system, children will learn new skills based upon the previous ones.
1. The Physical Exchange—the child learns to present an image of a desired object in order to receive the object. At this phase of training, images of highly desirable objects are made available to the child so that the child is motivated to ask for them. Such images may, for example, depict favorite toys. The child presents the image of the toy and receives the actual toy.
2. Expanding Spontaneity—the child must approach another person in order to present a card. This begins to build motivation and initiative. The child learns to seek out others and to communicate needs, desires and ideas.
3. Picture Discrimination—the child learns to sort through multiple images to find the correct one for the communication. This is akin to having a vocabulary to choose from.
4. Sentence Structure—the child learns to use ‘strips’ to create sentences. Some cards are ‘starter cards’ with phrases such as “I want”. The child begins to make more complete statements by using the “I want” card with a card that depicts the object wanted.
5. Responding to “What Do You Want?”—the child learns to answer the question, “What do you want?” by choosing cards and creating sentences.
6. Responsive and Spontaneous Commenting—the child learns to comment on the environment by using descriptors. Communication occurs through stating observations as “the sky is blue” or “the water is cold”.
Children Who May Benefit From the Use of PECS
Children who are age and developmentally mature enough to use language, but who do not, can benefit from the use of this system. Picture exchange communication systems allow children to communicate their needs, desires and ideas to their parents, caregivers, teachers, family members, peers and others in the community. Children with communication disorders, speech and hearing disorders, poor motor control that prohibits sign language, disorders of the Autism Spectrum and medical conditions that compromise speech can effectively use PECS. Additionally, children who use this system, as opposed to sign language, can readily communicate with others who are not specially trained. Further, PECS encourages the development of spoken language skills and may provide a ‘stop-gap’ communication for many who will learn and use spoken language after developing skills with picture exchange programs.
Family Participation in the Use of PECS
Family members should expect to be active participants in the use of picture exchange communication systems. PECS is designed to be the primary means of communication available to the child—for some temporarily and for others, as a lasting means of communicating effectively. Family members learn the system and help train the child in its use. Families will also have to invest in a card system or to create one themselves.
Desch, L., Gaebler-Spira, D., & Disabilities, t. C. (June 2008). Prescribing Assistive-Technology Systems: Focus on Children With Impaired Communication. PEDIATRICS, 121: 6 , 1271-1280.
Howlin P, G. R. (2007). The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: a pragmatic, group randomised controlled trial. Journal of Child Psychology and Psychiatry.48:5 , 473-481.