PECS in ABA: How It Supports Communication

The Picture Exchange Communication System (PECS) has transformed the landscape of Applied Behavior Analysis (ABA) therapy, offering a structured pathway to communication for individuals with autism spectrum disorder (ASD) and other developmental disabilities. With over 2.3 million Americans currently diagnosed with autism spectrum disorder, according to the CDC’s latest estimates, the need for effective communication interventions has never been more critical.

PECS represents a breakthrough in augmentative and alternative communication (AAC), providing a systematic approach that enables non-speaking individuals to initiate communication independently. Since its development in 1985 by Dr. Andy Bondy and Lori Frost, PECS has been implemented worldwide, helping thousands of individuals develop functional communication skills that enhance their quality of life and social interactions.

Understanding PECS: The Foundation of Visual Communication

The Picture Exchange Communication System is an evidence-based practice that teaches individuals to communicate using pictures and symbols. Unlike other communication methods that require prompting from communication partners, PECS emphasizes spontaneous, self-initiated communication from the very beginning.

Research indicates that approximately 25-30% of individuals with autism spectrum disorder remain minimally verbal throughout their lives. For these individuals, PECS offers an alternative pathway to express needs, wants, thoughts, and feelings. The system is designed to be portable, practical, and immediately functional, making it an ideal intervention for use across various settings including homes, schools, and community environments.

The Science Behind PECS Success

The effectiveness of PECS lies in its foundation in applied behavior analysis principles. The system utilizes positive reinforcement, systematic prompting procedures, and error correction strategies to teach communication skills. Studies have shown that PECS implementation can lead to significant improvements in communication abilities, with some research indicating that 76% of PECS users develop some level of independent speech after consistent implementation.

The visual nature of PECS also aligns with the learning strengths often observed in individuals with autism. Many people on the spectrum are visual learners who process pictorial information more effectively than auditory information. By capitalizing on these visual processing strengths, PECS creates a communication modality that feels natural and accessible.

The Six Phases of PECS: A Systematic Approach to Communication Development

PECS follows a carefully structured six-phase protocol that progressively builds communication skills from basic requesting to complex sentence construction and social commenting.

Phase I: How to Communicate

In the initial phase, individuals learn the fundamental mechanics of communication exchange. Two trainers work together – a communication partner and a physical prompter – to teach the learner to pick up a picture of a desired item and place it in the communication partner’s hand. This phase focuses purely on the physical exchange without requiring any vocal or gestural prompts.

The success of Phase I is measured by the individual’s ability to independently pick up and give a picture to request a preferred item. Most learners master this phase within 1-3 training sessions, though some may require additional practice depending on their individual learning pace and motor skills.

Phase II: Distance and Persistence

Phase II expands the communication skills learned in Phase I by introducing distance and persistence elements. Learners must travel to their communication book, remove the appropriate picture, travel to a communication partner, and gain their attention before making the exchange.

This phase is crucial for developing practical communication skills that can be used in real-world situations. It teaches individuals that communication requires effort and persistence, and that they must actively seek out communication partners rather than waiting for interactions to come to them.

Phase III: Picture Discrimination

In Phase III, learners develop the ability to discriminate between different pictures to select the one that corresponds to their desired item. This phase begins with two pictures – one highly preferred and one non-preferred or neutral – and gradually increases the number of options as discrimination skills improve.

The discrimination training in Phase III is essential for developing meaningful communication. Without the ability to select the correct picture, communication attempts become random and ineffective. Research shows that most individuals can learn to discriminate between 2-4 pictures within 2-4 weeks of consistent training.

Phase IV: Sentence Structure

Phase IV introduces sentence construction by teaching learners to create simple sentences using the “I want” symbol followed by the picture of the desired item. This phase marks a significant milestone in communication development, as it introduces the concept of grammar and sentence structure.

The transition to sentence structure often correlates with increased vocal approximations and word attempts. Studies indicate that approximately 50% of PECS users begin showing vocal improvements during or shortly after Phase IV implementation.

Phase V: Answering “What do you want?”

In Phase V, learners develop the ability to respond to the direct question “What do you want?” while maintaining their ability to spontaneously request items. This phase requires discrimination between spontaneous communication opportunities and prompted communication situations.

Phase V is particularly important for classroom and therapy settings where direct questioning is common. It ensures that individuals can participate in structured communication activities while maintaining their spontaneous communication skills.

Phase VI: Commenting

The final phase introduces commenting and responsive communication beyond basic requesting. Learners develop the ability to answer questions like “What do you see?” “What do you hear?” and “What is it?” This phase significantly expands the communicative functions beyond basic needs and wants.

Phase VI represents the most complex level of PECS implementation and often serves as a bridge to more advanced communication systems or speech development. Research indicates that individuals who successfully complete Phase VI show the highest rates of eventual speech development.

PECS Implementation in ABA Programs: Best Practices and Strategies

Successful PECS implementation within ABA programs requires careful planning, consistent application, and ongoing data collection. Board Certified Behavior Analysts (BCBAs) play a crucial role in designing individualized PECS programs that align with each learner’s specific needs and learning style.

Assessment and Baseline Data Collection

Before implementing PECS, comprehensive assessment is essential. This includes evaluating current communication skills, preferred items and activities, motor abilities, and visual processing skills. Baseline data collection should document current communication attempts, frequency of problem behaviors related to communication frustration, and social interaction patterns.

Standardized assessments such as the Vineland Adaptive Behavior Scales or the Assessment of Basic Language and Learning Skills (ABLLS-R) can provide valuable information for PECS program development. Additionally, preference assessments help identify highly motivating items that can be used as reinforcers during PECS training.

Creating Individualized PECS Programs

Each PECS program must be tailored to the individual’s unique needs, preferences, and learning characteristics. Factors to consider include:

Communication environment: Where will PECS be used most frequently?
Communication partners: Who are the primary people the individual needs to communicate with?
Motor skills: Does the individual have the fine motor skills needed for picture manipulation?
Visual processing: Can the individual visually discriminate between pictures?
Current communication attempts: What methods is the individual currently using to communicate?

Data Collection and Progress Monitoring

Systematic data collection is crucial for monitoring PECS progress and making informed decisions about program modifications. Key data points include:

Acquisition rate: How quickly is the individual learning each phase?
Generalization: Is the individual using PECS across different settings and people?
Spontaneous use: How often does the individual initiate communication without prompts?
Vocal approximations: Are there any accompanying vocalizations or word attempts?

Regular data review sessions should occur weekly or bi-weekly to assess progress and adjust training procedures as needed.

The Impact of PECS on Communication Development: Research and Outcomes

Extensive research has documented the effectiveness of PECS across diverse populations and settings. A comprehensive meta-analysis of PECS research published in the Journal of Autism and Developmental Disorders found significant improvements in communication skills across multiple studies, with effect sizes ranging from moderate to large.

Speech Development Outcomes

One of the most encouraging findings in PECS research relates to speech development. Contrary to early concerns that using pictures might inhibit speech development, research consistently shows that PECS can actually facilitate vocal communication. Studies indicate that:

76% of PECS users develop some independent speech
59% develop speech that is readily understood by unfamiliar listeners
40% become primarily vocal communicators who no longer rely heavily on pictures

The mechanism behind speech development appears to be related to the communicative success individuals experience with PECS. As they learn that communication is effective and rewarding, they become more motivated to attempt vocal communication.

Social Communication Improvements

PECS implementation often leads to improvements in social communication skills beyond basic requesting. Research has documented increases in:

Joint attention behaviors: Looking at communication partners during exchanges
Social initiation: Approaching others for communication purposes
Turn-taking skills: Participating in back-and-forth communication exchanges
Social commenting: Sharing information about the environment spontaneously

Reduction in Problem Behaviors

Communication frustration is a significant contributor to problem behaviors in individuals with autism. PECS provides an alternative outlet for communication, often leading to substantial reductions in challenging behaviors. Studies have shown decreases of 60-80% in problem behaviors following successful PECS implementation.

The reduction in problem behaviors creates a positive cycle: as challenging behaviors decrease, individuals have more opportunities for learning and social interaction, which further supports communication development.

Implementing PECS Across Different Settings

The portability and flexibility of PECS make it suitable for implementation across various environments. Each setting presents unique opportunities and challenges for PECS use.

Home Implementation

Family involvement is crucial for PECS success. Parents and caregivers need training and support to implement PECS consistently across daily routines. Home implementation should focus on:

Natural opportunities: Incorporating PECS into daily activities like meals, play, and bedtime routines
Family training: Providing comprehensive training for all family members
Environmental modifications: Ensuring pictures are accessible and communication books are available in key locations

School Implementation

Educational settings provide numerous opportunities for PECS use across academic and social activities. Successful school implementation requires:

Teacher training: Ensuring all educational staff understand PECS procedures
Classroom integration: Incorporating PECS into academic activities and social interactions
Peer awareness: Teaching typically developing peers how to respond to PECS communications

Community Implementation

PECS should extend beyond home and school settings to include community environments. This requires:

Portable systems: Ensuring communication books and pictures are always available
Community partner training: Teaching store clerks, restaurant staff, and other community members about PECS
Safety considerations: Including pictures for emergency situations and safety needs

Training and Professional Development for PECS Implementation

Effective PECS implementation requires proper training for all team members involved in the individual’s care and education. The Pyramid Educational Consultants organization provides official PECS training workshops that cover all aspects of implementation.

Training Components

Comprehensive PECS training should include:

Theoretical foundation: Understanding the principles underlying PECS effectiveness
Practical implementation: Hands-on practice with PECS procedures
Data collection: Learning to collect and analyze implementation data
Troubleshooting: Addressing common implementation challenges
Generalization strategies: Promoting PECS use across settings and people

Ongoing Support and Supervision

Initial training is just the beginning of successful PECS implementation. Ongoing support should include:

Regular supervision: Weekly or bi-weekly meetings to review progress and address challenges
Video review: Analyzing recorded sessions to improve implementation fidelity
Refresher training: Periodic review of procedures and updates on new research
Team collaboration: Regular team meetings to ensure consistency across implementers

Future Directions and Technology Integration

The field of augmentative and alternative communication continues to evolve, with new technologies offering exciting possibilities for PECS enhancement and expansion.

Digital PECS Applications

Tablet-based PECS applications are becoming increasingly popular, offering several advantages:

Portability: Tablets are often more convenient to carry than physical communication books
Sound integration: Digital pictures can include voice output
Data collection: Automatic tracking of communication attempts and progress
Customization: Easy addition and modification of pictures and vocabulary

Integration with Other AAC Systems

PECS often serves as a stepping stone to more complex communication systems. Research is exploring how PECS can be integrated with:

Speech-generating devices: Combining picture exchange with voice output technology
Sign language: Using PECS to teach sign language concepts
Written communication: Transitioning from pictures to written words and sentences

Conclusion: The Lasting Impact of PECS in ABA

The Picture Exchange Communication System has revolutionized communication intervention for individuals with autism and other developmental disabilities. Its systematic, evidence-based approach provides a clear pathway from non-communication to functional communication skills that can transform lives.

As ABA continues to evolve and incorporate new research findings, PECS remains a cornerstone intervention that demonstrates the power of systematic instruction and positive reinforcement. The success stories of thousands of individuals who have learned to communicate through PECS serve as a testament to the importance of never giving up on any individual’s potential for communication.

For families, educators, and clinicians working with individuals who struggle with communication, PECS offers hope and a proven methodology for building the fundamental human capacity to connect with others through meaningful communication. As we continue to refine our understanding of autism and communication development, PECS will undoubtedly continue to play a vital role in helping individuals find their voice and connect with the world around them.

The investment in proper PECS training and implementation pays dividends not only in communication development but in improved quality of life, reduced behavioral challenges, and enhanced social connections. In a world where communication is the foundation of human connection, PECS provides a bridge that can transform lives and open doors to independence and meaningful relationships.

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