PECS is a communication system that uses pictures instead of words. PECS training is used with children with autism who have speech and communication difficulties, and it is also often used for other conditions accompanied by being "nonverbal."
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PECS is a communication system that uses pictures instead of words. PECS training is used with children with autism who have speech and communication difficulties, and it is also often used for other conditions accompanied by being "nonverbal."
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that affects communication, behavior, and socialization. It affects all racial and social groups equally, although autism is diagnosed in boys about four times more often than in girls.
Developmental delay is defined as a significant delay in the development of gross and fine motor skills, speech, cognitive functions, social and personal activity, and daily living skills. Many children with ASD or developmental delay cannot speak and have functional impairments of communication skills, including the use of gestures such as pointing, waving goodbye or hello, and sharing interest with others.
For many people with autism or developmental delay, understanding speech is difficult, and the resulting behavior may be perceived as breaking social norms or defiance, when the person is actually showing frustration or a lack of understanding. Presenting information visually helps with processing it, and some adults with autism, such as Dr. Temple Grandin, a professor of animal science at Colorado State University and one of the best-known adults with high-functioning autism, describe their thinking as pictorial and based on visual images.
Visual support can take the form of real objects, photographs, schematic images, or words, depending on individual needs. Visual support is used to provide a structured environment, remind learners of the behavior expected in a particular situation, give step-by-step instructions for completing a task, and help form requests using a picture exchange system.
The PECS (Picture Exchange Communication System) card-based training method was developed by the specialists Frost and Bondy for teaching children with autism, and it is used in many countries. In children who cannot speak, speech may gradually appear. Children whose difficulties are so severe that they cannot learn to speak may be able to express their feelings with the help of cards. A child can pick up a card and build a sentence, for example: "I want to go for a walk" or "I don't want to go for a walk."
PECS training consists of six phases, delivered as discrete trials with strong reinforcers (an individual teaching approach used to teach skills in an organized, controlled, and systematic way). As a rule, PECS runs in parallel with ordinary speech development, and this communication system is two-way.
PECS begins with teaching how to communicate (Phase I) and then moves through five more phases: increasing the distance between communication partners (Phase II), discriminating between pictures (Phase III), building sentences (Phase IV), answering the question "What do you want?" (Phase V), and commenting (Phase VI). The system makes communication visible.
Communication is not just naming something or asking for it. Communication difficulties in people with autism make it hard for them to understand the communication process itself. A person needs to know what exactly to say, how to get another person's attention, how to deliver the message, and how to persist until they succeed or clearly fail.
A strength of the PECS system is that, to send a message, the child has to find the right picture, get the attention of the communication partner, and exchange the picture for the item. If the partner does not take the picture, communication has not happened. This makes the act of communication visible. People with ASD often try to deliver a message by speaking without getting the listener's attention, and their message is ignored. Or they try once and give up if no one responds. Handing over a picture from hand to hand means it is not possible to say something from the other side of the room and expect an answer. Communication becomes more visible and easier to understand.
The system helps a child with autism take the initiative in communication.
People with autism typically have difficulty initiating actions. This means that many of them will sit and wait until someone asks, "What do you want?" or hands them an augmentative communication system so they can say something. They should be able to voice their needs, wishes, and thoughts just as the rest of us do. To do this, they need to start communication themselves. In many cases, they need to be taught how.
PECS does not use phrases or prompts such as "What do you want?" Instead, situations are created in which the child wants to ask for something, and then a second person, without saying a word, physically prompts the child while standing behind them. Gradually these prompts are faded, and the child learns to start the picture exchange with the communication partner independently in order to receive a reward. As a result, the child begins to say on their own what they want, and is then taught to cross the distance to the pictures and to the communication partner to deliver the message.
In sessions, children build sentences from picture cards that show what they see, what they want to do, or what they want to say. At first, however, they spend a long time studying the cards and how to use them. For example, the teacher shows a picture of a spoon and says "eat, eat," many times. When it becomes clear that the child understands the meaning of the card, other cards are introduced that show everything around them. Then the child is taught to build sentences. For example, the child first learns to tell the cards "want" and "don't want" apart, then "eat" or "drink." After that, the child can learn to build the sentences "I want to eat" or "I want to drink."
Looking at a particular card, the child should understand which feeling it shows. For example, the "laugh" card shows a person laughing. Or a carton of milk may be drawn, and the child builds the phrase: "I want milk."
Learning takes quite a long time, but the progress can be encouraging. A child who cannot speak should not have to stay silent all the time. They understand a lot, and they should be given the chance to express themselves. During sessions the child thinks, works, learns, and explores, and as a result may be able to communicate at a level closer to adults and other children.