PECS Related Publications
PECS related publications
Adkins, T. & Axelrod, S. (2002). Topography- versus selection-based responding: Comparison of mand
acquisition in each modality. The Behavior Analyst Today, 2, 259-266.
Abstract: This study examined the acquisition of a mand repertoire by one child with pervasive developmental disorder and ADHD. The subject was taught to request preferred items using American Sign Language (a topography based response form)
and the Picture Exchange Communication System (a selection-based form). There were four types of sessions:
(1) training session for PECS, (2) training session for sign language, (3) test for generalization of the PECS words,
and (4) test for generalization for the sign words. The number of trials to meet criterion and the occurrence of spontaneous
emissions of the taught words was recorded. Also, the same word was taught for five days in both the PECS and the sign
session and the results were recorded. It was found that the selection- based verbal response technique (PECS) was more
effective in all areas. This finding contradicts the results of previous studies, suggesting that further research is needed.
(http://www.behavior-analyst-online.org/NEWBAT/Frameless%20BAT/BATissues.html)
Almeida, M., Piza, M., & LaMonica, D. (2005). Adaptation of the picture exchange communication system in a
school context (original title: Adaptações do sistema de comunicação por troca de figuras no contexto escolar).
Pró-Fono Revista de Atualização Científica, Barueri (SP), 17. 233-240.
Abstract: Background: alternative communication. Aim: to evaluate the efficacy of the adapted PECS and Picture
Communication Symbols (PCS) in the communication of a child with cerebral palsy. Method: the participant of this
study was a 9 year and 10 months old girl, with athetoid quadriplegia. All stages of the adapted Pecs were applied
(Walter, 2000), using the PCS pictures (Johnson, 1998), associated with the functional curriculum proposed by
LeBlanc (1991). An experimental AB Design was used in order to test the procedures. Results: the subject was able
to pass through all of the adapted Pecs phases and to use her communication board in school activities.
Conclusion: the adapted Pecs proved to be effective in improving the subject’s communication abilities.
Anderson, A, Moore, D & Bourne, T. (2007). Functional Communication and
Other Concomitant Behavior Change Following PECS Training: A Case Study.
Behaviour Change, 24, 1–8.
Abstract: The Picture Exchange Communication System (PECS) is widely used to teach children with language delays,
including those with autism, functional language. A feature of PECS is that it incorporates principles deemed by
some to be pivotal, leading to broader behaviour change. In this study, a 6-year-old child with autism was taught
functional language using PECS. Along with measures of language gains, concomitant changes in nontargeted
behaviours (play and TV viewing) following PECS training were observed. Results show increases in manding,
initiations and cumulative word counts, as well as positive changes in the nontargeted behaviours.
Bock, S .J., Stoner, J. B., Beck, A. R., Hanley, L., & Prochnow, J. (2005). Increasing functional communication
in non-speaking preschool children: Comparison of PECS and VOCA. Education and Training in
Developmental Disabilities, 40(3), 264-278.
Abstract: For individuals who have complex communication needs and for the interventionists who work with them,
the collection of empirically derived data that support the use of an intervention approach is critical. The purposes of this
study were to continue building an empirically derived base of support for, and to compare the relative effectiveness of two
communication intervention strategies (i.e., PECS and the use of VOCA) with preschool children who have complex
communication needs. Specific research questions were (a) Which communication strategy, PECS or VOCA, results
in a more rapid rate of acquisition of requesting skills for preschool children?, and (b) To what extent do communication
behaviors utilizing PECS and VOCA generalize from a pull-out setting to the classroom setting? Results are discussed
and clinical implications given.
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Bondy, A. (2001). PECS: Potential benefits and risks . The Behavior Analyst Today, 2, 127–132.
Abstract: The Picture Exchange Communication System (PECS) is an augmentative alternative communication strategy
for those who display little or no speech. The rationale for PECS and its training sequence is described. Each phase
of training is associated with specific behavior analytic teaching strategies. Skinner’s analysis of Verbal Behavior
forms the basis for teaching particular skills at specific points in the training sequence and also provide guidelines
for how best to design the teaching strategies. Common problems and potential solutions are offered for various levels
of training. The relationship between PECS and the co-development of speech, as well as its impact upon other
behaviors (e.g., behavior management concerns, social orientation, etc.) is briefly reviewed.
(http://www.behavior-analyst-online.org/NEWBAT/Frameless%20BAT/BATissues.html)
Bondy, A. S., & Frost, L. A. (1993). Mands across the water: A report on the application of the picture exchange
communication system in Peru. The Behavior Analyst, 16, 123–128. http://www.abainternational.org/tbajournal/
Bondy, A., & Frost, L. (1994). The picture exchange communication system. Focus on Autistic Behavior, 9, 1–19.
Abstract: A variety of strategies have been used to help children with autism acquire functional communication skills.
The Picture Exchange Communication System (PECS) is a unique communication training program that was de eloped
as a means of circumventing some shortcomings associated with these strategies. A description of the steps within
PECS is provided. Long-term group data have indicated that a large proportion of children started on PECS as preschoolers
acquire speech. Individual and group data supporting the use of PECS are provided. (http://www.proedinc.com/focus.html)
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Bondy, A. & Frost, L. (1998). The picture exchange communication system. Seminars in Speech and Language, 19, 373–389.
Abstract: The Picture Exchange Communication System (PECS) was developed as a means to teach children with autism
and related developmental disabilities a rapidly acquired, self-initiating, functional communication system. Its theoretical roots combine principles from applied behavior analysis and guidelines established withi the field of alternative and augmentative communication. This approach has several potential advantages relative to imitation-based strategies (both vocal and gestural) and symbol selection strategies. The system begins with the exchange of simple icons but rapidly builds “sentence” structure. The system also emphasizes developing the request function prior to developing responding to simple questions and commenting. The development of requesting with a sentence structure also permits the rapid development of attributes more traditionally taught within a receptive mode. The relationship between the introduction of PECS and various other behavioral issues (i.e., social approach and behavior management) as well as its relationship to the codevelopment of speech are reviewed.
( http://www.ovid.com/site/catalog/Journal/1176.jsp?top=2&mid=3&bottom=7&subsection=12
Bondy, A. & Frost, L. (2001). The Picture Exchange Communication System. Behavior Modification, 25, 725-744.
Abstract: The Picture Exchange Communication System (PECS) is an alternative/augmentative communication system that
was developed to teach functional communication to children with limited speech. The approach is unique in that it
teaches children to initiate communicative interactions within a social framework. This article describes the advantages
to implementing PECS over traditional approaches. The PECS training protocol is described wherein children are taught
to exchange a single picture for a desired item and eventually to construct picture-based sentences and use a variety
of attributes in their requests. The relationship of PECS’s implementation to the development of speech in previously
non-vocal students is reviewed. (http://www.sagepub.com/productSample_2675.pdf)
Bondy, A. & Frost, L. (2003). Communication strategies for visual learners. In O.I. Lovaas (Ed.).
Teaching Individuals with Developmental Disabilities: Basic Intervention Techniques (pp. 291-303).
Austin, TX: Pro-Ed. [Book chapter].
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Bondy, A., Tincani, M. & Frost, L. (2004). Multiply controlled verbal operants: An analysis and extension
to the Picture Exchange Communication System. The Behavior Analyst, 27,247-261.
Abstract: This paper presents Skinner’s (1957) analysis of verbal behavior as a framework for understanding language acquisition
in children with autism. We describe Skinner’s analysis of pure and impure verbal operants, and illustrate how this analysis
may be applied to designing communication training programs. The Picture Exchange Communication System (PECS) is a
training program influenced by Skinner’s framework. We describe the training sequence associated with PECS, and illustrate how this sequence may establish multiply controlled verbal behavior in children with autism. We conclude with an examination of how Skinner’s framework may apply to other communication modalities and training strategies.
http://www.abainternational.org/tbajournal/
Carr, D. & Felce, J. (2006). Increase in production of spoken words in some children with autism after PECS teaching
to Phase III. Journal of Autism and Developmental Disabilities.
Abstract: The context for this work was an evaluation study (Carr & Felce, under review) of the early phases of the
Picture Exchange Communication System [PECS] (Frost & Bondy, 1994; 2002). This paper reports that 5 of 24
children who received 15 hours of PECS teaching towards Phase III over a period of 4-5 weeks, showed
concomitant increases in speech production, either in initiating communication with staff or in responding,
or both. No children in the PECS group demonstrated a decrease in spoken words after receiving PECS
teaching. In the control group, only 1 of 17 children demonstrated a minimal increase and 4 of 17 children
demonstrated a decrease in use of spoken words after a similar period without PECS teaching.
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Carr, D. & Felce, J. (2006). The effects PECS teaching to Phase III on the communicative interactions between children with autism and their teachers. Journal of Autism and Developmental Disabilities.
Abstract: The study investigated the impact of mastery of the Picture Exchange Communication System (PECS) to Phase III, on
the communications of children with autism. Children aged between 3 and 7 years, formed a PECS intervention group
and a non-intervention control group. The intervention group received 15 h of PECS teaching over 5 weeks.
Three 2-h classroom observations recorded communications between the children and their teachers. These occurred:
6 weeks before teaching; during the week immediately prior to teaching; during the week immediately following teaching.
For the control group, two 2-h observations were separated by a 5-week interval without PECS teaching.
Communicative initiations and dyadic interactions increased significantly between the children and teachers in the PECS
group but not for the control group. http://dx.doi.org/10.1007/s10803-006-0203-1
Chambers, M. & Rehfeldt, R. (2003). Assessing the acquisition and generalization of two mand forms with adults with severe
developmental disabilities. Research in Developmental Disabilities, 24, 265-280.
Abstract: The purpose of this study was to determine whether manual sign or the Picture Exchange Communication System
(P.E.C.S.) (Frost and Bondy, 1994) would be more effective in teaching mand skills to adults with mental retardation in
the severe and profound range. Four participants were taught to mand for four reinforcing items using both communication
modalities, in an alternating treatments design. Three of four participants demonstrated criterion performance across all
four mands using P.E.C.S. first. Two of those three participants later demonstrated criterion performance for the mands
using manual sign. The fourth participant was removed from the study during training due to illness, but her progress
indicated greater acquisition with P.E.C.S. Generalization probes conducted at participants' respective residences
showed that three participants demonstrated generalization across settings using P.E.C.S., and two participants demonstrated generalization across settings using manual sign. Participants were also more likely to mand for reinforcing items not present using P.E.C.S. than using manual sign. (www.sciencedirect.com/science/journal/08914222)
Charlop-Christy, M.H., Carpenter, M, Le, L., LeBlanc, L, & Kelley, K. (2002). Using the Picture Exchange Communication System (PECS) with children with autism: Assessment of PECS acquisition, speech, social-communicative behavior, and problem behaviors. Journal of Applied Behavior Analysis, 35, 213-231.
Abstract: The picture exchange communication system (PECS) is an augmentative communication system frequently used with children with autism (Bondy & Frost, 1994; Siegel, 2000; Yamall, 2000). Despite its common clinical use, no well-controlled empirical investigations have been conducted to test the effectiveness of PECS. Using a multiple baseline design, the present study examined the acquisition of PECS with 3 children with autism. In addition, the study examined the effects of PECS training on the emergence of speech in play and academic settings. Ancillary measures of social-communicative behaviors and problem behaviors were recorded. Results indicated that all 3 children met the learning criterion for PECS and showed concomitant increases in verbal speech. Ancillary gains were associated with increases in social-communicative behaviors and decreases in problem behaviors. The results are discussed in terms of the provision of empirical support for PECS as well as the concomitant positive side effects of its use. (http://seab.envmed.rochester.edu/jaba/articles/2002/jaba-35-03-0213.pdf)
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Frea, W., Arnold, C. & Vittimberga, G. (2001). A demonstration of the effects of augmentative communication on the
extreme aggressive behavior of a child with autism within an integrated preschool setting.
Journal of Positive Behavior Intervention, 3, 194-198.
Abstract: Abstract: Research in the area of behavior support has repeatedly demonstrated the positive effects of learning
more effective and efficient communication on the challenging behaviors of individuals with developmental disabilities.
More recently, augmentative and alternative communication strategies have been receiving increased attention as
primary teaching goals for young children with autism. Use of picture exchange and choice-making opportunities has
been reported to facilitate speech acquisition and/or result in increased communicative attempts across daily routines.
The case study discussed in this article examines the effects of picture exchange on the severe aggressive behavior
of a preschooler with autism who was at risk of losing his integrated school placement. Picture exchange was introduced
within two play routines in the classroom. The effects of picture exchange on the student's aggression were evaluated
within a multiple baseline design. Results indicated that the student's aggressive behavior was eliminated in a brief
amount of time when picture exchanges were in place. These findings are discussed in terms of integrating augmentative
communication into behavioral support planning and future research in this area. (http://www.proedinc.com/jpbi.html)
Frost, L. (2002). The Picture Exchange Communication System. Perspectives on Language Learning and Education, 9, 13-16.
Frost, L. (2003). Effective ways to use PECS with verbal children. Autism/Asperger Digest.
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Frost, L. & Bondy, A. (2006). A common language: Using B.F. Skinner’s Verbal Behavior for assessment and treatment
of communication disabilities in SLP-ABA. The Journal of Speech and Language Pathology -
Applied Behavior Analysis, 1, 103-110.
Abstract: Professionals in the field of speech-language pathology (SLP) and applied behavior analysis (ABA) share a
common goal in the treatment of communication disorders. The two fields, however, do not share a common language.
Skinner’s definition of verbal behavior and his classification of verbal operants provide interventionists with a valuable tool
for classifying verbal behavior based on controlling variables. An understanding of the primary verbal operants and operants
under multiple control are essential for planning efficient verbal behavior intervention. This paper presents a primer on
B.F. Skinner’s 1957 publication, Verbal Behavior, a description of the primary verbal operants, verbal operants under multiple
control, and a discussion of using this taxonomy for writing precise communication goals for effective intervention.
http://www.behavior-analyst-today.com/SLP-ABA-VOL-1/SLP-ABA-1-2.pdf
Ganz, J. & Simpson, R. (2004). Effects on communicative requesting and speech development of the Picture
Exchange Communication System in children with characteristics of autism.
Journal of Autism and Developmental Disabilities, 34, 395-409.
Abstract: Few studies on augmentative and alternative communication (AAC) systems have addressed the potential for
such systems to impact word utterances in children with autism spectrum disorders (ASD).
The Picture Exchange Communication System (PECS) is an AAC system designed specifically to minimize
difficulties with communication skills experienced by individuals with ASD. The current study examined the
role of PECS in improving the number of words spoken, increasing the complexity and length of phrases,
and decreasing the non-word vocalizations of three young children with ASD and developmental delays (DD)
with related characteristics. Participants were taught Phases 1–4 of PECS (i.e., picture exchange, increased distance
, picture discrimination, and sentence construction). The results indicated that PECS was mastered rapidly by the
participants and word utterances increased in number of words and complexity of grammar. (http://www.springerlink.com/)
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Ganz, J.B., Cook, K.E., Corbin-Newsome, J., Bourgeois, B., & Flores, M. (2005). Variations on the Use of a Pictorial
Alternative Communication System with a Child with Autism and Developmental Delays.
TEACHING Exceptional Children Plus, 1(6) Article 3.
Abstract: As aberrant behavior is often recognized as the number one form of communication, it becomes imperative
that as parents, teachers, and educators we must address and systematically teach or provide all children with an
effective means of communication. While many augmentative and alternative communication systems such as manual
sign language and the Picture Exchange Communication System (Frost & Bondy, 1994) have shown tremendous success
, some students with developmental disabilities students unique needs require more individually tailored communication
training that necessitates empirical inquiry and use of collective expertise. Doing so may facilitate the acquisition
of skills and behaviors that improve communication skills through independent appropriate means for meeting students’
personal needs and desires. This article systematically provides a variation of the Picture Exchange Communication
System (PECS) including materials, resources, and methodology necessary
(http://escholarship.bc.edu/education/tecplus/vol1/iss6/3)
Heneker, S. & Page, L.M. (2003). Functional Communication: the impact of PECS. Speech & Language Therapy in Practice, 12-14.
Abstract: The Picture Exchange Communication System (PECS TM) aims to teach individual users to initiate communication.
The effectiveness of introducing this approach to whole classes within a school for autistic spectrum disordered children was investigated in two groups. Class staff and parents attended a formal PECS training course and the impact on the amount, functions and method of communication and the level of adult support required were recorded. Observations were carried out in four different contexts: free play, snack, swimming and structured teaching. For group 1 children, aged 6 to 8, the amount of communication increased in all activities apart from swimming. Requesting was the most frequent function at both base-line and follow-up. The most frequently used method of communication at base-line was by symbols. At follow-up symbols was the main method for snack and structured teaching and physical communication was predominant for free-play and swimming. The presence of an object/event was the main level of stimulus to which children responded for all activities. For Group 2 children, aged 9-10 years, total communicative acts increased for all activities apart from structured teaching, where the decrease may have been due to their being taught more independent skills of commenting for the first time. Requesting remained the most frequent function of communication, and more formal means of communication were observed. The presence of an object/event remained the main stimulus for snack and swimming, but more independent responses were seen in free-play, with the presence of a listener becoming the level of cue required to initiate communication. At follow-up, children involved in the study appeared to show less frustration, were able to accept that their requests might not always be met, and could wait patiently for adult attention. (http://www.speechmag.com/)
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Howlin, P., Gordon, R.K., Pasco, G., Wade, A. & Charman, T. (2007). The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: a pragmatic, group randomized controlled trial. Journal of Child Psychology and Psychiatry (prepublication).
Abstract: Objective: To assess the effectiveness of expert training and consultancy for teachers of children with autism spectrum disorder in the use of the Picture Exchange Communication System (PECS). Method: Design: Group randomized, controlled trial (3 groups: immediate treatment, delayed treatment, no treatment). Participants: 84 elementary school children, mean age 6.8 years. Treatment: A 2-day PECS workshop for teachers plus 6 half-day, school-based training sessions with expert consultants over 5 months. Outcome measures: Rates of: communicative initiations, use of PECS, and speech in the classroom; Autism Diagnostic Observation Schedule-Generic (ADOS-G) domain scores for Communication and Reciprocal Social Interaction; scores on formal language tests. Results: Controlling for baseline age, developmental quotient (DQ) and language; rates of initiations and PECS usage increased significantly immediately post-treatment (Odds Ratio (OR) of being in a higher ordinal rate category 2.72, 95% confidence interval 1.22–6.09, p < .05 and OR 3.90 (95%CI 1.75–8.68), p < .001, respectively). There were no increases in frequency of speech, or improvements in ADOS-G ratings or language test scores. Conclusions: The results indicate modest effectiveness of PECS teacher training/consultancy. Rates of pupils’ initiations and use of symbols in the classroom increased, although there
was no evidence of improvement in other areas of communication.
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Koita, H. & Sonoyama, S. (2004). Communication training using the Picture Exchange Communication System (PECS): Case study of a child with autistic disorder. Japanese Journal of Behavior Analysis, 19, 161-174.
Abstract: The purpose of this study was to examine the effect of training with the Picture Exchange Communication System (PECS) on the acquisition of functional communication skills. Participants were a child with autism who did not speak, and his mother. Intervention was conducted with the changing conditioning design, including 6 phases and follow up. The PECS training was implemented by the participant’s mother in his home. In the home, intervention was implemented using backward chaining and other methods, the child’s mother taught him give her icons in order to make requests and answer questions. Measures were the percentage of correct responses in the PECS training, the frequency of spontaneous requesting with using the PECS, and the form and the initial time of speech after the intervention has begun. As a result, the boy learned the PECS in a comparatively short period, and spontaneous requesting using the PECS increased. After the intervention, some speech appeared, but its frequency was low. Although the PECS training could be effectively implemented by the mother in home, the procedures for commenting need to be examine further.
Koita,H., Sonoyama,S., & Takeuchi,K.(2003). Communication Training With the Picture Exchange Communication System (PECS) for Children With Autistic Disorder: Program and Current and Future Research. Japanese Journal of Behavior Analysis , 18, 120-130. (Japanese)The Training
Abstract: This review article would be one of the first studies to be published in Japan on the PECS. The PECS was developed by Frost and Bondy as a means to teach children with autistic disorder and related developmental disabilities a self-initiating,
functional communication system that could be rapidly acquired. Its theoretical roots combine principles from applied behavior analysis and guidelines established within the field of augmentative and alternative communication. The PECS training manual was first published in 1994, and revised in 2002. In the PECS training protocol, children are taught to exchange a picture for a desired item and eventually learn to construct picture-based sentences and use a variety of attributes in their requests. The system emphasizes developing the request function prior to developing responding to simple questions and commenting. In the present article, we described the PECS procedure, summarize effects of communication training by PECS, and comment on the future of PECS.
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Kravits, T. R., Kamps, D.M., & Kemmerer, K. (2002). Brief report: Increasing communication skills for an elementary-aged student with autism using the picture exchange communication system. Journal of Autism and Developmental Disorders, 32, 225-230.
Abstract: Communication and interactions with others are a few of the hardest tasks for an autistic child. This study showed how the gap may be bridged by using a system called the Picture Exchange Communication System (PECS). A 6-year-old girl named Molly showed much improvement in both her verbalizations and socialization skills using this method which gives promise to execution of these programs. (http://www.kluweronline.com/issn/0162-3257/contents)
Lancioni, G., O’Reilly, M., Cuvo, A., Singh, N., Sigafoos, J. & Didden, R. (in press). PECS and VOCAs to enable students with developmental disabilities to make requests: An overview of the literature. Research in Developmental Disabilities.
Abstract: This paper provides an overview of the literature dealing with the use of the Picture Exchange Communication System (PECS) and voice output communication aids (VOCAs) for promoting the performance of requests by students with developmental disabilities. Computerized and manual searches were carried out to identify the studies published during the last 15 years (i.e., the period between 1992 and 2006 during which PECS and VOCA approaches became popular). Thirty-seven studies were identified and then divided into three groups concerning the use of the PECS or equivalents, the use of VOCAs or equivalents, and the comparison of both these approaches, respectively. Of the 173 students involved in studies using the PECS or equivalents only three could be considered failures, while a fourth one did not progress in the program due to illness. Similarly, of the 39 students who used VOCAs or equivalents only three could be considered failures, while one was partly successful. Finally, of the 11 students involved in the comparisons between PECS and VOCAs none could be classified as a failure. The results are very encouraging but methodological concerns and the relatively limited use of the systems in terms of request items and request opportunities suggest caution. Caution may also be needed in interpreting the reported similarities between the two systems in usability and effectiveness.
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Liddle, K. (2001). Implementing the Picture Exchange Communication System (PECS). International Journal of Language and Communication Disorders, 36, 391-395.
Abstract: PECS was developed in Delaware, USA over 10 years ago by Bondy and Frost (1994a). Over the last two years PECS has been introduced to this country and has raised a great deal of interest in people working in the field of autistic spectrum disorders (ASD). This paper will address some of the issues that arose during the establishment of PECS in one special school. Changes seen in 21 children with severe learning difficulties who have been taught to use PECS are reported and the use of PECS with children who do not have an ASD is discussed. (http://www.tandf.co.uk/journals/titles/13682822.asp)
Lund, S.K. & Troha, J.M. (2007). Teaching Young People who are Blind and have Autism to Make Requests Using a Variation on the Picture Exchange Communication System with Tactile Symbols: A Preliminary Investigation. Journal of Autism Developmental Disorders,
Abstract: This study used a single-subject multiple baseline across participants design to evaluate the effectiveness of a modified
picture exchange communication system (PECS) teaching protocol with tactile symbols. Three students (two male, one female) aged 12-17 years who had autism and were blind participated in the study. The instructional program involved three phases. First, each participant learned to exchange a tactile symbol with his/her communication partner to request a preferred item/activity. Second, the distance between the communication partner and the participant was increased. Third, the participants were required to discriminate between two dissimilar tactile symbols. One out of three participants completed all phases of the instructional program. Although the other two participants did not complete the program, they demonstrated improvement from baseline responding rates.This study provided preliminary results that using tactile symbols with strategies from PECS may be an effective method to teach requesting to youth who are blind and have autism.
Magiati, I. & Howlin, P. (2003). A pilot evaluation study of the Picture Exchange Communication System (PECS) for children with autistic spectrum disorders, The International Journal of Autism, 7(3): 297-320.
Abstract: A pilot study was conducted to evaluate the effects of training teachers of children with autistic spectrum disorders (ASDs) in the use of the Picture Exchange Communication System (PECS). Thirty-four children with ASDs (29 boys and 5 girls) were selected from eight specialist schools. Teaching staff attended a 2 day PECS workshop and received six half-day visits from PECS consultants. Data on the children's use of PECS, spontaneous communication, and adaptive behaviour were collected before the study and at set times following the workshop. Significant, rapid increases were recorded in the level of PECS attained by the children, in their PECS vocabulary, and in their frequency of PECS use over time. Improvements in children's general level of communication were slower to occur. The majority of participants showed improvements in their ability to use PECS. The results are discussed in relation to the methodological and practical difficulties that arose during the project. (Journal website: http://www.sagepub.co.uk/journal.aspx?pid=105478&sc=1)
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Marckel, J.M, Neef, N.A. & Ferreri, S.J. (2006). A preliminary analysis of teaching improvisation with the picture exchange communication system to children with autism. Journal of Applied Behavior Analysis, 39, 109-115.
Abstract: Two young boys with autism who used the picture exchange communication system were taught to solve problems (improvise) by using descriptors (functions, colors, and shapes) to request desired items for which specific pictures were unavailable. The results of a multiple baseline across descriptors showed that training increased the number of improvised requests, and that these skills generalized to novel items, and across settings and listeners in the natural environment.
Okalidou, A., & Malandraki, G. (in press). The application of PECS in children with autism and deafness: A case study. Focus on Autism and Other Developmental Disabilities.
Abstract: The subject of this study is a 10-year-old non-verbal Greek boy, who has been diagnosed with both bilateral sensory-neural profound hearing loss and autism. The Picture Exchange Communication System (PECS), with some modifications and extensions, was applied for a 4-month intensive intervention period. His original communication and behavioral status as well as the PECS application process are presented along with the communicative, language and psychosocial outcomes following the entire intervention program. In addition, follow-up data are presented six months post-intervention.
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Peterson, S., Bondy, A., Glassberg, M. & Neef, N. (2002, May). The relationship of match-to-sample to visual discrimination skills utilized within PECS. Paper presented at the annual Association for Behavior Analysis convention, Toronto, CA.[See link for full paper]
Peterson, S., Glassberg, M., Neef, N. & Bondy, A. (2002, May). PECS acquisition: Patterns of skill development across four young children. Paper presented at the annual Association for Behavior Analysis convention, Toronto, CA. [See link for full paper]
Rehfeldt, R. & Root, S. (2005). Establishing derived requesting skills in adults with severe developmental disabilities. Journal of Applied Behavior Analysis, 38, 101-105.
Abstract: This project examined whether a history of reinforced relational responding would result in derived requesting skills in three adults with disabilities. Participants were first taught to request preferred items using pictures [with PECS]; they were then taught conditional discriminations between pictures and their dictated names and dictated names and their corresponding text. Finally, requests for preferred items using corresponding text were evaluated. All three participants demonstrated derived requesting skills. (http://seab.envmed.rochester.edu/jaba/)
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Schwartz, I. S., Garfinkle, A. N., & Bauer, J. (1998). Communicative outcomes for young children with disabilities. Topics in Early Childhood Special Education, 18, 144–159.
Abstract: The Picture Exchange Communication System (PECS) has become a widely known and used augmentative system for teaching functional communication skills and potentially providing a bridge to speech acquisition. Unfortunately, although there is a great deal of anecdotal clinical evidence about the PECS, there is little empirical information about its efficacy. We present two studies documenting the use of PECS for preschool children with severe disabilities. The first study analyzed the PECS acquisition data for 31 preschool children and demonstrated that young children with severe communication delays and disorders can learn to use PECS quickly and efficiently. The second study followed 18 preschool PECS users for a year. The results of language samples taken at snack time and during free-choice activities indicated that PECS use generalizes to untrained settings and may have concomitant effects on
untrained language functions. Directions for future research are discussed. (http://www.proedinc.com/tec.html)
Simon, E., Whitehair, P., & Toll, D. (1996). A case study: Follow-up assessment of facilitated communication. Journal of Autism & Developmental Disorders. 26 (1), 9-18.
Abstract: A 6-month follow-up of an individual reported to engage in validated facilitated communication (FC) is presented.
Three main issues are addressed: the current status of the individual's FC use, the effect of food reinforcers on his
communicative ability, and a comparison of FC to the Picture Exchange Communication System (PECS). Results indicated that the individual did not engage in any validated FC, that performance was equivalent on food and nonfood trials, and that
PECS was the preferred mode of communication, yielding 100% accuracy in a message-passing, object identification task.
Implications of these findings are discussed in the context of an individual's right to communicate by objectively validated
methods. (http://www.kluweronline.com/issn/0162-3257/contents)
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Stoner, J., Beck, A., Bock, S., Hickey, K., Kosuwan, K., & Thompson, J. (2006). The effectiveness of the Picture Exchange Communication System with nonspeaking adults. Remedial and Special Education, 27, 154-165.
Abstract: Picture Exchange Communication System (PECS) training was implemented with 5 nonspeaking adults with mental retardation who were not currently using any type of functional communication system. A modified ABAB, single-subject design was used to assess the effectiveness of PECS in enhancing the functional communication skills of these individuals. Three individuals progressed through 4 PECS training phases relatively quickly and developed functional skills that they were able to display in home and community settings. Two other individuals demonstrated limited progress, and the PECS training did not meaningfully alter their level of communicative competence. Implications for teaching functional communication skills to nonspeaking adults are discussed, and recommendations for future research are provided.
Tincani, M. (2004). Comparing the Picture Exchange Communication System and sign language training for children with autism. Focus on Autism and Other Developmental Studies, 19, 152-163.
Abstract: This study compared the effects of Picture Exchange Communication System (PECS) and sign language training on the acquisition of mands (requests for preferred items) of students with autism. The study also examined the differential effects of each modality on students' acquisition of vocal behavior. Participants were two elementary school students with autism enrolled in a suburban public school. Training sessions involved presentations of preferred items, prompting and prompt fading procedures. Probes were conducted to evaluate the generalization of learned mands to classroom teachers. For one participant, sign language training produced a higher percentage of independent mands. PECS training produced a higher percentage of independent mands for the other participant. For both participants, sign language training produced a higher percentage of vocalizations during training. Mands learned with the experimenter generalized to classroom teachers. The results of the study suggest that acquisition of picture exchange and sign language may vary as a function of individual student characteristics, specifically, motor imitation skills prior to intervention. However, further research is needed to determine the optimal procedures for teaching both modalities to students with communication difficulties. (http://www.proedinc.com/focus.html)
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Tincani, M., Crozier, S. & Alazetta, L. (2006). The Picture Exchange Communication System: Effects on manding and speech development for school-aged children with autism. Education and Training in Developmental Disabilities, 41, 177–184.
Abstract: We examined the effects of the Picture Exchange Communication System (PECS; Frost & Bondy, 2002) on the manding (requesting) and speech development of school-aged children with autism. In study 1, two participants, Damian and Bob, were taught PECS within a delayed multiple baseline design. Both participants demonstrated increased levels of manding after implementation of PECS. Only Damian demonstrated any measurable speech during study 1. His speech development occurred primarily during phase IV of PECS. Because of the positive relationship between Phase IV and increased speech for Damian, study 2 was conducted to confirm a functional relationship between phase IV procedures and speech development for an additional participant. Carl received phase IV training procedures in two conditions, administered in an ABAB design. In condition A, no reinforcement was provided for vocalization; in condition B, reinforcement was provided for vocalization after a delay of 3- to 5-s. The vocal reinforcement procedures in phase B differentially increased Carl’s speech. Results are discussed in terms of research on augmentative and alternative communication and speech development for children with autism.
Webb, T. (1999). Look who's talking! Special Children, April/May.
Abstract: The author who is a teacher at Avalon Special School, Street, Somerset, introduced PECS to a class of 6, 4/5 year old children, with severe communication difficulties, and of whom 5 have autistic spectrum disorders. The work started mid-September 1998 and within weeks all children who were previously at a pre-verbal level, were verbalising, and now five months on are using spoken language to communicate spontaneously with and without the use of symbols/words.
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Webb, T. (2000) Can children with autism be taught to communicate using PECS?Good Autism Practice (GAP), 1, 29-43.
Abstract: This paper reports one of the first studies to be conducted in the UK on the impact of PECS on children with an autism spectrum disorder and severe learning difficulties. Teresa Webb is a teacher at a special school for children with severe and multiple learning difficulties. In September 1998, she introduced PECS to a class of six children aged between 4 and 6 years. All, but one, had an asd and all had severe communication difficulties. In her opinion, PECS has had a major effect on the children’s skills and behaviour and has also influenced how staff work. The parents too report big improvements in their child’s communication skills and visitors to the school have been impressed by what they see. Clearly, the conclusions that can be drawn from the study are limited in that there was no comparison group of children who did not receive PECS or who were engaged in a different intervention and so further research is required. http://www.corelearning.co.uk/gap/index.asp
Webb T (2000) The talking goes on - The Picture Exchange Communication System. Special Children, June/July 2000.
Abstract: This article reviews the progress of a group of children 19 months after being introduced to PECS which was reported in Special Children 1999. The group have progressed from using 3-5 word sentences incorporating attributes to spontaneously requesting and commenting both with and without PECS. As speech developed the teacher continued to use PECS as a framework for teaching further communicative functions and a range of curriculum subjects. The familiar framework enabled the assimilation of new concepts and ideas more easily, and they were able to ask and respond to a range of questions. They progressed to more advanced requesting and commenting lessons and used the conjunction ‘and’ and the indefinite article ‘a’ within 13 word sentences. There was increasing evidence of generalisation as the taught structures were used spontaneously at home, which underlines the importance of ensuring the same vocabulary is available in all environments. Gradually, the children were observed using commenting spontaneously both with and without PECS, and the skill extended into narrative and description. The author used PECS right across the day, which enabled language to be integrated with the social and environmental context and enabled the mapping of language onto experiences. The
development of functional communication impacted on reducing contextually inappropriate behaviours. In fact it also raised the question of whose behaviour changed the most, the children’s or the staff? Staff found that by using PECS they could eliminate prompts, allow time to observe, facilitate children to respond and self-correct, and as a result peer interaction and independence was able to develop.
Webb, T., Baker, S. & Bondy, A. (2005). Picture Exchange Communication System. In L. Wankoff (Ed.) Innovative Methods in Language Intervention. (pp. 111-139). Austin, TX: Pro-Ed Inc.
Abstract: Book chapter, based on work by Teresa Webb and Sue Baker in a class in the UK.
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Yoder, P. & Stone, W.(2006). Randomized comparison of two communication interventions for preschoolers with autism spectrum disorders. Journal of Consulting and Clinical Psychology, 74, 426-35.
Abstract: This randomized group experiment compared the efficacy of 2 communication interventions (Responsive Education and Prelinguistic Milieu Teaching [RPMT] and the Picture Exchange Communication System [PECS]) in 36 preschoolers with autism spectrum disorders. Each treatment was delivered 3 times per week, in 20-min sessions, for 6 months. The results revealed that the RPMT facilitated the frequency of generalized turn taking and generalized initiating joint attention more than did the PECS. The latter effect occurred only for children who began treatment with at least some initiating joint attention. In contrast, the PECS facilitated generalized requests more than the RPMT in children with very little initiating joint attention prior to treatment. These effect sizes were large.
Yoder, P. & Stone, W. (2006). Randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers With ASD. Journal of Speech, Language, and Hearing Research, 49, 698-711.
Abstract: This randomized group experiment compared the efficacy of 2 communication interventions (Responsive Education and Prelinguistic Milieu Teaching [RPMT] and the Picture Exchange Communication System [PECS]) on spoken communication in 36 preschoolers with autism spectrum disorders (ASD). Each treatment was delivered to children for a maximum total of 24 hr over a 6-month period. Spoken communication was assessed in a rigorous test of generalization at pretreatment, post-treatment, and 6-month follow-up periods. PECS was more successful than RPMT in increasing the number of nonimitative spoken communication acts and the number of different nonimitative words used at the post-treatment period. Considering growth over all 3 measurement periods, an exploratory analysis showed that growth rate of the number of different nonimitative words was faster in the PECS group than in the RPMT group for children who began treatment with relatively high object exploration. In contrast, analogous slopes were steeper in the RPMT group than in the PECS group for children who began treatment with relatively low object exploration.
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Yokoyama, K., Naoi, N., & Yamamoto, J. (2006). Teaching verbal behavior using the Picture Exchange Communication System (PECS) with children with autistic spectrum disorder. Japanese Journal of Special Education, 43, 485-503.
Abstract: The Picture Exchange Communication System (PECS) is widely sued with non-verbal children with autistic disorders as an Augmentative and Alternative Communication (AAC). Most of the participants in prior research on that method, although referred to as non-verbal, had initial vocal repertoires of at least a few words. The purpose of the present study was to examine whether 3 elementary-school-age children with autistic disorders whose vocal repertoires were severely limited, such as only a few phonemes, could acquire elementary communication skills using PECS. The present study incorporated task analysis, in which a sequence of picture-exchanging behaviors was divided into 4 components. The results demonstrated that all 3 children acquired the basic components of PECS within a short period. Data from the task analysis revealed that, with increased use of PECS, their prior mode of communication (grabbing, reaching, or crying) was gradually replaced, thereby indicating the reinforcing value embedded in PECS. In addition, the present data suggest that PECS training produced collateral behavioral changes, such as an emergence of intelligible vocalization, even in students who had previously had severely limited vocal repertoires.
See also:
Mirenda, P. (2003). Toward functional augmentative and alternative communication for students with autism: Manual signs, graphic symbols, and voice output communication aids. Language, Speech, and Hearing Services in Schools, 34, 203-216
Abstract: Many individuals with autism are candidates for augmentative and alternative communication (AAC) systems, either to supplement (i.e., augment) their existing speech or to act as their primary (i.e., alternative) method of expressive communication. The purpose of this article is to summarize research and directions for future research with regard to two questions related to the delivery of AAC supports to these individuals: (a) What AAC modality is preferable to use? and (b) What do we know about the use of voice output communication aids with people with autism? (http:/www.asha.org)
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