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Interventions & approaches

Picture Exchange Communication System (PECS)

Written by Rachel Whitcombe, Specialist Speech and Language Therapist (HCPC, MRCSLT), 12 years paediatric

Definition

The Picture Exchange Communication System is a structured augmentative and alternative communication (AAC) approach, developed by Andy Bondy and Lori Frost (1985), that teaches children to exchange picture cards to request, comment, and answer questions. PECS is delivered in six structured phases by SaLT-trained or PECS-Level 1-trained practitioners.

In context for parents

Key checkpoints

  • The Picture Exchange Communication System is a structured AAC approach developed by Andy Bondy and Lori Frost (1985).
  • Teaches children to exchange picture cards to request, comment, and answer questions.
  • Six structured phases delivered by SaLT-trained or PECS Level 1-trained practitioners.
  • Pyramid Educational Consultants UK runs accredited Level 1 and Level 2 PECS training for UK practitioners.
  • Section F should specify PECS phase, staff training (Level 1 minimum), daily frequency, and SaLT supervision schedule.

PECS is one of the most evidence-supported AAC systems for autistic children with limited spoken language. Phase 1 teaches the child to exchange a single picture for a highly motivating item: the act of communication first, before vocabulary or sentence structure. Phase 2 extends the exchange distance and persistence. Phase 3 introduces discrimination between pictures. Phase 4 builds sentence structure ("I want + item"). Phase 5 teaches answering "what do you want?". Phase 6 introduces commenting.

PECS is not just "using pictures". It is a structured behavioural protocol with specific teaching procedures at each phase. Inappropriate prompting (verbal prompts, hand-over-hand without fading) can produce a child who exchanges pictures but does not communicate. Pyramid Educational Consultants UK runs the accredited Level 1 and Level 2 PECS training for UK practitioners.

Where PECS works best:

  • Pre-verbal or minimally verbal autistic children for whom requesting is the immediate functional need.
  • Children who have not responded to verbal-only communication teaching.
  • Children whose families and schools can sustain consistent PECS delivery across settings.

Where the picture is more nuanced:

  • For children with strong receptive language and emerging speech, a high-tech AAC system (Proloquo2Go, GoTalk, eye-gaze devices) may be a better fit than picture exchange.
  • For children with motor planning difficulties, a sign-supported approach (Makaton or BSL) may complement or replace PECS.
  • The SaLT's role is to match the system to the child.

In an EHCP, Section F should specify the AAC system named (PECS, plus phase), the staff training (PECS Level 1 minimum for the delivering staff), the daily frequency of delivery, and the SaLT supervision and review schedule. Generic "use of AAC" is not enforceable provision.

Related terms

The terms parents most often see alongside Picture Exchange Communication System.

Where parents ask about this

Parents usually find this page after a SaLT has recommended PECS, when a school has started PECS without training, or when wanting AAC specified in Section F. Searches include "PECS training school", "PECS versus AAC device", and "PECS Section F EHCP". A Beaakon SaLT trained in PECS can carry out an AAC assessment, recommend the right system, train school staff to PECS Level 1, and write Section F-grade wording.

References

The primary legislation, statutory guidance, research, and clinical tools this page draws on.

Picture Exchange Communication System (PECS) | Beaakon