Information taken from American Speech-Language Hearing Association (ASHA) and Communication Matters


Picture exchange communication system (PECS) is a very specific and systemic approach to teaching nonverbal children or children with limited verbalizations how to communicate with others by using pictures.  It should be noted that just because pictures are being used to communicate does not necessarily mean that PECS is being implemented.  PECS is systematic and there are very specific phases to this approach.  Through PECS children can be taught effective communication.  They can express their wants and needs by giving a picture of a desired object to their communicative partner and then receiving the desired object.  For example, if a child wants juice they can give their parent the picture with the juice.  The parent will then give the child the desired juice.  Children can eventually learn to put words and sentences together using PECS.


PECS was originally designed in 1985 to teach autistic children how to communicate.  However, PECS has expanded and it is now used to teach a wide variety of populations and ages.  PECS is mostly used to help people who are unable to communicate through regular speech.  Nonetheless, this approach can also be used to teach children social communication.  For example, some children may be very good at identifying pictures in books or labeling items around the house; however, they have difficulty initiating conversation with someone to express wants and needs.  PECS teaches children to initiate and request for what they want.  PECS may be recommended if your child has severe difficulty with communication.    


  1. How to communicate: During this phase a child learns how to communicate. The child learns that if they hand the picture to the communicative partner they will get what they want.  Two adults are needed for this phase.  One person will sit in front of the child and hold out the desired item.  The second person will sit behind the child and direct the child’s hand to pick up the picture and give it to the other adult sitting in front. 
  2. Distance and persistence: Children are encouraged and rewarded for being “persistent” with their communication. Children may have to obtain a picture that is across the room and give it to the adult or they may have to give a picture that is right next to them to an adult who is across the room. 
  3. Picture discrimination: The child chooses what he / she wants between 2 pictures. Typically one of the pictures is very motivating while the other picture is an item that the child is not interested in.  This teaches a child that he / she must look at the pictures and discriminate between the 2.
  4. Sentence structure: The child is taught how to formulate a simple sentence using the pictures. Many times the carrier phrase “I want” is paired with the desired object (i.e., “I want ball”).
  5. Answering questions: The child is taught how to answer the question “what do you want” using pictures.
  6. Commenting: The child is taught how to comment in response to what they see or hear. They may use the following carrier phrases: “I see”, “It is a”, “I hear”, etc.   


At Key Therapies we will work closely with families to help teach the phases of PECS.  Teaching a child to use PECS takes time and patience from his / her family and from the speech-language pathologist.  Dedication and persistence is necessary to best help the child.     

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