The Picture Exchange Communication System.
PECS gives you a ready-made picture protocol that quickly creates requesting and may spark later speech.
01Research in Context
What this study did
Cullinan et al. (2001) wrote the first full guide to the Picture Exchange Communication System.
They laid out six phases that teach a child to trade a picture for an item, then build sentences and answer questions.
The paper is a roadmap, not an experiment; it tells clinicians exactly how to run each lesson.
What they found
The authors claim PECS can give non-vocal children a way to ask for things right away.
They also say the same steps may later help spoken words come out, but they give no new data to prove it.
How this fits with other research
Preston et al. (2009) later pooled every PECS study and agreed the system is easy to learn and works for requesting.
They warn that clear gains in speech or big drops in problem behavior are still iffy without extra help.
Alfuraih et al. (2024) show the same six phases work for children with multiple disabilities, not just autism.
Koudys et al. (2025) prove you can teach the whole protocol to parents over Zoom and still get strong child gains.
Why it matters
You now have a free, step-by-step script for turning pictures into a child’s first words.
Use it to build early manding, then watch Preston et al. (2009) to decide when to add speech or behavior plans.
If travel or staffing is tight, copy Koudys et al. (2025) and coach parents through a webcam instead.
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Join Free →Place one highly preferred item and its picture on the table; prompt the child to hand you the card and immediately give the item—start Phase I of PECS.
02At a glance
03Original 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 nonvocal students is reviewed.
Behavior modification, 2001 · doi:10.1177/0145445501255004