Meta-analysis of PECS with individuals with ASD: investigation of targeted versus non-targeted outcomes, participant characteristics, and implementation phase.
PECS gives the biggest communication boost to preschoolers with autism who reach Phase III or higher.
01Research in Context
What this study did
Leaf et al. (2012) pooled every PECS paper they could find. They looked at who the kids were and how far each study moved through the six PECS phases.
They asked two questions: does PECS boost the exact skills it targets, and does it spill over to other areas like tantrums or play?
What they found
PECS works best for plain requesting. Preschoolers with autism made the biggest leaps, especially when teams pushed them past Phase III.
Gains in untargeted areas, like social play or IQ, were smaller and less steady.
How this fits with other research
Reni et al. (2022) extends the story. They gave five non-verbal preschoolers 24 PECS sessions and saw the same jump in requests plus a drop in problem behavior. Their extra detail on dose and parent stress fills a gap the meta-analysis could not.
Belmonte et al. (2008) extends PECS to blind autistic teens. Only two of three learned to ask with tactile symbols, and just one finished all phases. The weaker outcome is not a contradiction—visual PECS for preschoolers simply travels better than tactile PECS for blind adolescents.
Ganz et al. (2009) is a building block inside the meta-analysis. Two parents taught their kids to request new items with homemade pictures. The single-case success became part of the larger positive pool the 2012 paper summarizes.
Why it matters
If you work with preschoolers who have autism, move them through PECS quickly and aim past Phase III. That is where the clearest communication gains live. Track only the skills you are teaching; do not expect big side benefits in play or behavior without extra plans.
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02At a glance
03Original abstract
The Picture Exchange Communication System (PECS) is a widely used picture/icon aided augmentative communication system designed for learners with autism and other developmental disorders. This meta-analysis analyzes the extant empirical literature for PECS relative to targeted (functional communication) and non-targeted concomitant outcomes (behavior, social skills, and speech) for learners with autism, learners with autism and intellectual disabilities and those with autism and multiple disabilities. Effect size analyses were done using the Improvement Rate Difference method, an advanced metric. Effect sizes were independently analyzed for targeted and non-targeted outcomes, student age, learner disability, and number of phases in the PECS protocol acquired by learners. Results supported the judgment that PECS is a promising intervention method. Analysis also revealed that functional communication outcomes associated with the PECS protocol were most impacted, that preschool children and those with autism generally showed the strongest training effects, and that in general students who advanced through the most PECS protocol phases had the best outcomes.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.09.023