Effectiveness of picture exchange communication system in developing requesting skills for children with multiple disabilities.

Three nonverbal preschoolers with severe intellectual disability got PECS training. The team used a multiple baseline across kids design. Sessions happened at home and at school.

Each child learned to hand a picture card to get a toy or snack. The trainers followed the first three PECS phases. They tracked how many correct requests the kids made each day.

All three kids started making requests within 10 sessions. Their correct requests jumped from zero to 8-12 per session. The skills lasted after training stopped and showed up with new toys and new adults.

Parents and teachers kept using PECS without help. Two months later the kids still asked for items every day.

Danitz et al. (2014) meta-analysis says PECS works best for autistic kids who also have ID. Alfuraih’s results match that advice. The kids here had ID plus other delays, and PECS still worked.

Gilroy et al. (2023) compared function-based PECS to high-tech AAC in older students. Both groups gained the same amount. The new study shows the same benefit can start earlier, at preschool age.

Bondy et al. (2004) mapped PECS steps to Skinner’s verbal operants. Alfuraih’s team used that map to teach pure mands first, then moved to discriminated requests.

If you serve nonverbal preschoolers with severe ID, start PECS right away. You do not need fancy tablets; picture cards are enough. Run phases 1-3, track daily requests, and probe with new items and people. The skills will hold after you thin reinforcement and leave the site.