Teaching young people who are blind and have autism to make requests using a variation on the picture exchange communication system with tactile symbols: a preliminary investigation.

Belmonte et al. (2008) tested a touch-only version of PECS for three blind autistic teens. They swapped the usual pictures for raised-line symbols the kids could feel.

The team ran a multiple-baseline design. They measured how often each teen handed a tactile card to an adult to ask for a snack or toy.

Two students tripled their requests within a few weeks. One of them finished all six PECS phases. The third student never moved past Phase II.

Progress was slow. Blindness made it harder to tell similar symbols apart. Extra discrimination drills were needed.

Bracken et al. (2014) later showed that deaf-blind adults with learning disabilities mastered the same PECS phases when cards were enlarged and raised. Their 100% success rate extends the tactile idea to an older, dual-sensory group.

Reni et al. (2022) used standard picture PECS with five nonverbal preschoolers. All kids zipped through 24 sessions and parents saw less tantrums. The contrast looks like a contradiction, but it isn't: preschoolers had vision and simpler symbols, so they moved faster.

The big meta-analysis by Leaf et al. (2012) backs both stories. It says PECS works best when kids finish more phases. The 2008 teens stalled partly because tactile discrimination ate time.

If you serve blind autistic clients, tactile PECS can unlock first requests, but plan for longer teaching loops. Add extra symbol-feel drills and keep reinforcers highly preferred. One teen still plateaued, so have a back-up AAC ready.