Service Delivery

Telehealth Picture Exchange Communication System Caregiver Training: A Multi-Site Community Evaluation.

Koudys et al. (2025) · Journal of autism and developmental disorders 2025
★ The Verdict

A short telehealth course lets parents run PECS like pros and keeps kids requesting for months.

✓ Read this if BCBAs serving rural or home-bound families who need PECS.
✗ Skip if Clinicians already flooded with in-person staff who master PECS.

01Research in Context

01

What this study did

The team tested a Zoom-based PECS class for parents. They called it the PECSperts package.

Caregivers of children with autism joined from home. Coaches taught them each step of the picture exchange.

Later checks looked at how well parents ran PECS and how accurately kids traded pictures.

02

What they found

Parents scored high on fidelity after the course. Children made more correct picture trades.

Both skills stayed strong one month and three months later.

03

How this fits with other research

McCoy et al. (2019) warned that teacher PECS training often fades. The new study shows telehealth follow-ups may keep the skill alive.

Ferreira et al. (2022) worked with mothers in the same room. Julie et al. moved the same idea online and got similar gains, proving distance is no barrier.

Alfuraih et al. (2024) showed PECS works in clinics. This project extends those gains to living rooms through a screen.

04

Why it matters

You no longer need to drive to families to train PECS. A short Zoom course plus brief booster calls lifts caregiver accuracy and child communication for months. Schedule a telehealth PECS kick-off this week and cut travel time while keeping outcomes high.

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→ Action — try this Monday

Email caregivers a Zoom link, email them the PECS manual, and run the first picture-exchange demo online.

02At a glance

Intervention
picture exchange communication system
Design
quasi experimental
Sample size
18
Population
autism spectrum disorder
Finding
positive
Magnitude
large

03Original abstract

A large body of evidence has established the Picture Exchange Communication System (PECS) as an evidence-based practice to support communication development for children diagnosed with autism spectrum disorder (ASD). Although PECS involves a manualized teaching protocol, there is not a corresponding systematic approach to caregiver PECS training. Caregivers play an integral role in children's communication skill development, therefore strategies to engage and train caregivers to support their child's PECS use are critical. The purpose of the present study was to explore caregiver PECS teaching integrity and child PECS implementation accuracy following participation in a manualized caregiver PECS training program (i.e., the PECSperts Caregiver Training Package). This study was conducted as part of a multi-site community research project and used a quasi-experimental design with non-random group assignment. A total of 18 caregiver-child dyads participated (treatment group, n = 11; waitlist comparison group, n = 7). Results indicate that caregiver PECS teaching integrity and child PECS implementation accuracy increased significantly for members of the treatment group, with a large effect size. Caregiver participants reported high levels of satisfaction with the training. Results were generally maintained at one- and three-month follow ups. Results suggest that the PECSperts Caregiver Training Package is an ecologically valid, time- and cost-efficient approach to caregiver training that supports caregiver PECS treatment integrity and child PECS implementation accuracy. Although further research is required, the findings provide emerging support for PECSperts as a promising approach to community-based, caregiver and child PECS training.

Journal of autism and developmental disorders, 2025 · doi:10.1177/10883576231178266