Children on the autism spectrum can find the long-term goal of utilizing the Picture Exchange Communication System^Ⓡ (PECS^Ⓡ) to communicate difficult. Communication can be challenging for your child for many reasons, including having a limited vocabulary or limited vocalization, or both. Communication challenges are different for each child. Some children might be completely nonverbal, while others might copy (or “echo”) words and sounds with no associated meaning. Because children on the autism spectrum can have difficulty initiating communication, they sometimes engage in disruptive behaviors because their needs are not being met. The Picture Exchange Communication System (PECS), which allows a person to communicate using pictures, can be a helpful set of skills for children on the autism spectrum to learn to communicate their needs more effectively. Pictures can be used to communicate requests, thoughts, or anything that can be easily shown using a picture. Using PECS gives your child the ability to initiate communication through pictures by giving them the option to bring a picture forward if they want it or need it. The PECS teaches your child beginning communication skills and how to make choices. The communication skills they learn are transferable to verbal communication, and the ability to make choices is a valuable lesson for your child to learn for use in day-to-day life.

The following resources will help you better understand PECS:

What Is PECS And How Does It Improve Communication? - Lexington Services

What is the Picture Exchange Communication System or PECS?: Articles: Indiana Resource Center for Autism: Indiana University Bloomington.

There are six phases of PECS, beginning with how to communicate using pictures and ending with formulating simple sentences.

The six phases of PECS are:

• Phase 1: Associate pictures with real-world actions / items. Once it is decided which items / actions will be used with the PECS, you begin to create an association between the pictures and actions / items. Only single pictures should be used in Phase 1. Take the time to build the correlation between the pictures being used and the items or actions they represent. Build the association by rewarding your child with the item or action when they choose the associated picture. For example, if your child picks the image of the iPad, reward them with words of affirmation and the use of the iPad to build the association between the image and the item. For words and actions such as “all done” and “yes,” use the pictures whenever you say the phrase or when the action occurs. With “all done,” you can have the picture of the word ready when you finish a task and show it when you say “All done!” to your child. This helps to build the association between the word and action. Do not introduce any additional or extra items with the image. This may make it seem like the picture has more than one association. If you ask your child what they want, and they bring you the picture of the iPad, use affirming words and hand them the iPad to show that they used the picture correctly. You should minimize the use of other rewards (for example, a piece of candy) or begin to phase them out so your child does not confuse the use of the image of the iPad with being given the iPad and being given another item, such as a piece of candy.
• Phase 2: Generalize the skill. Once your child associates specific pictures with items or actions, teach your child how to use the PECS in different environments and with different people. Encourage your child to use the pictures to communicate with different people in their lives. Use words of affirmation and give them the item when they use the pictures to communicate with others. You should also bring the pictures along with you when you leave the home and  encourage your child to use the cards to communicate wants and needs in unfamiliar environments. For example, when you go to a new park, you should encourage them to use the pictures to ask for their snacks or juice.
• Phase 3: Discriminate between multiple items. Your child is presented with two images and is asked to choose which one they want. Once they have mastered choosing between two items, you can move to three items, and so on. Present your child with two different options and have them choose which picture they want. After they have shown the ability to comfortably choose between two items, you can increase to three items, then four, and so on. For example, present your child with a picture for “juice” and a picture for “snack” and ask them to choose one item (for example, ask the question “What do you want?”). When your child selects the picture of the item they want, reward them with it, whether it is the juice or the snack. If your child chooses both, prompt them to choose again and remind them to choose one option. Repeat this until your child is able to discriminate between the two. Be sure to use encouragement throughout.
• Phase 4: Sentence strips. Encourage your child to form sentences using a combination of “sentence strips” and pictures. Sentence strips state phrases such as, “I want,” or “I feel.” Your child will form a sentence by using, for example, the “I want” sentence strip and the picture of the item they want, such as juice or snack.
• Phase 5: Answer questions. Encourage your child to use all PECS resources to answer questions. For example, when you ask them what they want, encourage them to use the sentence strip for “I want” and the picture of the item they want, rather than simply using the picture of the item they want.
• Phase 6: Moving beyond question and answer. Phase 6 builds upon the PECS and teaches your child to comment on the world around them by introducing more complex pictorial language, such as complex actions. For example, your child can say they want to take a break outside by doing: “I want” sentence strip + [PECS for outside] + [PECS for break]. 

The following strategies may help your child make progress towards mastering the long-term goal of utilizing PECS:

• Identify the most important items for your child to know. An important note: you should start small and expand. Try not to overwhelm your child with the number of PECS options. Observe your child’s habits and make a list of their most-used items, favorite snacks, and often-done actions. These will be useful words to find pictures of, so your child can use them when learning the PECS. Begin with the most important words and actions and then expand to favorites, and then to other words you will want your child to know and use.
• Build an association between an item / action and the image. In order to successfully use the PECS, an association between the item / action and its representative image must be established. For example, you want your child to associate a picture of their favorite toy robot with the actual item. You can do this by handing your child the picture and then handing them the toy. Or, you can place the picture next to the toy and repeat this with all other pictures and items you want to build associations between. Encourage your child’s use of the PECS by rewarding them with the item / activity when they present the image. As the association increases and your child can confidently use the image to receive the reward, phase out rewarding your child every time. Instead, communicate with your child, either through PECS cards or another mode of communication, whether they can or cannot have the item or do the action.
• Use PECS when communicating with your child to demonstrate its use. Utilizing PECS when communicating with your child will model how the system is used and also encourage your child to use it in return.
• Additional resources:

• For the parents:

The Phases of PECS: Arthur’s Story - YouTube

PECS Card Categories (mypecs.com)

LANYARD VISUAL CUE CARDS, PRINTABLE PECS WITH BOARDMAKER PICTURES, SPED, Autism (teacherspayteachers.com)

Free Materials - Pyramid Educational Consultants (pecsusa.com)

• See the tab: “PICS FOR PECS PICTURE GRIDS”

PECS: Steps for Implementation (unc.edu)

• For the child:

What Animal Do You Hear Guessing Educational Learning PECS Sentence Kids Toddlers Children - YouTube

• For this video, you may want to watch it ahead of time and provide your child with the appropriate images / cards so they can follow along.

In order to help your child master the long-term goal of utilizing PECS, you can work with your child on the short-term goals of saying yes / no, asking for a break, requesting food / drink, requesting desired activities / items, or making statements.

Saying Yes / No

For the short-term goal of saying yes / no, you can choose a target such as saying “yes,” saying “no,” responding to yes / no questions, etc.

• Step 1: Decide what you would like your child to learn to communicate using PECS. For example, you can choose the target of saying “yes” while working on the short-term goal of saying yes / no. Select one picture as follows: one image of their favorite activity, such as someone going down a slide. Also have the card / image of the word “yes” ready for use. If you are choosing an activity, such as going down a slide, be near the activity so you can provide an example or appropriate prompting if necessary.
• Step 2: An initial/specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as the image of a thumbs up, or a verbal SD (“Time to say, ‘yes’!” or “Let’s say, ‘yes’!”). 
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently to say “yes” in response to the image for which you prompted. The baseline level will vary according to your child and their specific abilities. As an example, you can count how many times in a row your child is able to independently say “yes” in response to the image you prompted for. Alternatively, you can count how many times within a given time interval (e.g., 5 min, 10 min, 15 min, etc.) your child was able to independently provide the response you prompted for. 
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of saying “yes”), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, you can show your child the image (image of someone going down a slide) and say, “Do I want to do this?” and then pause for five seconds before holding up the image of the word “yes” while nodding. Afterwards, go down the slide.
• Step 5: Collect data on how your child makes progress. For example, count how many times in a row your child can meet the target of saying “yes” independently. Alternatively, you can track progress by recording how long it takes your child to meet the target of saying “yes” independently. Or, alternatively, you can track progress by counting the number of successful attempts at saying “yes” during a session. 
• Step 6: Track how your child makes progress to meet the target of saying “yes” by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at saying “yes” over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can say “yes,” and compare that with the percentage threshold necessary to meet the target.

Asking For a Break

For the short-term goal of asking for a break, you can choose a target such as identifying when to ask for a break, asking for a break using one card, asking for a break using a sentence, etc.

• Step 1: Decide what you would like your child to learn to communicate using PECS. For example, you can choose the target of asking for a break using one card while working on the short-term goal of asking for a break. Select a picture as follows: an image of someone overwhelmed / overstimulated. Also have the card / image of the word “break” ready for use.
• Step 2: An initial / specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as the image of the word “break,” or a verbal SD (“Time to ask for a break!” or “Do you need a break?”). 
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently to ask for a break using one card. The baseline level will vary according to your child and their specific abilities. As an example, you can count how many times in a row your child is able to independently ask for a break using one card. Alternatively, you can count how many times within a given time interval (e.g., 5 min, 10 min, 15 min, etc.) your child was able to independently provide the response you prompted for. 
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of asking for a break using one card), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, you can show your child the image (an image of someone overwhelmed / overstimulated) and say “I need a break,” while holding up an image of the word “break.” Take a break from this activity by moving to a different room or turning your attention to a different activity for a short period of time.
• Step 5: Collect data on how your child makes progress. For example, count how many times in a row your child can meet the target of asking for a break using one card independently. Alternatively, you can track progress by recording how long it takes your child to meet the target of asking for a break using one card independently. Or, alternatively, you can track progress by counting the number of successful attempts at asking for a break using one card during a session. 
• Step 6: Track how your child makes progress to meet the target of asking for a break using one card by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at asking for a break using one card over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can ask for a break using one card, and compare that with the percentage threshold necessary to meet the target.

Requesting Food / Drink

For the short-term goal of requesting food / drink, you can choose a target such as asking for a snack using one image, asking for juice using one image, asking for a snack using a sentence strip, asking for juice using a sentence strip, etc.

• Step 1: Decide what you would like your child to learn to communicate using PECS. For example, you can choose the target of asking for a snack using one image while working on the short-term goal of requesting food / drink. Select a picture as follows: one image of someone eating. Also have the card / image of their favorite snack, such as pretzels, ready for use.
• Step 2: An initial / specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as the image of an animated image of a child eating, or a verbal SD (“Time to ask for a snack!” or “Let’s ask for a snack!”). 
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently to ask for a snack using one image. The baseline level will vary according to your child and their specific abilities. As an example, you can count how many times in a row your child is able to independently ask for a snack using one image. Alternatively, you can count how many times within a given time interval (e.g., 15 min, 30 min, 45 min, etc.) your child was able to independently provide the response you prompted for.
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of asking for a snack using one image), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, you can show your child the image (an image of someone eating) and say, “Do you want a snack?” and hold up the image of pretzels. Then, eat a pretzel.
• Step 5: Collect data on how your child makes progress. For example, count how many times in a row your child can meet the target of asking for a snack using one image independently. Alternatively, you can track progress by recording how long it takes your child to meet the target of asking for a snack using one image independently. Or, alternatively, you can track progress by counting the number of successful attempts at asking for a snack using one image during a session. 
• Step 6: Track how your child makes progress to meet the target of asking for a snack using one image by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at asking for snack using one image over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can ask for a snack using one image, and compare that with the percentage threshold necessary to meet the target.

Requesting Desired Activities / Items

For the short-term goal of requesting desired activities / items, you can choose a target such as asking for outside play using one image, asking to watch TV using one image, asking for the iPad using one image, asking for outside play using a sentence strip, asking to watch TV using a sentence strip, asking for an iPad using a sentence strip, etc.

• Step 1: Decide what you would like your child to learn to communicate using PECS. For example, you can choose the target of asking for outside play using one image while working on the short-term goal of requesting desired activities / items. Select a picture as follows: one image of someone looking outside. Also have the card / image for “outside,” such as this image of two children outside, ready for use.
• Step 2: An initial / specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as the image of outdoor scenery, like a sidewalk with grass and trees, or a verbal SD (“Time to ask to go outside!” or “Let’s ask to go outside!”). 
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently to ask for outside play using one image. The baseline level will vary according to your child and their specific abilities. As an example, you can count how many times in a row your child is able to independently ask for outside play using one image. Alternatively, you can count how many times within a given time interval (e.g., 5 min, 45 min, etc.) your child was able to independently provide the response you prompted for. 
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of asking for outside play using one image), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, you can show your child the image (the image of someone looking outside) and ask, “Do I want to go outside?” Then, hold up the image / card for “outside,” such as this image of two children outside and go outside.
• Step 5: Collect data on how your child makes progress. For example, count how many times in a row your child can meet the target of asking for outside play using one image independently. Alternatively, you can track progress by recording how long it takes your child to meet the target of asking for outside play using one image independently. Or, alternatively, you can track progress by counting the number of successful attempts at asking for outside play using one image during a session. 
• Step 6: Track how your child makes progress to meet the target of asking for outside play using one image by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at asking for outside play using one image over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can ask for outside play using one image, and compare that with the percentage threshold necessary to meet the target.

Making Statements

For the short-term goal of making statements, you can choose a target such as saying “all done” using one image, saying “more” using one image, saying “all done” using a sentence strip, saying “more” using a sentence strip, etc.

• Step 1: Decide what you would like your child to learn to communicate using PECS. For example, you can choose the target of saying “all done” using one image while working on the short-term goal of making statements. Select a picture as follows: one image of a figure with a question mark. Also have the card / image for “all done,” such as a check mark, ready for use.
• Step 2: An initial / specific discriminative stimulus (SD) should be selected that will cue your child that the task will start. This SD can be a visual SD, such as the image of a check mark, or a verbal SD (“Time to say we are all done!” or “Let’s say that we’re all done!”). 
• Step 3: Collect baseline level data by providing the SD from Step 2 and allowing your child to attempt independently to say “all done” using one image. The baseline level will vary according to your child and their specific abilities. As an example, you can count how many times in a row your child is able to independently say “all done” using one image. Alternatively, you can count how many times within a given time interval (e.g., 5 min, 15 min, 30 min, etc.) your child was able to independently provide the response you prompted for. 
• Step 4: To begin the trial to monitor progress towards meeting the target (i.e., the target of saying “all done” using one image), provide the SD from Step 2 and allow your child to attempt independently. When your child is successful, provide reinforcement. If the reinforcer for the behavior is a tangible item, such as a small snack or a token for a token board, ensure that it is provided with a great deal of verbal praise. Ideally, you want your child’s positive behavior to be supported solely by social reinforcement. If the behavior was not displayed, end the trial and provide the appropriate level of prompting on the following trial. For example, you can show your child the corresponding image (image of a figure with a question mark) and ask, “What is happening?” Hold up the card / image for “all done,” such as a check mark, and begin to put away the task or activity.
• Step 5: Collect data on how your child makes progress. For example, count how many times in a row your child can meet the target of saying “all done” using one image independently. Alternatively, you can track progress by recording how long it takes your child to meet the target of saying “all done” using one image independently. Or, alternatively, you can track progress by counting the number of successful attempts at saying “all done” using one image during a session. 
• Step 6: Track how your child makes progress to meet the target of saying “all done” using one image by comparing with either a number threshold or a percentage threshold (necessary to meet the target). For example, you can record the number of successful attempts at saying “all done” using one image over a certain number of sessions, and compare that with the number threshold necessary to meet the target. Alternatively, you can record what percentage of times your child can say “all done” using one image, and compare that with the percentage threshold necessary to meet the target.