PECS

PECS, or Picture Exchange Communication System, is exactly what the name suggests. The exchange of a picture to communicate. This system was developed to help people with autism and developmental disabilities who are nonverbal or have limited verbal communication. PECS may also be used in conjunction with a voice output communication device.

There are six phases when teaching a child to use the picture exchange system. (In my personal experience, not all children will be able to comprehend the full program. My son uses picture exchange but has never been able to follow this "program" or go though the steps listed. He just points to what he wants.)

Phase I

The first phase is to spontaneously request items or activities. Identify what the child wants. Find the things that they will "ask" for. ie- a favorite toy. This phase usually requires two teachers. (a parent, teacher, therapist, brother, or sister.) The first teacher shows the child something that they really like. The second teacher stays behind the child and waits for her to reach for the item. Then helps the child to pick up the picture of that item and hand it to the first teacher. When the first teacher has the picture, they immediately give the child the item requested. Verbal confirmation is given by the first adult. (e.g. "Oh, you want a cookie"). The second teacher should slowly back off, working towards the child independently reaching for the picture and handing it to the first teacher. The teacher should not ask what the child wants or tell them which picture to choose. The goal in this phase is for the child to spontaneously initiate communication.

Phase II

Once the child understands phase I, and can independently make a request, Phase II should be started. In Phase II the child continues to request items or activities, but they are required to move a greater distance to get to the picture or to get to the first teacher. Also begin to use the picture exchange in different settings (at the store or in a different room). Then people other than the initial teachers. (parents, teachers, siblings, schoolmates). The child also begins expanding his vocabulary of symbols, requesting different reinforcing objects or activities. At this time only one picture should be offered as a choice.

Phase III

The teacher asks the child to chose between several items on a board, working toward making personal choices. The teacher may begin by asking, "What do you want?" but this should be quickly faded out so the child will make choices spontaneously. If the child finds it difficult to chose between too many pictures, reduce the number of choices to 2 or 3, and work towards a larger number. 

Phase IV

Once the child can quickly and easily choose between pictures, and make spontaneous requests for a variety of items, to different people, the program begins to focus on sentence structure. The child is taught to use sentence strips to make longer requests. The child will start combining a picture for "I want" with a picture of the requested item or activity. The two pictures will be attached to a sentence strip and the entire strip would be exchanged with the communicative partner for the pictured item or activity.

Phase V

The fifth and sixth phases occur at the same time, focusing on different extensions of the child's skill.  Adjectives and other words can be added.

Phase VI

Through the use of pictures for "I see," "I hear," "I feel," "I smell," etc. the child will be taught to comment on elements of his environment.