Guest Blog by Bethan Williams, SLT/BCBA

Smiling woman sitting in front of a cabinet The conversation with a parent about introducing an augmentative system of communication is never easy. Some parents feel that this means that professionals have given up on the prospect of speech. This is not true. A conscientious therapist will always strive for speech but will also ensure that while this is worked on, a child has a more immediate way of communicating. By doing so, we can immediately address and reduce the enormous frustration experienced by a child who cannot communicate their needs and wants. When this basic human right is addressed, a child is also in a better position to tolerate the intensive support and teaching they need.

Below are some of the reasons why the Picture Exchange Communication System® (PECS®) is my first choice in the vast majority of situations.

1. PECS is a hands-on, paper-based system.A young boy exchanges a picture to communicate with his mum

The PECS protocol ensures that a child learns and practices the physical approach required for effective communication. In order that a request is acknowledged and honoured, the child needs to go to the person from whom they need help. This is very different from an electronic system introduced too soon where a child may well stand in a corner, back turned, pressing a button which delivers something like I want chocolate over and over again.

2. PECS is entirely child-centred and individualised.

A young boy looks at the array of pictures in his communication bookWhen starting PECS a careful inventory of what the child likes and wants is used as a springboard. The child will only ever ask for what motivates and interests them and this will be available immediately once they have asked for it. A book of pictures of common objects or a communication board in a playground may look impressive, but there is no way of knowing that they represent anything of interest to a child with delayed and/or disordered communication. As an aside, I have never seen any child or adult spontaneously use a community or school-based community board and sometimes wonder whether their presence reflects intention more than true functionality.

3. PECS respects the child’s autonomy.A young girl happily hands a picture to her teacher who is kneeling down and smiling

The PECS protocol limits the intrusive nature of physical prompts which sadly feature largely in the lives of many children with additional needs. In the very early stages of PECS, another adult is needed to stand silently behind a child and gently prompt them to reach for the picture and hand it to the adult. Once this is done, the request is immediately honoured in less than a second and the prompter ceases all physical contact. In many instances a gestural prompt can be used in this stage, the prompt that is right for the child is always advocated.  The aim is for the child to understand as quickly as possible that reaching for a picture and giving it to another person brings only good things to that child. As a result, the need for the physical prompter is only temporary. In many cases, they are needed for less than an hour.

4. PECS is clear and universally understood.

A girl uses pictures to order food at a food counterPECS provides an unambiguous method of communication. There is no confusion about what a picture means. If there is, an explanatory word can be printed on the PECS card. Sign language can be difficult to interpret even if the people around the child are familiar with signs, as they are often not produced accurately, especially when individuals have issues with fine and gross motor control and imitation. Compare and contrast to an experience where a child hands over a picture of, say, an ice cream to someone in a shop. There is no ambiguity, and everyone comes out of the situation happy!


5. PECS teaches picture understanding through experience.

A child does not have to understand pictures and what they mean before using PECS. Learning how to do this is an integral part of the process of PECS. Some children come to PECS knowing what a picture means. Others have no idea. They will learn quickly and easily because PECS incorporates specific sophisticated processes to teach this skill.


The Goal: Communication for LifeA young adult works on school work with his AAC device next to him

The reference to augmentative communication strongly conveys the aim of a professional to put something in place alongside efforts to teach and develop speech as a primary means of communication. I have worked with many children where this has been the case, and they are gradually able to fade out use of PECS. For others, speech may not become truly functional. However, if these children have been introduced to PECS, they are still able to use the system as a way of communicating their needs and wants.

A child’s communication needs must be of priority in every educational setting. A person with no say in what they do and what they like is highly likely to be extremely unhappy or extremely angry. Often, they are both. This is both intolerable and unethical. PECS provides a clear evidence-based approach to addressing this situation and providing an almost immediate solution.

PECS offers an evidence-based, practical, and compassionate solution, giving children a voice, reducing frustration, and building meaningful connections.

About the Author

Bethan Williams is a UK-based dually certified, Speech and Language Therapist and Board Certified Behaviour Analyst, with extensive experience supporting children with communication challenges. Passionate about giving every child a voice, she specialises in using evidence-based, practical strategies like PECS to help learners develop meaningful and functional communication skills.

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