Answer the questions on this flow chart to determine if a person is a candidate for PECS.

The most critical element to the success of PECS is identification of a powerful set of reinforcers. The team must identify items and/or activities that the learner enjoys throughout the day. In addition it is important to plan for communication opportunities such as carefully monitoring the identified reinforcers so that accessibility is limited. If these items are always freely available, the learner would likely be less motivated to request the items during your initial PECS lessons. In addition, pictures will need to be made prior to your first PECS session. The symbol set does not matter in the early stages of PECS. We recommend that you identify a symbol set that is easy for you to reproduce and maintain. If changes in the symbol set are necessary, these changes will be made in Phase III.

Matching/discrimination skills are not necessary to begin PECS. PECS begins by teaching the important foundational communication skills of “how to communicate” and “how to be persistent with communication.” We begin by using single icons during the first two phases of PECS. During the initial phases, the picture functions as a ticket that must be exchanged with a communication partner. These concepts parallel typical language development, in that young children begin engaging in basic communication skills (i.e. joint attention with gestures) prior to development of the first words. In a similar fashion, we teach the art of communication via PECS first and then focus on building the picture vocabulary in Phase III. Specific teaching strategies are utilised in Phase III to teach discrimination of the icons. These teaching strategies have been effective with children who previously were not able to master a variety of match-to-sample lessons.

Research from as early as the 1960s has demonstrated that AAC (Augmentative and Alternative Communication) systems do not inhibit the development of speech, but rather facilitate the development of speech.

As we view the PECS Communication Book as equivalent to the learner’s voice, each learner will need to have their own Communication Book. We don’t share voices, so our students should not be required to share the Communication Books. The learner will be taught to transport the book to all settings beginning in Phase II. After that time, it will always be the learner’s responsibility to carry the book throughout the day.

Following Phase III discrimination training, it is appropriate to use Topic/Activity Boards. These boards contain vocabulary that is relevant to a specific location or activity. For instance, in the home setting there may be a topic board located in the kitchen that includes a variety of food choices. In the motor area at school, the board may include all relevant pictures of gross motor activities. Remember that if the item is reinforcing to your learner, the picture from the Activity Board should also be replicated in the PECS Communication Book. One helpful strategy within the home setting may be to use the Insert Pages within the Communication Book as the Activity Boards that can be posted around the home. That way, when you’re ready to leave the house, the Insert Pages can be easily gathered into the Communication Book.

The length of the training session will be dependent on two variables. The first variable involves the learner’s interest. You can conduct one trial or twenty trials, as long as your learner continues to initiate (e.g. reaching towards the item). Once the learner stops initiating, the trainer can decide to either offer a new/different reinforcer or end the session. Keep in mind that you should always end the session on a positive note, prior to satiation, boredom and/or occurrence of Contextually Inappropriate behaviours (CIBs).

The second variable involves the availability of the second trainer. Two trainers are required for implementation of Phase I of the protocol. As such, session length may sometimes be dependent on the time constraints of the second trainer.

Visual discrimination skills are neither a prerequisite for starting Phase I, nor a target objective of this phase. During Phase I the picture acts as a ticket that is exchanged for a desired item. As such, only one picture is presented at a time.

However, the learner may ask for several different items during a session. Each time the reinforcer changes, the corresponding picture is placed directly in front of the student. So, although only a single picture is presented at one time, the learner should be exchanging a variety of pictures for all identified reinforcers throughout the day.

You must have two trainers to begin implementation of the PECS protocol with your learner. One person will play the role of the communicative partner. The second trainer will play the role of the physical prompter. Research indicates that physical prompts delivered from behind the learner are more effective and easier to fade than those that are delivered from the front. As such, if you do not have two trainers available you should wait to begin implementing PECS.

PECS should be implemented in all settings beginning in Phase I. The initial exchanges typically take place in a structured setting, as the communicative partner, physical prompter and student are aligned close together. Trainers should structure communication opportunities in the classroom, playground, cafeteria, home, community, etc. Anywhere a speaking individual is using his voice to communicate is a target area for PECS implementation.

The following areas may need to be addressed to help skill acquisition in Phase I:

1. Reinforcers: Assess the items you are using. Are the items/activities powerful reinforcers from the learner’s perspective? Conduct frequent preference assessments to make sure the items/activities are still wanted. Also, be sure to engineer your environment so that reinforcers are not “free” throughout the day. Reinforcers should be placed inside containers or on high shelves, so if the learner wants to access the item, he/she has to make a request.
2. Learner Initiation: Have you been waiting for the learner to initiate (i.e. reach toward the item) BEFORE prompting the exchange? Phase I targets learner initiation, so the reach must happen before the trainers intervene. If the learner is not reaching towards the item, this may be an indication that the learner is no longer interested or does not want the reinforcer. This may be a good time to conduct a miniature preference assessment within the lesson.
3. Trainers: Have you been using two trainers, a communicative partner and a physical prompter, to teach the exchange? You must have two trainers to teach Phase I. There is no way to teach Phase I initiation skills with a single trainer. Assess that both trainers are following the PECS protocol. A PECS Implementer Checklist can be found in The PECS Training Manual, 2nd Edition, page 355.

Please note that some learners may demonstrate a slower learning curve. If the individual tends to learn all skills at a slower pace, it would be reasonable to assume that acquisition of Phase I skills would also take some time.

One picture is presented at a time at Phase II. The picture should be placed on the front of the book, as the Communication Book is introduced at the beginning of this phase. Although only a single picture is presented at one time, the learner should be exchanging a variety of pictures for all identified reinforcers throughout the day. Discrimination is not a requirement for Phase II. Phase II focuses on distance and persistence.

Teaching distance and persistence will be imperative for our learners to view PECS as a functional means of communication. Our students must learn that they can communicate with all people in all environments, even if the communication partner isn’t nearby. As such, you should identify times during the day when travel is appropriate. This can occur during natural movement times including physical education, recess time, etc. In addition to traveling within the structured classroom settings, you may also teach your learners to acquire attention in other ways. Many of our students learn to raise their hands to acquire the teacher’s attention within the classroom setting.

For our learners that have mobility issues, including learners that are wheelchair bound, we should not expect walking/moving long distances. Instead, we will teach the use of a call switch (i.e. talking photo frame, BIGmack Switch, bell, etc.). The physical prompter will teach the learner to hit the call switch, which is programmed with a generic expression such as “Come here, please.” This will be the communicative partner’s indication to approach the learner. From there, the learner will exchange the single picture for the reinforcer. The communicative partner should slowly increase the amount of time before availability to receive the learner’s message. The call switch and Communication Book should be permanently located in an area that is easily accessible (i.e. book and switch placed on wheelchair). Information on how to teach this can be found in The PECS Training Manual, 2nd Edition.

As soon as the learner has demonstrated distance and persistence with communicative interactions, Phase IIIA – Visual Discrimination Skills should be introduced. During other times throughout the day, the learner should continue to generalise Phase II skills.

Before considering the use of alternative strategies, the team should assess the training procedures that have been used to teach Phase IIIA.

1. Did the team begin with a highly preferred vs. a non-preferred or contextually irrelevant item?
2. Were all team members implementing the 4-step error correction strategy?
3. Was the team quickly reinforcing the new behaviour in discrimination training?
4. Did the team persist with the above strategies for long enough to determine the effectiveness of the strategy?
5. Were enough opportunities and trials at the level of training conducted each day?
6. Also keep in mind that the team should be providing the learner with opportunities at his level of training and at his level of mastery across each day.

If Phase IIIA (the first level of Discrimination Training) was implemented properly, and progress has not been documented, then alternative strategies should be explored. Any alternative you use will involve changing some part of the lesson (i.e. how we present the choices). These changes are often in the form of prompts that we put into the lesson to help the student succeed. Once we note success, those prompts should be faded to elimination. Refer to your handout packet from the PECS Level 1 Training or The PECS Training Manual, 2nd Edition for a refresher on some Discrimination Training Alternatives. 

New vocabulary can be added at any phase. Remember, the new vocabulary is chosen based upon your learner’s preferences/reinforcers. When your learner is in Phase IIIB-Complex Discrimination and beyond, the trainer should conduct a Correspondence Check to ensure that the learner understands the picture.

During active training of the Phase IV skills, the learner is taught to first place the Sentence Starter (I want) on the Sentence Strip and then to place the reinforcer picture on the strip. After mastery of Phase IV, the learner may independently begin constructing the Sentence Strip in novel ways. The learner may place both pictures on the strip at the same time and/or place the reinforcer picture first on the Sentence Strip followed by the Sentence Starter. These types of Sentence Strip constructions are fine, provided that the final exchanged Sentence Strip appears in the correct order. If errors in sequence do occur, remember to use the Backstep Error Correction Procedure.

Initially, the communicative partner should remove the pictures from the Sentence Strip and replace both the strip and pictures on/in the Communication Book. Requiring the PECS user to do so unnecessarily slows the communicative response for him or her. Some learners insist on being the ones to put their pictures back, though. This is fine.

Essentially, as learners become integrated into community activities, they will need to learn to take the Sentence Strip back from the “lay communicative partner,” so that pictures and Sentence Strips don’t get lost. When teaching this skill, we recommend the use of physical prompts or gestures instead of verbal prompts (i.e., “Put your pictures away”). The physical prompts or gestures you insert into this lesson should be much easier to fade than verbal prompts and will promote independence as quickly as possible.

During Phase IV training and beyond, the trainer should pause while reading the Sentence Strip. This pause time is known as the constant time delay and gives the student a chance to vocalise. If the learner displays vocal approximations and/or clearly articulated words, we will “have a party!” We want to differentially reinforce any speech attempts by providing more of the reinforcer or a longer amount of time with the item. The message to the learner is that speech is GREAT, but his/her functional communication system will continue to be an effective way to communicate on days when the words are not easy to produce.

Attributes should be introduced immediately following Phase IV mastery. Prior to introducing specific lessons, the team should identify attribute concepts that are important and meaningful from the learner’s perspective. Examples could include colour, size, number and/or shape concepts. Remember that the learner does not need to demonstrate receptive understanding of the concept prior to use of the concept expressively.

This is a common occurrence, and we will attempt to change the learning environment slightly in order to teach this skill. While we often recommend that the icons related to the lesson be placed on the front of the Communication Book for initial training sessions, this may indeed promote the type of behaviour you are describing. Try placing all of the learner’s icons inside of the Communication Book, including the “I want” icon. This will create a bit of a delay to the pictures and may allow you the opportunity to ask the question and provide the delayed prompting strategy. Be sure to provide opportunities for the learner to request spontaneously across the day as well!

Because the consequence for commenting is social reinforcement, Phase VI can be a difficult skill for some of our learners. We will begin by teaching commenting based upon the sense that is most motivating and/or meaningful from the learner’s perspective. Common Sentence Starters include: “I hear,” “I see,” “I smell,” etc. Though not all learners will have success with this phase, the team has still provided the learner with a functional means of communication to request important items and/or activities.

The communicative partner can systematically eliminate the entire question as a way to elicit the spontaneous comment. For example, “What do you see/hear/smell/etc.?” the communicative partner can ask, followed with “What do you?” and then “What do?” and, finally, “What?” Please note that not all of our learners will demonstrate success with spontaneous commenting. Celebrate the skills that the learner has mastered. It’s wonderful that the learner has mastered spontaneous and responsive requesting, as well as responsive commenting!