Picture Exchange Communication System for Autists

Subject: Healthcare Research
Pages: 2
Words: 545
Reading time:
2 min
Study level: College

PECS’ functioning is based on the usage of images and other visual illustrations of real objects. Specifically, “this system uses figures/photographs selected according to the lexical repertoire of each individual” (Santos et al., 2021, p. 2). Overall, there are six phases comprising the training process using PECS. The first is Physical exchange, in which a therapist instructs a child to use cards to highlight what he or she is attracted to. The second phase is Distance and communication, in which cards become the primary means of communication used by ASD children. The next phase is the Discrimination of figures, which implies that these children “must discriminate the cards and give the communication partner the one appropriate to the situation” (Santos et al., 2021, p. 2). Starting with this phase, children are able to demonstrate their intentionality.

The complexity of communicative tasks increases significantly with the next three phases. In the fourth phase (Sentence structure), the child enhances their vocabulary by starting to use action verbs indicating desire. The fifth phase, which is Responding to ‘what do you want?’, has the children use cards to communicate simple phrases. The final phase is named Commenting, in which a child answers simple questions using the same manner of communication with cards. In essence, PECS supplants words and traditional means of communication with cards. The goal of the study is to ascertain whether PECS implementation improves children’s comprehension of instructions.

The study uses a longitudinal format, which presupposes analysis of data over a period of time. The study incorporated twenty participants, five of whom were girls, while the other fifteen were boys. The age of the study participants ranged from 6 to 12 years. The instruments used to evaluate children included the Autism Behavior Checklist, SON-R 2½-7 [a], the Vineland Adaptive Behavior Scale, and the average extension parameter of the Vocal Behavior Assessment. In order to understand how effective children are at comprehending instructions, specific instructions were created, which included ““go get..”; “give me…”; “keep…”; “put…”, “go to…”; “sit down”; “come…”; “stop”” (Santos et al., 2021, p. 3). Within instructions, therapists utilized both cards as well as gestures.

The results of the study showcased an increase in comprehension of instructions. Phases 1, 2, and 3 showed impeccable performance, while tater phases with each subsequent phase yielded fewer correct results. 80% of children during phase 4 responded correctly, followed by 60% in phase 5, and finishing with 20% in phase 6. However, visual instructions appear to yield more results than oral ones. Most strikingly, “In about 85% of the children, oral emission was restricted to the production of vocalizations, and in 15% to the minimum verbalization of isolated words” (Santos et al., 2021, p. 4). This implies that visual instructions should be prioritized over oral ones.

Study limitations included sample size, the number of sessions (24), and the overall study duration. First, 20 participants are not enough to make substantial statistical conclusions. Second, the authors of the study “consider as a study limitation the 24-session duration of the PECS Implementation Program” (Santos et al., 2021, p. 5). Therefore, more research is recommended, encompassing more participants, instruction sessions, and longer study duration. Nevertheless, the limited available data suggests that PECS is effective and should be practiced in communication with ADS children.


Santos, P. D. A., Bordini, D., Scattolin, M., Asevedo, G. R. D. C., Caetano, S. C., Paula, C. S., Perissinoto, J., & Tamanaha, A. C. (2021). The impact of the implementation of the Picture Exchange Communication System – PECS on understanding instructions in children with Autism Spectrum Disorders. CoDAS, 33(2). 1-5. Web.