PECS: How it helps children who are not yet speaking.

PECS can be a useful tool for children who do not yet speak, who speak very little, or who have difficulty using speech to communicate functionally.

For many families, the main concern is whether using pictures will delay speech, whether the child will become dependent on the cards, or whether this strategy should only be used in cases of autism. The answer requires caution: PECS can help some children, but it must be well-indicated, well-taught, and integrated into a broader communication plan.

The term PECS comes from Picture Exchange Communication System, That is, a system of communication through the exchange of images. In practice, the child learns to give an image to another person to ask for something, initiate an interaction, or, in more advanced stages, construct short sentences and make comments. It is a structured form of... augmentative and alternative communication, used when speech is not yet sufficient to meet daily needs.

This article explains what PECS is, how it works, which children it may be suitable for, and what precautions should be taken before implementing it at home, at school, or in other settings. Speech therapy.

What is PECS?

PECS is a picture exchange communication system. The child learns that they can give a picture to an adult to get something they want, such as a toy, a cookie, an activity, or a break. The central idea is to teach the child to initiate communication functionally, instead of relying solely on the adult to ask questions, guess needs, or anticipate everything.

PECS is not just about "using flashcards." Nor is it simply about showing pictograms to the child. The system has its own teaching sequence and should be applied with clear objectives. It begins with simple requests and can evolve into choosing between images, constructing sentences, answering questions, and making comments.

For a child who does not yet speak, This structure can be important because it transforms communication into something concrete. The child realizes that communication has an effect: when they deliver the right image, another person understands their intention and responds.

Is PECS the same as using pictograms?

Not exactly. Pictograms can be part of PECS, but not all use of pictograms is PECS. This distinction is important.

A family can use pictures to organize routines, anticipate bath time, show the sequence of the day, or help a child choose between two activities. This is visual support and can be very useful. PECS, on the other hand, is a specific system for teaching communication through the exchange of pictures, with progressive phases and objectives for initiating communication.

For example, showing a child a picture of a "snack" to signal that they are going to eat is different from teaching a child to pick up a picture of a "snack," go to an adult, and hand over that picture to ask for food. In the first case, the image supports understanding. In the second, the image is used by the child to express an intention.

For which children might PECS be indicated?

PECS can be considered when a child has significant difficulty communicating through speech. It is not exclusive to children with autism, although it is widely used in that context. It can also be considered for children with language development disorders, intellectual disabilities, genetic syndromes, childhood apraxia of speech, motor difficulties, or other conditions that limit oral expression.

Some situations in which PECS may be assessed include:

• A child who does not yet use words to ask for or answer.
• A child who communicates primarily through crying, tantrums, pulling the adult's hand, or leading the adult to an object.
• A child who has communicative intent but is unable to express it clearly.
• A child who understands some routines but is unable to initiate communication.
• Child with autism who uses little functional speech.
• A child who repeats words but has difficulty asking for things, choosing things, or commenting.
• Child with very limited speech and frequent frustration due to not being understood.

PECS should not be chosen simply because the child "doesn't speak." First, it's necessary to understand how they communicate, what they understand, what motivates them, what gestures they use, how they play, how they respond to adults, and whether they can discriminate between images. When there is language delay, The decision should result from an individual assessment, not from a rule that applies the same to all children.

How does PECS help children who are not yet speaking?

PECS can help because it offers the child a concrete, visual, and functional way to communicate. Instead of relying exclusively on speech, the child gains an alternative way to express needs and intentions.

It helps to initiate communication.

One of the most important features of PECS is teaching the child to initiate interaction. Many children with communication difficulties only respond when the adult asks. Others expect the adult to guess what they want. In PECS, the child learns that they can go to their communication partner and hand over a picture to communicate.

This point is particularly relevant in children with autism, because the difficulty may not only lie in words, but also in social initiative, joint attention, and the functional use of communication. Therefore, strategies of language stimulation at home They can complement PECS, provided they are tailored to the child's profile.

It reduces frustration and behaviors that are difficult to interpret.

When a child is unable to ask for, refuse, or choose, they may use their body to communicate. They may cry, scream, run away, throw objects, grab an adult, or become very angry. These behaviors are not always "bad behavior." Often, they are forms of communication without a clear form.

If a child learns to hand over a picture to ask for "water," "pause," "play," or "help," they may feel more in control of their environment. This doesn't solve all behaviors, but it can reduce some of the frustration associated with difficulty being understood.

It creates a bridge between intention and language.

PECS can help a child understand that communication involves an intention, a partner, and a response. This connection is important because many children don't yet use words, but already have desires, preferences, discomforts, and interests. The system makes this intention more visible.

In the initial stages, communication may be very focused on requests. Later, the goal should be to expand. The child needs to communicate more than just "I want." They also need to say "no," "that's finished," "help," "I like it," "I don't like it," "I'm tired," "look," and "I want to play.".

Does PECS delay speech?

This is one of the most frequently asked questions. The available evidence on augmentative and alternative communication does not support the idea that providing an alternative form of communication prevents speech. On the contrary, when well applied, a visual strategy can reduce pressure, increase communication opportunities, and create more meaningful interactions.

However, this does not mean that PECS will make all children start talking. Some children may develop more vocalizations or words. Others may continue to need pictures, gestures, communication boards, or digital devices. The main goal should be functional communication, not just speech production.

In clinical practice, it is important to avoid two extreme ideas: thinking that PECS "cures" speech impairment, or thinking that PECS prevents speech. Neither of these positions is accurate. PECS is a tool, not a guarantee. Its value depends on the child, the quality of implementation, motivation, context, and specialized follow-up.

The PECS phases explained in a simple way.

PECS is organized into stages. This progression helps the child move from simple exchanges to more complex forms of communication.

Phase 1: Learning how to change an image

The child learns to pick up a picture of something they want and give it to a communication partner. The goal is to understand that the image serves to communicate and that communication has consequences.

Phase 2: Communicate persistently.

The child learns to seek out the adult, move towards them, and persist in communication. This helps to generalize the skill to different spaces, people, and moments.

Phase 3: Choose between images

The child learns to distinguish images. Instead of always using a single image, they begin to select the image that corresponds to what they want to ask for.

Phase 4: Building simple sentences

The child learns to use a structure, such as "I want" followed by an image of the object or activity. This phase brings the system closer to a more linguistic organization.

Phase 5: Answering questions

The child learns to respond to questions like "what do you want?". While useful, this phase should not replace spontaneous communication. Responding is different from initiating communication.

Phase 6: Comment

The child learns to use the system to comment on what they see, hear, feel, or perceive. This phase is essential because communication is not just about asking for things. It's also about sharing attention, interest, and experience.

PECS at home: what parents should know

PECS may seem simple, but it must be used with guidance. Creating cards and asking the child to hand them out isn't enough. The family needs to understand when to use it, how to respond, how to avoid dependence on prompts, and how to create natural opportunities.

Some important precautions:

• Choose images of items that are truly motivating for the child.
• Use few images at the beginning, but with a clear intention to expand vocabulary.
• Don't turn every interaction into a training session.
• Respond quickly and consistently when the child communicates.
• Avoid constantly asking the child to repeat the word aloud.
• Use the system in real-life routines, such as snack time, bath time, playtime, and leaving the house.
• Involving the school, family, and other caregivers is crucial for consistency.

Home use should be functional. The child should understand that communication serves to influence the world, not just to match cards. Therefore, PECS should appear in natural moments and not be kept in a folder used only during consultations.

PECS in schools and in social contexts

At school, PECS can help a child ask for help, choose activities, respond to routines, participate in play, and communicate basic needs. But the goal shouldn't just be the child's adaptation to the school environment. The environment must also adapt to allow for communication.

Teachers, assistants, and therapists need to know where the communication book is, how to respond to the child's attempts, and how to create opportunities for participation. If the system is only used with a specific adult, the child may not generalize the skill.

Ideally, the PECS should be aligned with the objectives defined in speech therapy for children, with family and school. Communication should be worked on in the contexts where the child actually lives, learns, and plays.

Limitations of PECS

PECS can be useful, but it has limitations. Not all children respond in the same way. Some have difficulty discriminating between images. Others are not interested in the objects used as motivation. Some may only use the system to ask for things, without developing comments or richer interaction. Others may need more robust systems, such as communication boards with essential vocabulary, apps, or voice-enabled devices.

It is also important not to confuse implementation with results. If PECS is poorly applied, with unmotivating images, excessive physical assistance, insufficient generalization, or a lack of communicative objectives, progress is likely to be limited.

Therefore, PECS should be seen as one option within a larger set of communication strategies. For some children, it will be a good entry point. For others, it may be insufficient or unsuitable.

PECS, autism, and functional communication

In children with autism, communication can be affected in various ways. Some do not speak. Others speak, but use few words with social intent. Some repeat phrases, but have difficulty asking for help or sharing interests. Others know how to name objects, but cannot communicate discomfort.

PECS can be especially helpful when a child needs to learn that communication is an action directed at another person. It's not just about identifying images. It's about creating a communicative exchange.

However, autism intervention should be broader. It can include play, joint attention, turn-taking in interaction, understanding routines, social communication, emotional regulation, and family support. PECS can be a tool within this plan, but it should not be the entire plan.

When should you seek expert evaluation?

You should seek evaluation when a child is not yet speaking, communicates little, shows frequent frustration, or cannot clearly express their needs. It is also advisable to seek guidance if the school or family is already using pictures but without consistent progress.

The speech therapist can assess whether PECS makes sense, whether the child would benefit more from another augmentative and alternative communication system, or whether a combined plan should be created. This decision should consider the child's current communication, comprehension, communicative intent, motor skills, interests, and the contexts in which they need to communicate.

In many cases, the Online speech therapy It can also help parents adjust strategies at home, especially when the goal is to guide routines, model the use of images, and monitor the evolution of communication. The recommendation should be made on a case-by-case basis.

Conclusion

PECS can help children who are not yet speaking because it offers a concrete way to initiate communication. For some children, this bridge reduces frustration, increases autonomy, and creates more opportunities for interaction. For others, it may only be a step before more complete systems or other forms of communication.

The essential point is not to wait for speech to enable communication. A child who does not yet speak continues to have desires, interests, discomforts, choices, and ideas. Giving them a way to express themselves is not giving up on speech. It is recognizing that communication begins before words.

When well-chosen and properly implemented, PECS can be a relevant tool. However, it must be used judiciously, with functional objectives and professional supervision, especially when dealing with young children, autism, language delays, or complex communication difficulties.