PECS

• Replacing words with pictures which will encourage speech. Help children make the first move in communication rather than only responding.
• Frost and Bondy 2002- steps of programme

  Pre-programme- find objects a child finds interesting and motivating used as a reinforcer
• Physical exchange- child/ adult with ASD, facilitator, teacher

  1. Teacher will present motivating object to child

  2. Child reaches and facilitator will encourage to pick up card

  3. Facilitator helps hand over

  4. Teacher won't do anything until after exchange

  5. Rewarded positive
• Increase independence


  1. More distance

  2. Child needs to put in more effort

  3. Learn persistence

  4. More structure

  5. There's a picture book, the pictures will get moved round
• Range of pictures


  • Learning similar pictures
• Answer direct questions with learned phrases


  Exchange answering using learned answer strips
• Commenting and more questions

  1. What do you have/hear?

  2. 'I have a blue ball'

  3. More complex sentence strips
• +     ASD adults can contribute to society and earn a living. Independence. Lowers cost to wider society of social care and welfare benefits.
• Modern day use- Apps
• +      Charlop Christy - 3 boys with ASD. All went through ineffective programmes before PECS, with 2 15 minute sessions every week the boys showed more spontaneous speech, one went from 28% to 100%. And it was maintained 12 moths after. Eye contact and joint attention improved. Less tantrums and disruptions.
• PECS can be learned quickly and easily. Mean time of 170 minutes for all stages
• +      Doesn’t require children to possess eye contact skills before training.
• Attractive face validity to parents
• -      Small sample not generalisable
• -      Flippin- reviewed studies, 8 experiments 18 participants and 3 group studies (95 receiving PECS, 65 control.)

  Limited support for the intervention. Moderate or small gains and no evidence of maintenance
• -      Some evidence of negative effects- delayed speech. Concerns from psychologists. It’s no better than adequate.
• +      Motivating objects, increase success

  +      Rapid progress, increase self-esteem and reduce the stress in family.

  +      Baron Choen- criticism, should find intrinsic reward and not withhold external rewards, they should be free to play as the wish.
• Financial- expensive, need trained and qualified practitioner, Lack of evidence can’t justify expenses