Using PECS for Language Delayed Toddlers

Many young children need another way to communicate before they learn to talk. Speech-language pathologists often recommend that parents introduce pictures to help give a child an additional way to express his wants and needs. The most popular method for beginning to teach children to communicate with pictures is The Picture Exchange Communication System, commonly called PECS.

There are lots of myths and misconceptions concerning PECS. First of all, just because you’re using pictures doesn’t necessarily mean you’re using PECS. PECS is a very specific and systematic protocol for teaching a child to request items that he wants using pictures. This program was authored by Bundy, an applied behavioral analysis psychologist, and Frost, a speech-language pathologist in 1985. This program began as a way to teach autistic children to communicate, but it’s been expanded and used in a wide variety of populations and ages.

PECS consists of 6 very distinct phases based on the principles from the fields of applied behavioral analysis (ABA) and speech-language pathology.

If you’re just placing pictures out in front of your child and letting him choose which one he wants, you’re not using PECS. If your SLP is encouraging you to take digital pictures and hang them on the fridge in hopes that your child will point to what he wants, you’re not using PECS. If you are showing him a picture to help him understand what comes next in his day, you’re not using PECS. These are all very valid methods for using pictures to communicate and process language, but they are not PECS.

PECS is a very specific program outlined in its latest version in 2002 in a training manual that’s helpful for both clinicians and parents. You can get more information on ordering this system at the website at I highly recommend that parents who want to begin to use PECS with their children should order the manual and read it from cover to cover. It’s an easy read and very parent-friendly. Don’t depend on your SLP to teach you or to implement the program in the way it was intended. Read it yourself so that you know exactly how to introduce each phase. Using the phases just as they were intended is the quickest and easiest way to successfully implement this sytem for your child. Don’t cheat! Do it correctly, the first time!

(Just a quick note – I have also purchased additional used copies from e-bay. It’s cheaper than new, but you may get a highlighted, dog-earred, or stained copy, but that’s usually okay for me and the parents of children on my caseload!)

This information about PECS is directly from their website –

“PECS begins with teaching a student to exchange a picture of a desired item with a communicative partner, who immediately honors the request (a mand within Skinner’s terminology). Rather than verbal prompts we use our unique 2-Person Prompting Procedure, building immediate initiation while avoiding prompt dependency. The system goes on to teach discrimination of symbols and the development of simple sentences. In the most advanced Phases, individuals learn to respond to statements and questions (i.e., intraverbals) as well as learn to comment about common items and activities (i.e., tacts). Many preschoolers using PECS also begin developing speech.”

In real-life parent language, this means that you first select items that you KNOW your kid is going to want and take pictures of these. Things I always use with kids are snacks (think junk foods not green beans) or highly preferred toys. You can use PECS or Boardmaker pictures (colored drawings similar to cartoons), but I do usually take pictures witha phone or a digital camera, print them, and then laminate them so they are EXACT visual representations of what the child wants and can stand up to attempts to throw, tear, and eat them! Kinkos laminates pictures cheaply, or you can go the really cheap route and use clear shelf-liner paper or clear packing tape to cover your pictures. If you think you are going to use PECS for a while, go ahead and invest in a $30 laminator from an office supply place or WalMart. It’s worth the money.

Initially I don’t enourage parents to spend lots of money on supplies other than the a way to take and laminate the pictures. If a parents doesn’t own a smart phone, get a digital camera (which most people have or can borrow).  Places like WalMart and Walgreens are cheap alternatives for printing pictures if a family doesn’t already have a decent printer. Don’t rush out and buy the velcro or a special notebook until you know you’re going to be using this system for a while.

I actually also loan parents my copy of the PECS manual to read initially, then they buy their own when we decide this is a method we’re going to use for a while. But again, if your SLP isn’t providing you a copy of the real thing, go ahead and purchase the manual yourself. You may have to end up letting her (or him) borrow your copy to learn how to do it correctly!

Also remember that PECS takes two adults to implement. One adult is the one who “prompts” the child to by holding the item the child wants to entice him to trade his picture for the item and then holding out the other hand to accept the picture. The second adult is the “helper” who sits behind or beside the child and physically helps him pick up the picture and give it to the other adult. You MUST have 2 adults to use PECS initially. This is a deal breaker if you don’t. Wait to practice until Dad comes home, Grandma is there, or during therapy time. I have trained older siblings as young as 6 or 7 to help too.

One other word of caution – This is supposed to be mostly a nonverbal cueing system, meaning that children are supposed to learn to trade pictures for items they want WITHOUT LOTS OF VERBAL INSTRUCTION. This is HARD for some parents. If you are saying too much during the initial phases, you’re defeating the whole purpose of PECS. I have had parents who repeatedly say, “Give me the card! Where’s your picture? You have to give it to me. I’m not giving you this until you pick up the card, etc…..” Don’t do this! Prompt in just the way the PECS manual says!

Another misconception about PECS is that it is only for nonverbal children. While it can be used it this way, it can also be used to teach interacting/social skills for a child who is verbal but doesn’t communicate very well. For example, some children talk, such as labeling pictures or quoting from their favorite movies, but they don’t understand how to initiate a request to ask for that they want. PECS teaches children how to approach another person and begin interaction by systematically training these skills using pictures.

Initially requesting is targeted in PECS, but later phases also work on responding to questions and commenting (I see, I hear, etc….)

In the middle phases of PECS you’re also going to be teaching picture discrimination so that you can be sure your child can tell the difference between pictures. This is helpful because sometimes children select pictures with no real communicative intent. PECS eliminates this because you’ll be using a picture of an item your child doesn’t want. What a lesson to learn! If you give mommy the wrong picture, you get the wrong item! It’s a very tough lesson to learn, but how else can you be sure your child is really choosing? Many parents want to skip this phase and begin to offer choices for pictures too soon. They give two pictures for things their child may really want, so he never learns to look at the pictures and “choose.” This approach teaches this important skill like no other method I’ve ever used. When children master this phase, they are purposefully choosing and discriminating between pictures for items. That’s communicating!

One other great skill PECS teaches is helping kids learn to seek out other people to communicate. It requires that children lean across a distance or walk across the room  to trade a picture for an item they want. Again, this approach teaches this skill in a very concrete way. Once children learn to do this, they almost always begin to “lead” their parents to what they want (if they haven’t done this already!).

Some parents are afraid that using pictures to teach their child to communicate may mean that their child will never learn to talk. Let me beg you to change your mind! Using PECS (or another alternative method like sign language) actually INCREASES the likelihood that a child will become a verbal communicator! Research has confirmed this with PECS. For more information on these studies visit the PECS site. In my opinion, a child who isn’t going to talk for a long time absolutely needs to learn another way to communicate. As his parent, you should want that for him to save yourself some frustration and heartache!


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