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 www.pecs.com. 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!

Laura

Sign Up for your
Free Book

FREE-EBOOK

Subscribe

Subscribe to the Podcast in iTunes

Browse Products

Featured Product

Recent Posts

Teach Me To Talk Testimonials

Happy Therapists, Teachers, Parents & Children

"Hello Miss Laura,

First, I would like to thank you for all you do for us moms who are lacking support in the autism community, and thank you for providing tons of information and resources to help our bright children. I myself benefited so much from watching your videos and reading your daily emails. I cannot stress enough how much all this information helped my toddler. Of course, getting an autism diagnosis for your child is extremely scary (she was diagnosed at 2 years old) and I was depressed and did not know what autism was, how it affected children, and how to teach children struggling with this condition. However, your videos helped me to find light in my child and now I am your biggest fan! I rewatch your videos over and over again to make sure I didn't miss anything that can help my daughter. I even purchase two books- Autism workbook and Teach me to Play. My toddler was completely non-verbal, she didn't know how to imitate, no eye contact, no pointing.. you name it she didn't have any skills and I didn't know how to teach her! And that is until I discover ed You- my toddlers (Fairy: smiling_face_with_3_hearts:)!

Now she is little sweet 2.5 years old and she says "mama" (I cried when she said that magic word), she waves bye bye or hi, she points, she gives "high 5", her joint attention is great and overall she is doing so much better! And that's all because I have been doing everything you described in your books and videos! I. My mind I always play "repetition, repetition and repetition", teaching her everything through play that she so much enjoys!!! I can write forever explaining how much I taught her through yr videos and books! And the most amazing thing is that her speech therapist is a big fan of yours as well so it worked out perfectly since we understand each other and work based on your teachings! The therapist even owns the same books I own ...I am so grateful that my toddler has such an amazing therapist; especially the one that understands autism and is ready for a real challenge! God bless you for all you do and I cannot wait for my toddler blossom.. you gave me hope and lit the light inside me. And I'm determined to work with my girl :)"

"Dear Laura Mize and Team,

Thank you so much for all your hard work and publishing books! Our 17-month-old toddler suddenly exploded into speaking and imitating everybody's gestures and sounds, just a week or two after we 'completed' all activities that are listed under 11 pre-linguistic skills! Your method really works!"

Grateful customer.

"Hi Laura!

I absolutely LOVE all of your workbooks, especially your Autism Workbook. Starting with Social Games has been a game changer for many of my littles with ASD and their families. It's been the best way for them to finally connect and sustain shared attention and engagement, leading to longer social interactions, through play!"

Jodie, Dev, Therapist

"Hi Ms. Laura,

Thank you so much for the videos you have posted on your youtube channel. They are so direct, informative, and helpful. Thank you for being a resource for me to become a better therapist."

Dianne

"Hi Laura - I just wanted to say I received my copies of the Apraxia workbooks yesterday and I LOVED workbook 1 (not ready for 2). I'm on chapter 8 and going through the questions carefully so I'm prepared to help my son. I knew it was a great book when you acknowledged the fact that sometimes therapists and doctors don't bring a positive and supportive vibe when diagnosing. I remember being terrified at the mention of apraxia and ASD by both because they had these very concerned looks and made it seem like it was a death sentence. I know now (in LARGE PART, THANKS TO YOU AND YOUR VIDEOS) that it doesn't have to be!! I see a future for him now. You SINGLE-HANDEDLY, through your books and videos have empowered me to help my son after the doctors and therapists have gone home. You've given me strategies, play ideas, plans on how to keep moving forward. I don't always do things right, but I know I'm on the right track and I love that I can reference, and re-reference your books to help me keep going. As I was reading the book, I was so proud of myself because I've used strategies from your previous books and it felt good because I could check off a lot of the skills that you discuss. So, thank you for all your previous books as well!!"

"Gosh, I love all of your emails/podcast/website, just everything!! I work in early intervention as a behavior analyst and am learning so much from you!"

Thank you!

Hailey

 

"Laura,

I love your work! I am a professor of early childhood special education and a speech language pathologist! I have worked to help children learn to communicate and I know how valuable the information you share is for both early interventionists and pediatric speech language pathologists!

Thank you for systematically organizing and explaining essential steps for young children to learn and develop. You are having a great impact on our profession, the ECE profession and families!"

Sincerely,

David

"Thank you.

If this is Laura herself reading this email let me take this opportunity to thank you from the bottom of my heart for all that you have put forth for us professionals. I own every manual (except the autism manual) and have watched every course on DVD. I have listened to countless podcasts. All of what I’ve come to be as an Early Intervention speech therapist was absolutely to your credit. With your resources at my side I have never needed to scramble for answers and strategies and above all the clear language I use when communicating with parents. My fun, animated affect and key phrases I use have been learned through watching your example. So….thank you! May you be blessed."

Chaya

"I just wanted to thank you so much for your incredible help! You are so kind and lovely and every time I implement something you've taught in your manuals or videos it is always a success, I cannot thank you enough. I really appreciate how specific you are in giving us examples of wording to use and how to use a toy in therapy with your videos, it is exactly what I need to properly help my little students. I also really appreciate your list of books of list of toys. I have seen my little students make significant progress thanks to you. I'm looking forward to watching more of your videos, taking more of your CEU's, and reading more of your materials. From the bottom of my heart: thank you so much again!!"

Lauren

"Dear Laura,

What an inspiration!

Thank you for helping me be a better Developmental Therapist. I often listen to your podcasts which help me help families.

Your enthusiasm, professionalism and
the sheer volume of information is so great.

You are part of my team.

I just wanted you to know I appreciate you."

Margaret

"Dear Laura,

Thank you for your generosity in sharing so much knowledge in such a clear and enthusiastic way.

As a retired audiologist with a fabulous and language delayed grandson, I used your podcasts and outstanding publication, The Autism Workbook, to inspire and guide me over the past year.

It works!! He went from barely verbal, no gestures, didn't respond to his name etc etc to a verbal, social, curious, ready to imitate anything, fill in the blanks on familiar "set" speech, generate his own totally appropriate and mostly understandable sentences...not just short phrases anymore... full little paragraphs...about imaginary things, what he did during the day, what he wants. True communication!

You make a powerful difference in this world! ❤"

With gratitude,
Diane

"Laura Mize, you are a Godsend. I don’t know how one human can have so many helpful things to say in a beautifully organized way, so often. Always amazes me when another super helpful email comes from you, and for free. With free YouTube videos and cheap CEUs. THANK YOU!!!"

Sheila, Canada

"I purchased the book on autism and have watched the #400s series podcasts. Laura Mize has been more effective in teaching autistic tendencies, than many professors, shadowing professions, and the 100s of books, articles and classes or videos, or live workshop speakers, have been at teaching effective practices for a child with ASD. Some of the many lessons she has taught, which I will now use, to be a more effective Interventionist, include but are not limited to: red flags, typical behaviors, self-stimulating behaviors, not taking away toys, rather showing child to play with toy appropriately. She gives examples of child's actions, "inappropriate," explains the reason for: why the child is engaging in these behaviors and how they can be replaced with more appropriate, effective fuctional and age-appropriate skills."

"I’m sure Laura gets these messages all the time, but I thought I’d share. I stumbled across Laura‘s "Autism or Speech Delay?" YouTube video when I really needed it. This video finally listed and explained some of the red flags my son was showing for autism. I share the link anytime a parent is questioning in my FB autism group. This mother I don’t even know said Laura's video changed her life. I know exactly how she feels because It changed families too. Thank you to everyone at Teach Me To Talk."

LINDSAY

"Good Morning Laura,
I received your book (The Autism Workbook) yesterday and it is absolutely amazing! As I evaluate young children (0-3) for developmental delays and write plans for them with their parents, there are a ton of ideas that are ready to use. Others that reinforce what I have been doing, and saying, all along. Thank you so, so much for writing this incredible book and pulling everything together in one place!"

FRANCINE IN MICHIGAN

"Thank you very much for sharing your knowledge, experience, and guidance.
I’m a parent who bought the autism workbook and it’s the only clear resource I found to make a change in my son. I’m really thankful to Ms. Laura for helping out people like us all over the world."

"Laura Mize, all I have to say is that ALL YOUR STRATEGIES WORK."

ANNE, YouTube viewer

"We have 7 SLPs in our preschool (public) program for special needs children (ages 3-5) and we use your courses, books, and techniques every day! :-) We have seen our preschoolers make such great gains!"

 

"I just received Teach Me to Play With You, and it is ALREADY WORKING! WOW!

Girl…my son is 3 years old, and he NEVER asks for something using words. We were playing “Get Your Belly” (from Teach Me to Play WITH You), and after several times, he laughed and screamed "BEWIEEE!!!"  It was a hoot. And I can't believe he said it! I have played with him like this before, but this time I took your advice and acted CRAZY!! I will act like a total lunatic if it will get him to talk to me!  Now I can give him "the look" from across the room, and he will say it. That manual is so amazingly practical, and it is a GODSEND right now! Thank you SO MUCH!”

"I wanted to send you a quick email to say thank you. I started watching your videos/podcasts about 4 months ago. My son has gone from losing words he previously used, only having about 7 words at his 2 year check up in August (assessed at a blended 10 month language level) -- to now having so many words, increased social engagement, following commands, spontaneously requesting things, and naming letters & numbers (not in order) as well as colors. We had our monthly meeting with our SLP through the state infants & toddlers program and it felt like we were just bragging the whole time, but I knew in the back of my head it was because I have been using strategies you taught me.

We still have so much work to do with our sweet boy, but I know in my heart he would not have succeeded without the education you provided. I will continue to read your emails & watch videos as we go along this journey and face challenges, but credit is due to you, Laura.

Thank you so much, endlessly."

KATIE

"I just want to tell how fortunate I feel to have found your website and you!! I became a special instructor in EI almost a year ago and I started with hardly any applicable training. I felt so lost and confused as how to help the kids I work with learn how to use words and play. Honestly, I didn't even understand the importance of play, although I always played with my kids. But, once I started to watch your podcasts and get some of your manuals I felt a weight had been lifted off my shoulders and that I could finally teach these kids and their families something of value from a real therapist and based on research!. Thank you so much for seeing the need to help other EI service providers and providing a forum to share your knowledge and years of valuable experience. I'm sure you get a lot of these emails every week if not every day, but I wanted to make I could add to those notes of gratitude!! THANK YOU again!!"

SS

"Just wanted to say a HUGE thank you for these emails and your books, I have them all and they have seriously saved and improved my sessions with my kiddos. Huge thank you."

REBECCA

"I was very frustrated with how speech therapy was going for my child. I would take him and drop him off and not hear much of anything from his therapist and teachers other than, "He had a good (or a bad!) day." Your materials were invaluable for us because I learned how to work with him on his speech. I learned how to teach him to talk and play. I learned how to pay attention to his cues and work with him to teach him to communicate. Without it, I have no doubt he still wouldn’t talk."

BRITNEY

"Hi! I just wanted to say (from an SLT perspective) how incredibly useful I am finding absolutely all of your articles, blogs and resources - I only discovered your site last month and have just received all your books which I feel I am learning more than on my entire university training course!! But also the way in which you give specific, realistic, fun, encouraging ideas for working with parents is really just fantastic, I only wish I have your site sooner! Thanks so much from the UK! Kind regards."

HANNAH

"I just wanted to reach out to say thank you for making things a little easier to manage for me this year. I made the transition from school SLP to private therapist about a year ago. While the change was welcome, it was a lot, and I was just getting my footing in the clinic when I began teletherapy full time. Your website has been a huge lifeline in helping me work with late talkers and coach their parents in an accessible but effective way, even remotely. I look forward to getting your emails each week. I am floored by the amount of valuable, free information that your website provides, and I’m looking forward to investing in your workbooks soon. A sincere thank you for all you do!"

ALLISON

"You are an inspiration! I am truly grateful for the way you put into words and writing how to do what we do as SLPs. At this time in my 13 years of practicing, I find your encouragement keeps me going. As a single mom, I find it a stretch to buy materials these days and I am so thankful for the freebies you so generously share that help me teach my families. I don’t have much time to put together lists or quick references for parents!! Much gratitude!!"

ANDREA

"I just really appreciate your courses! I have two new clinicians that I’m working with and have recommended these courses to both of them. I’ve watched quite a few and have learned so much about serving this population. To be honest, before I started implementing your strategies I was a little frustrated with the lack of progress. My skills with engaging these little ones have improved so much! Thank you so much for making these CEUs so valuable!" C, SLP
 
 

Laura thank you so much. Btw, you have transformed my therapy- I have become such a competent and strong therapist after watching probably like 350 of your videos and podcasts over the past few years. And I am a seasoned therapist with almost 25 years experience. (Yes prob 350 episodes ha!) But there was still a lot I learned from you. I have such a thorough understanding of birth to 3 development and how to properly incorporate appropriate therapeutic goals, techniques and strategies now, thanks to you. Kelly

 
But I just keep watching and learning because we can always learn something new! 
Thanks for all you do! 

Hi Laura,I want to thank you so much for the resources you provide, my daughter has delayed speech and though she qualifies for CDS. Honestly the most progress she has made in her speech/language development has been after I implemented your 5 top strategies for delayed talkers! She is now almost 2.5 and her vocabulary is well over 75 (I haven’t counted recently, could be over 100) words when at 2 she barely had four words. Honestly the last few months have been a transformation for her.

Ann