Evidence-Based Practice: Picture Exchange Communication System

Overview of Picture Exchange Communication System (PECS)

The Picture Exchange Communication System (PECS) was developed at the Delaware Autistic
Program (DAP) and was designed to teach young children to communicate in a social context
(Bondy & Frost, 1994; Frost & Bondy, 2002). Using PECS, learners are taught to give a picture
of a desired item to a communicative partner in exchange for the item. There are six phases of
PECS instruction, with each phase building on the last. The phases are: (1) Teaching the
physically assisted exchange, (2) Expanding spontaneity, (3) Simultaneous discrimination of
pictures, (4) Building sentence structure, (5) Responding to, “What do you want?” and (6)
Commenting in response to a question.

Five studies were found to meet the evidence-based practice criteria and serve as the evidence
base for PECS. Two of the studies were randomized, controlled group designs, and three were
single subject studies demonstrating control through a variety of research designs including
multiple baseline, alternating treatments, changing criterion, and withdrawal.
With what ages is PECS effective?
In the five studies documenting the evidence base for PECS, the youngest child was three
years of age, and the oldest was twelve years old. Specific numbers of participants and age
data can be found in the evidence base below.
What skills or intervention goals can be addressed by PECS?
In the evidence-base, communication, social, and behavior skills were the primary targets for
In what settings can PECS be effectively used?
The research evidence suggests that PECS can be used in multiple settings, including schools,
homes, and therapy settings.
Brief Package:
 [PDF, 719446KB ] 10/01/2010

Brief Components

 [PDF, 33108KB] 10/01/2010
Evidence base:
 [PDF, 23904KB] 10/01/2010
Steps for Implementation:
 [PDF, 106919KB] 10/01/2010
Implementation Checklist:
 [PDF, 139352KB] 10/01/2010