PECS: Flexing the Power of the Picture Exchange Communication System

PECS, or the Picture Exchange Communication System, enables individuals who have little or no verbal language skills to communicate with others through pictures. The system was first developed in 1984 for use with preschool children who had autism. It has since been used with adults and children across a wide variety of conditions including aphasia, apraxia, cerebral palsy, and Down syndrome.

PECS consists of six phases that systematically build skills so that the individual can learn to initiate interactions and communicate with others.

The Six Phases:

1. How to Communicate

In this stage, the individual gives a single picture of a highly desired item or activity to a communication partner who immediately responds to the request. This stage helps the individual to learn that communication is an interaction with others and can help to meet wants and needs.

2. Distance and Persistence

Once a basic communication exchange is mastered,  the individual is taught to generalize the communication exchange to include different people and different places. They will start to travel across the room and persist in the communication efforts.

3. Picture Discrimination

At this phase, the individual learns to select the desired picture when given a selection of two or more pictures. They start to communicate their choice.

4. Sentence Structure

Using a sentence strip, the individual starts to learn to build a sentence using the “I want” phrase and then selecting the picture of the desired picture to complete the sentence (example- “I want bubbles”). This sentence structure is expanded by adding different adverbs, adjectives, and prepositions

5. Responsive Requesting

Learning to respond to the question “What do you want?” is the focus of this phase.  Instead of initiating a communication interaction, they are responding to someone else’s.

6. Commenting

The final stage expands the individual’s communication skills so that they can comment in response to questions like “What do you see?”, “What is that?”, “What do you hear?”.  Sentences will start with phrases such as “I see”, “I hear”, “I feel”, and “It is.”


Since PECS is highly structured and initially requires an individual to only point to a picture, most individuals can become successful communicators using this system. It is a great low tech, low expense option that can crack the door to communication and self-regulation for non-verbal and minimally-verbal individuals.


Example- “I want the red ball.”

Some parents worry that PECS will interfere with their child’s ability to learn to use words. However, research has shown that some children who use PECS will also develop speech. Children will communicate in whatever form is easiest for them. So, as a child develops speech, they will utilize verbal communication over selecting pictures.  PECS may help a child organize language in a way that they can understand it. For children who remain non-verbal, the skills used with PECS can often transition to speech generating devices to future expand language.

If your child or loved one struggles with verbal communication, Enablr Therapy can help. We have a team of highly skilled and experienced speech language pathologists who can assess speech and language skills and create a personalized intervention plan.

Contact us to learn more or browse our roster of therapists to book directly!

About Enablr Therapy
Enablr Therapy offers speech, occupational, and physical therapy to people of all ages and abilities through our school-based therapy services as well as cash-based services for individual clients. Individual clients can be seen through convenient online sessions in many states across the country.