PECS stands for the Picture Exchange Communication System, and the ke word in that name is exchange. Your child does not point at a picture or tap one on a screen. They pick up a card, carry it to a person, and place it in that person’s hand.
That difference sounds small, and it changes everything. Pointing works only if an adult is already watching. Handing something to someone requires finding a person, getting their attention, and completing a social act. That is communication rather than indication.
Here is how the system works, what each of the six phases involves, and what the research says about the question nearly every parent asks first. Most of what follows comes from running these phases in family kitchens and classrooms, which is where our ABA programs spend the majority of their time.
If your child has no dependable way to ask for what they want yet, that is the gap picture exchange was built to close. It is one of the first things our team at Achieve ABA Therapy Group looks at when a family tells us that mornings have turned into a guessing game.
Definition of PECS
PECS was developed in 1985 by Andy Bondy and Lori Frost, working with preschoolers at the Delaware Autism Program. They noticed that most communication teaching at the time depended on an adult starting the interaction, and they wanted a system where the child moved first.
The exchange is the skill
Plenty of children can point to a picture of juice. Far fewer can find that picture, cross a room, locate an adult, and put the card in their hand. PECS teaches the second version, because the second version works when nobody is paying attention yet. It is also why PECS is not the same as a choice board on the fridge, which only answers a question an adult already asked.
Why nobody talks during the early phases
One of the most surprising things parents observe in a first PECS session is the silence. In Phase 1, no verbal prompts are used at all. No “what do you want,” no “use your picture,” no “give it to me.”
This is deliberate. A child who learns the exchange alongside a spoken cue tends to wait for that cue before doing anything, which produces a child who communicates only when asked. Removing the words from the start builds a child who initiates. It feels unnatural for about a week, and then it feels obvious.
Where PECS sits among communication systems
PECS is one form of augmentative and alternative communication, the broad category that covers picture systems, sign language, and speech-generating devices. The American Speech-Language-Hearing Association describes AAC as anything that supplements or compensates for difficulty with spoken or written communication.
In the 2020 review by the National Clearinghouse on Autism Evidence and Practice at the University of North Carolina, PECS stopped being listed as its own evidence-based practice and was folded into the broader AAC category, where it is supported by 47 single-case design studies. That reclassification is a bookkeeping change rather than a downgrade, but it is worth knowing if you go looking for PECS on the list of 28 evidence-based practices and cannot find it by name.
The Six Phases of PECS, Step by Step
Each phase has a specific goal and a specific set of criteria for moving on. Knowing which phase your child is in tells you what to expect at home and what not to push for yet.
| Phase | What Your Child Learns | What Changes for You |
|---|---|---|
| 1. Physically assisted exchange | Hand a single picture to a person to get the item | Two adults, no talking, guidance from behind |
| 2. Expanding spontaneity | Travel to the book and to a person, with more people and places | Move farther away, add partners and settings |
| 3. Picture discrimination | Choose the right picture from several options | Add pictures, check they take what they asked for |
| 4. Building sentence structure | Build a request on a sentence strip | Read the strip aloud and pause before naming the item |
| 5. Responding to a question | Answer when asked what they want | Ask, then wait a little longer each time |
| 6. Commenting | Label what they notice, not just what they want | Respond with praise rather than the object |
Phase 1: The physically assisted exchange
Two adults are required. One sits across from your child as the communicative partner, holding something your child badly wants. The second sits behind or beside your child as the helper, and physically guides the hand to pick up the card and place it in the partner’s open palm.
The helper’s physical assistance fades first, working backward from the last step of the exchange. Only after that does the partner stop holding out an open hand. Your child is ready for Phase 2 when they reach for the item, pick up the card, hand it over, and receive the item without help.
Phase 2: Expanding spontaneity
Now distance enters the picture, in two directions. Your child learns to travel to the communication book to get a card, and to travel across the room to find a person to give it to.
This is also where you add communication partners and settings. Siblings, grandparents, the babysitter. Kitchen, car, park. A child who only exchanges with one parent in one room does not yet have a communication system, they have a habit.
Phase 3: Picture discrimination
Phase 3 starts with only two cards: one showing something your child loves, and one showing something they do not want at all. That contrast is intentional, because it makes the difference between the cards meaningful immediately.
Clinicians run correspondence checks here, which means handing your child whatever they asked for rather than what you assume they meant. If a child hands over the pretzel card and then pushes the pretzel away, that tells us the picture is not yet carrying meaning. Cards also get moved around the book on purpose, so your child cannot succeed by remembering a position.
Phase 4: Building sentence structure
A sentence strip appears, with a starter card fixed on the left. Your child places the item picture beside it, pulls off the whole strip, and hands the strip over.
One detail here is quietly important. When the partner reads the strip aloud, they pause before naming the item. That pause is a small open door. If your child fills it with any sound at all, the item comes immediately along with warm praise. This is where spoken words often first appear, and it happens because the structure invites them rather than demands them.
Phase 5: Responding to a question
Your child learns to answer a direct question about what they want. It begins with a simultaneous point and question, then the gap between the two grows.
The goal your team is watching for is your child beating the prompt, meaning they answer before the pointing finger arrives. Requesting on their own must continue throughout this phase, because a child who only responds to questions has traded one kind of dependence for another.
Phase 6: Commenting
Everything up to this point has been about getting something. Phase 6 is about noticing something and telling a person about it, which is a different and much harder skill.
A new starter card is introduced for observations, and here is the part that surprises families: when your child comments on an object, they get praise and attention, not the object. The reward for sharing an observation is the social response. Learning that distinction is a genuine developmental step.
How long all of this takes varies enormously. One frequently cited study found an average of roughly 246 training trials to move through all six phases, which sounds like a lot until you realize a busy morning can hold twenty opportunities.
Will PECS Stop My Child From Talking?
This deserves a direct answer rather than reassurance, because it is the concern that stops families from starting. Some parents worry that giving a child an easier route will remove any reason to attempt the harder one.
What the research shows
A systematic review by Schlosser and Wendt examined studies of AAC intervention and speech production in children with autism, covering nine single-subject studies and two group studies. The finding was that AAC interventions do not impede speech production, and most of the studies reported an increase. The authors were careful to add that the gains were modest, and that families and clinicians should hold realistic expectations.
Modest is the honest word. PECS is not a speech treatment and no one should choose it expecting talking as the outcome. It is a communication system, and communication is what it reliably delivers.
Why the worry makes sense anyway
The fear is not irrational. It comes from watching your child struggle and wanting the struggle to produce speech rather than route around it. I have sat with parents who felt that agreeing to picture cards meant giving up on something.
What shifts the feeling is watching what happens once a child can ask. Frustration drops, mornings get shorter, and a child who can communicate ends up in far more conversations, which is where speech has its best chance of showing up.
What we watch for when speech starts appearing
If vocalizations emerge, we do not pull the cards away. We reinforce both, honor the exchange, and let speech take over on its own timeline as it becomes the faster option for your child.
This is one of several areas where a behavior analyst and a speech-language pathologist should be talking to each other directly. Our overview of who does what across disciplines is a useful primer before that first joint call.
Making PECS Work at Home
Home is where PECS is either reinforced or quietly undone. None of what follows requires special training, but all of it requires everyone in the house doing the same thing.
Give the book a permanent home
The communication book needs one location that never changes, low enough for your child to reach without asking. A kitchen counter beside the fridge works well because that is where a lot of wanting happens.
Make a second copy. Books get left at school, in cars, and at grandparents’ houses, and a missing book means a child with no voice for the afternoon.
Honor every exchange, including the inconvenient ones
This is the hardest rule. If your child hands you the cookie card at 5:45 while dinner is cooking, the cookie should appear. Early on, the exchange has to work every single time, or your child learns that the cards are unreliable and goes back to whatever used to work.
You can manage this by controlling what is in the book rather than by refusing requests. If cookies before dinner are a problem, the cookie card comes out of the book until after dinner. Once your child is fluent, delays and gentle refusals can be introduced deliberately by your team.
Expand past snacks
Almost every book starts as a food menu, because food is motivating and easy to control. A book that stays a food menu limits your child to talking about eating.
Add cards for activities, people, places, and help. Bubbles, tickles, outside, music, bathroom, all done, help me. The bathroom card in particular pairs naturally with the kind of routine work described in our guide to toileting routines.
Recruit everyone who spends time with your child
A child whose grandparents guess correctly without the book is a child with a reason to skip the book. Kind, well-meaning mind reading is the most common thing that stalls progress at home.
One short conversation usually fixes it. Our parent training sessions often include the extended family for exactly this reason, and families using in-home ABA can have a therapist coach grandparents directly in the room where it happens.
Troubleshooting Common PECS Problems
Nearly every family runs into at least one of these. All four have specific fixes rather than requiring you to start over.
My child grabs the item instead of exchanging
Expected, especially early. The helper interrupts the reach and redirects the hand to the card, without saying anything, so the reach becomes the beginning of an exchange rather than a failed attempt.
Grabbing sometimes intensifies for a few days once it stops working, which is a normal pattern rather than a sign the plan is failing. Our post on why behavior spikes explains the shape that usually takes.
My child hands me the whole book
Usually a Phase 3 problem in disguise. Handing over the book means the individual cards are not yet carrying distinct meaning, so your child is offering everything and letting you sort it out.
The fix is to go back and reduce, not to push forward. Fewer cards, stronger contrast between them, and correspondence checks until each picture reliably predicts a specific outcome.
My child picks by position rather than meaning
Children are excellent at finding shortcuts. If the juice card is always top left, your child may be selecting top left rather than juice.
Move the cards around constantly. If discrimination is still shaky, the standard trick is to increase contrast temporarily: make the target picture larger, keep it in color while the distractor is black and white, or use a blank card as the alternative. Those supports get faded once the discrimination is solid.
Progress has stalled and nobody knows why
Before assuming the phase is too hard, check the reinforcer. A card only works if the thing behind it is genuinely wanted today, and preferences shift week to week.
The free PECS resource packet from the AFIRM team at the University of North Carolina includes a preference checklist and a phase-by-phase troubleshooting list you can work through with your team. It is 21 pages, free, and written to be used rather than admired.
PECS, Sign Language, and Speech Devices
PECS is not the only option, and it is not automatically the right first choice. Which system fits depends on your child’s motor skills, their visual attention, and where they spend their days.
Where a speech-generating device may fit better
Tablets and dedicated devices produce spoken output, which means anyone within earshot understands the message without knowing your child. They also carry hundreds of words without a binder full of laminated cards.
The trade-offs are real: cost, breakage, battery life, and the fact that a device can be more distracting for some children than a paper card. Some families start with PECS and transition, and that transition tends to go smoothly because the underlying skill of initiating with a symbol has already been built.
Where sign language fits
Signs are always available and cost nothing. The limitation is the audience, since a fluent signer can still only be understood by people who know the signs. Many children end up using several modes at once, which is a healthy outcome rather than a confused one.
Who should be making this decision
A speech-language pathologist and a behavior analyst, together, after watching your child rather than after a conversation about preferences. If your child has not been formally evaluated yet, our autism evaluation team can start that process, and our walkthrough of the first assessment explains how communication targets get chosen.
How to Tell If PECS Is Working
Progress in the early phases can be hard to see from inside a busy week. These three measures give you something more reliable than a general impression.
Count the exchanges your child starts
Not the ones you set up, and not the ones that followed a question. Count the times your child crossed a room and handed you a card because they decided to. A tally on the fridge is enough.
- Spontaneous exchanges per day.
- Number of different people your child has exchanged with this week.
- Number of different rooms or settings where an exchange happened.
- Number of distinct cards used, rather than total exchanges.
Watch what happens to frustration
Many families notice a drop in screaming, grabbing, or dropping to the floor before they notice any communication milestone. That drop is data. Behavior doing the work of communicating becomes unnecessary once a faster option exists.
Check whether the vocabulary is growing
A book that has held the same eight cards since spring is a warning sign. Vocabulary should expand steadily, and should increasingly include things beyond food.
If there is one idea worth carrying out of this, it is that the first exchange is not really about the picture. It is the moment your child learns that a specific action, directed at a specific person, reliably changes what happens next. Everything after that is vocabulary.
Start by noticing what your child already wants badly enough to work for. That preference is the fuel, and it is the one thing no protocol can supply for you.
If you want help deciding whether PECS is the right fit or getting the first phases running, our early intervention and in-home teams work with families in Denver, Aurora, Colorado Springs, Loveland, Longmont, Greenwood Village, and communities across our service areas.
Call 720-463-9000 or reach out here. If you are earlier in the process and just working out where to begin, our step-by-step walkthrough covers the practical order of operations.
FAQs
These come up in nearly every parent training block we run, from Greeley to Grand Junction.
What age can a child start PECS?
There is no fixed minimum. PECS has been used with toddlers and with adults. What matters more than age is whether your child wants things, since a strong preference is the engine that drives the first exchange. Children who can pick up a small card and release it into a hand generally have the motor skills required.
Does my child need to be nonverbal to use PECS?
No. Plenty of children with some speech use PECS, particularly children whose words come and go depending on stress, or whose speech is hard for unfamiliar people to understand. The question is whether your child has a reliable way to communicate, not whether they have any words at all.
Do I need special cards or an official kit?
No specific pictures or symbols are required. Photos you take on your phone, clip art, or product packaging all work, and for some children a photograph of their own cup beats a generic drawing. What you do need is a dedicated book that holds the cards in one place.
Can I teach PECS myself?
Parents run PECS at home successfully every day, but the protocol has specific procedures, particularly the Phase 3 error correction sequence, that are easy to get subtly wrong. Training through Pyramid Educational Consultants, the organization founded by the developers, is the standard route for professionals. Most families do best learning the phases alongside a trained clinician and then running it independently.
How long does each phase take?
It varies widely. Some children move through Phase 1 in a handful of sessions, while others spend weeks there. Phase 3 is the most common place to slow down, because discrimination is genuinely harder than exchange. Steady progress within a phase is a better sign than speed across phases.
Will PECS work at school and daycare?
It works well in group settings as long as the adults there are trained and a second book lives on site. Our school-based and daycare-based ABA teams coordinate directly with staff so the phase your child is on is the same at nine in the morning and six at night.
What happens once my child finishes Phase 6?
Phase 6 is the end of the protocol, not the end of communication work. From there the focus moves to expanding vocabulary, adding descriptors, asking questions, and social exchanges with peers. Some children transition toward speech or a device, and others continue with PECS as their primary system for years.
Sources:
- Sam, A., & AFIRM Team. (2025). Picture Exchange Communication System (Updated). UNC Chapel Hill, Frank Porter Graham Child Development Institute, AFIRM. https://afirm.fpg.unc.edu/wp-content/uploads/PECS-Resource-Packet-Sam-AFIRM-Team-Updated-2025.pdf
- Steinbrenner, J. R., Hume, K., Odom, S. L., et al. (2020). Evidence-Based Practices for Children, Youth, and Young Adults with Autism. UNC Chapel Hill, FPG, NCAEP Review Team. https://ncaep.fpg.unc.edu/wp-content/uploads/EBP-Report-2020.pdf
- Nowell, S., Sam, A., Waters, V., Dees, R., & AFIRM Team. (2022). Augmentative & Alternative Communication. UNC Chapel Hill, FPG, AFIRM. https://afirm.fpg.unc.edu/wp-content/uploads/Augmentative-Alternative-Communication-Brief-Packet-Nowell-et-al-2022.pdf
- Tereshko, L. (2022). Picture Exchange Communication System: A treatment summary. Science in Autism Treatment, 19(10). Association for Science in Autism Treatment. https://asatonline.org/for-parents/learn-more-about-specific-treatments/picture-exchange-communication-system-pecs/
- Association for Science in Autism Treatment. Shaping and related ABA technique summaries — parent-facing library index. https://asatonline.org/for-parents/learn-more-about-specific-treatments/
- Flippin, M., Reszka, S., & Watson, L. R. (2010). Effectiveness of the Picture Exchange Communication System (PECS) on communication and speech for children with autism spectrum disorders: a meta-analysis. American Journal of Speech-Language Pathology, 19(2), 178–195. https://www.ncbi.nlm.nih.gov/books/NBK78681/
- Schlosser, R. W., & Wendt, O. (2008). Effects of augmentative and alternative communication intervention on speech production in children with autism: a systematic review. American Journal of Speech-Language Pathology, 17(3), 212–230. https://www.ncbi.nlm.nih.gov/books/NBK76412/
- Charlop-Christy, M. H., Carpenter, M., Le, L., LeBlanc, L. A., & Kellet, K. (2002). Using the Picture Exchange Communication System (PECS) with children with autism. Journal of Applied Behavior Analysis, 35(3), 213–231. https://pubmed.ncbi.nlm.nih.gov/12365736/
- National Professional Development Center on ASD. Evidence-Based Practices. UNC FPG. https://autismpdc.fpg.unc.edu/ebps/
- American Speech-Language-Hearing Association. Augmentative and Alternative Communication (Practice Portal). https://www.asha.org/practice-portal/professional-issues/augmentative-and-alternative-communication