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A Picture is Worth a Thousand Words: 5 myths about the Picture Exchange Communication System (PECS)

Written by: Krysta Beaudry, B.Sc.S., Speech-Language Pathology Graduate Student


What is PECS?

The Picture Exchange Communication System (PECS) is a unique alternative/ augmentative communication training protocol designed to help children and adults with communication, cognitive and physical difficulties engage in functional communication. First let’s talk about communication. Here is a scenario: A little girl attempts to lick her ice cream on a warm summer day, but the ice cream scoop falls on the ground. The little girl stops, gasps and looks at her father. As he turns to her, she looks back at the spilled ice cream and then back to him. She continues looking back and forth between her father and the scoop, until he, too, sees the ice cream scoop and reacts. She has not yet developed any whole words to say but her father certainly understands that she wants him to react. Did she communicate? Some will argue no, since she did not use any words and some will argue yes, because she still got her message across. In fact, she did communicate. Functional communication is defined as an exchange involving at least 2 people where the action of one person is directed toward the other person to achieve a certain outcome. Now, let’s talk get back to PECS. PECS is a specific protocol for teaching expressive use of pictures for an individual to communicate wants and needs, and to comment about the world. PECS has been a controversial subject and a hot topic of research for many years due to the multiple myths related to the system. Below, we will discuss 5 myths related to PECS.





Myth #1: If we’re using pictures of any kind, we’re using PECS

PECS is a specific protocol including 6 distinct phases of teaching, as well as strategies for introducing attributes (e.g., colour and size) into the individual's language where pictures are used to engage in verbal behaviour. The individual progresses through the phases, the following phase expanding on the skills mastered in the previous phase. It combines knowledge from the fields of applied behaviour analysis (ABA) and speech-language pathology (SLP) to produce an effective method for teaching functional communication. PECS certified educators must complete an intensive training in order to properly implement PECS.


Myth #2: PECS is only used for those who are non-verbal

While PECS has been proven very useful and successful with nonverbal children, the system can also help many other populations with the purpose of eliciting and initiating functional communication. PECS is appropriate, not just with children or adults that are not verbally communicating, but with those who are verbal, yet lack person-directed communication, the need for a social approach or spontaneous communication initiation. Populations where PECS might be suitable could be Autism Spectrum Disorder (ASD), Down Syndrome, late-talking children, aphasia, Childhood Apraxia of Speech (CAS), head injury, and others. That being said, PECS can be very effective for those who do not speak but it can also teach important skills to those who do talk.


Myth #3: PECS will prevent the development of speech or interfere with any current speech

As with any other alternative communication system, the use of PECS will increase the likelihood that an individual will become a verbal communicator. Introducing an augmentative/alternative communication system like PECS can help bridge the gap for children who are not yet verbally communicating but need an accessible means of communication as speech and language develop. Without an effective means of communication, these children are at risk for social, emotional, and behavior problems. Research has shown that the use of augmentative communication systems does not inhibit speech development but, on the contrary, enhances the likelihood of the development or improvement of speech.” (Bondy & Frost, 2004). Even if a person doesn't start to speak with PECS, that individual will have an effective way to communicate with lots of different people in their world.

Myth #4: PECS cannot be used with children who have visual impairments, fine motor, or gross motor difficulties PECS can be used with a wide range of age-groups and disabilities. Accommodations can be made for children and adults with visual impairments, fine motor, or gross motor difficulties. Modifications such as varying the size of the picture and/or using real photographs instead of cartoon-like pictures could be beneficial to those with visual impairments. Placing the picture on an object (e.g., bottle cap) to make it easier to grab/pick up from the book could be helpful for individuals with fine motor difficulties. A voice switch or button to request a communication partner in order to perform an exchange could be supportive for individuals with gross motor difficulties or for those who are non-ambulatory.


Myth #5: Only simple requests are possible via PECS

Requesting is the first skill taught in PECS, but the protocol's final phase focuses on teaching commenting (e.g., I see, I hear, I smell). As the individual progresses through the phases, sentences become longer not only because multiple items may be requested or commented on but also because attributes and other qualifiers are adding additional qualifying features of language (e.g., colours, shapes, size). That being said, the vocabulary of PECS users grows in terms of both, the number of pictures as well as the length and complexity of the sentence structure. It is recommended to provide a long sentence strip with a continuous Velcro strip in order to allow individuals to create longer sentences instead of limiting the length of the request/comment by the number of Velcro dots on the strip. PECS is not about a person just getting their needs and desires met, but about communication with other people in their world.


Tell me and I will forget

Show me and I will remember

Involve me and I will understand forever

- Confucius



References:


1. Bondy, A. (2012). The unusual suspects: Myths and misconceptions associated with PECS. The Psychological Record, 62(4), 789-816. https://www.pecs-unitedkingdom.com/download/Bondy-TPRVOL62No4.pdf

2. Frost, L., & Bondy, A. (2002). The Picture Exchange Communication System (PECS) training manual (2nd ed.). Newark, DE: Pyramid Publications.

3. North Shore Pediatric Therapy. Common misconceptions about Picture Exchange Communication System. https://www.nspt4kids.com/specialties-and-services/speech-language-pathology/common-misconceptions-picture-exchange-communication-system/

4. Reed, Amanda. Myths and Misconceptions: You've heard about PECS, but do you really know what it is?. Pyramid Group Management. https://pecsusa.com/download/MythsandMisconceptions2010.pdf


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