Guide to Effective Programs
for Children and Youth

PICTURE EXCHANGE COMMUNICATION SYSTEM (PECS)

OVERVIEW

The Picture Exchange Communication System (PECS) seeks to improve the communication skills of children with an Autism Spectrum Disorder (ASD). The program consists of initial training and then follow-up visits from PECS consultants which demonstrate the program materials to children. A randomized, experimental evaluation of the program found that it was effective in increasing the rate of children’s initiations to communication post-treatment. This impact however, was short-lived. The program also had no impacts on rates of speech, communication, reciprocal social interaction, or scores on standardized language usage.

DESCRIPTION OF PROGRAM

Target population: Elementary school-aged children who have been diagnosed with autism or an autism spectrum disorder

The Picture Exchange Communication System (PECS) was developed for children who have been diagnosed with an Autism Spectrum Disorder (ASD). The program consists of a trained PECS consultant who attend classrooms several times per month during a school year and demonstrate the PECS program, which is a series of pictorial cards that children can use to initiate communication with others. Teachers are also given a brief training before the implementation of the program and are monitored by PECS consultants during the program. They can ask questions and discuss problems with consultants as needed.

EVALUATION(S) OF PROGRAM

Howlin, P., Gordon, R. K., Pasco, G., Wade, A., & Charman, T. (2007). The effectiveness of Picture Exchange Communication System (PECS) training for teachers of children with autism: A pragmatic, group randomized controlled trial. Journal of Child Psychology and Psychiatry, 48(5), 473-481.

Evaluated population: 84 elementary school children ages 4-11 with autism or an autism spectrum disorder. These students came from 38 schools in the greater London area which provided specialized services for autism spectrum disorders.

Approach: The researchers identified schools which provided services for children with autism spectrum disorders. 15 schools were eventually selected and a total of 18 classrooms from these schools. These classes were matched and then randomly assigned to conditions; treatment, delayed treatment, and a no treatment control group. Children in the treatment group received 6 visits per month for a total of 5 months. In each visit, consultants demonstrated PECS to students and monitored teachers’ progress with the program. The delayed treatment condition received the same intervention in the next school term. The control group received no intervention. All children in the study were assessed at baseline, at the conclusion of the treatment group’s program, and at the conclusion of the delayed treatment group’s program.

Results: Data were analyzed on an Intent-To-Treat (ITT) basis except for one treatment classroom which withdrew from the study after random assignment. There were some differences between groups at baseline. Children in the delayed treatment group had higher levels of language impairment than the treatment and control groups. Also, children in the treatment group had higher levels of verbalization than those in the delayed treatment group.

At follow-up, children in the treatment group were more likely to have a higher initiation rate than those who had received no training. The treatment effects were short-lived and by the second follow-up period, when active intervention had ceased, children receiving the early intervention no longer had higher initiation rates than the control group. The program had no impacts on rates of speech, communication, reciprocal social interaction, or scores on standardized language usage.

Note: Analyses were designed to adjust for the effect of clustering within schools.

SOURCES FOR MORE INFORMATION

Program curriculum is available for purchase and for sample download at: http://www.pecs.com/

References

Program categorized in this guide according to the following:

Evaluated participant ages: 4-11 / Program age ranges in the Guide: middle childhood

Program components: provider-based; school-based

Measured outcomes: education and cognitive development; social and emotional health and development

Program information last updated 11/7/07