by Catherine Horton, MS, CCC-SLP, BCBA, CAGS

A new blog asking the question, ‘Why are you using PECS?’ attempts to discredit the literature base that supports the Picture Exchange Communication System® (PECS®) Protocol, as well as undermine the significant and positive communication outcomes experienced by individuals across the globe.  With over 190 PECS-related publications and 25,000 people attending PECS Training every year, the protocol is arguably one of the most popular approaches to teaching functional communication skills.  So, it comes as no surprise that some individuals will attempt to garner public attention by citing inaccuracies, misinformation and personal opinions related to the protocol.  As the Clinical Director of Pyramid US, I’m happy to provide the many reasons why I use PECS and share how the system continues to teach individuals around the world about the power of communication.

Teacher sitting on the floor demonstrating a song to young students in a circleWhen I started working in the field as a Speech Language Pathologist, I had many learners on my caseload with no functional communication skills.  For some students, I tried to teach sign language.  For others, we worked on speech imitation lessons.  Still others had boards filled with pictures and a few had Speech Generating Devices (SGD). And for some students, I tried what I inaccurately referred to as “PECS”.  I had yet to attend training and did not understand what the protocol actually entailed.  So, I made some pictures and my students kind-of moved those pictures around.  At that time, my learners were not making significant gains with their communication skills and did not develop large communicative repertoires.

Lori Frost, co-developer of PECS, standing and presenting a workshopFortunately, I attended an actual PECS Training early in my career and quickly understood all the things that I was doing wrong.  I learned that there IS a way to teach learners to initiate communication.  In fact, in the very first phase of PECS, we teach our learners about the power to “go first” in an interaction, while simultaneously teaching that interactions with other people are both meaningful and valuable.  And, that’s only Phase I!  The protocol successively builds upon learning to teach sentence structure, expansion of skills and other communicative functions.  In addition to building functional communication skills, the literature supports what we often observe – many young children using PECS begin using speech in conjunction with the exchange of the picture.

Critics of PECS often like to say that, “PECS only teaches requests.”  This falsehood generally indicates that the naysayer has never attended training or reviewed the PECS Training Manual, Second Edition.  Yes, we begin teaching our learners to communicate about things that are important to them by teaching requesting skills.  However, there is an entire phase, Phase VI, that is devoted to teaching commenting lessons.  Recommendations for advanced language lessons are also provided.

It’s also been reported that the protocol ignores other important skills like teaching our learners how to say, “No”.  Yet at every training, we reiterate the importance of the Critical Communication Skills.  We provide plans to teach learners to indicate acceptance, as well as reject items, materials and other activities.  And, we also discuss the importance of teaching learners to ask for help and breaks, as well as a variety of receptive/listener skills.

While we’re on the topic of rejection, it’s important to note that just because an individual uses PECS, this does not mean that items and activities are always available at the exact moment the item is discussed.  It’s a valuable life skill to teach everyone when it may be necessary to wait for an item and/or accept when something is not available.  We plan for these skills in similar ways that parents teach all children the life lessons of “no”.

Finally, what about the use of prompts?  To answer that question, I think we first need to consider when prompts are provided.  Teaching communication must always be about helping learners to deliver their message…NEVER about forcing them to tell us something they don’t want to say.  Therefore, we only help our learners exchange a message following a clear indication that they have gone first in the interaction.  Then, any prompt that is provided is quickly eliminated.  Thus, physical prompts can be used to establish happy and successful lessons while at the same time respecting an individual’s autonomy. 

It’s a discredit to our learners who could benefit from PECS when people rely on personal opinions and inaccuracies to say things like, “I don’t like PECS” or “I don’t use PECS anymore”.  I don’t like goat cheese, but that doesn’t give me clearance to devalue goats or cheese manufacturers.  In fact, shouldn’t positive communicative outcomes outweigh personal preferences?

Is PECS the only option?  Certainly not.  However, I will continue to use PECS because it teaches learners of all ability levels about the power of communication. It is also the only manualized protocol available that teaches skills starting with initiation all the way through advanced language skills.  This same protocol is actively being used and successfully applied to teaching learners to use Speech Generating Devices.  And, one cannot argue with the wealth of literature that supports the effectiveness, not only to teach functional communication skills but also to increase the number of spoken words and decrease challenging behaviors.

Young boy gives his excited teacher a picture to communicate

If you’ve ever witnessed the joy in a child’s eye when they make their first independent exchange at Phase I, or a caregiver burst into happy tears when their child seeks them out to exchange a message, or the very first word said while exchanging a picture, you’ll understand that YES, I will continue to use PECS.  The better question is… Why AREN’T you using PECS?