The Picture Exchange Communication System® (PECS®) is an evidence-based practice that has been researched since 1994 and continues to have an expanding body of research supporting its effectiveness. Research articles from all over the world about the efficacy of PECS for learners of various ages, diagnoses, and settings have been published in peer-reviewed journals, text books, and professional periodicals. Below is a comprehensive list of research articles along with several literature reviews related to PECS. If you are conducting research about PECS or would like to share an article that is not listed here, please feel free to contact us at admin@pecsaustralia.com.
Showing 1 - 10 out of 202 results.

(2021). O impacto da implementação do Picture Exchange Communication System – PECS na compreensão de instruções em crianças com Transtorno do Espectro do Autismo. Communication Disorders.
Audiology and Swallowing (CoDA S), Vol. 33, 2.

The purpose of this study was to analyze the impact of the implementation of the Picture Exchange Communication System (PECS) on the comprehension of instructions by children with Autism Spectrum Disorder (ASD).

(2021). The Impact of the Implementation of the Picture Exchange Communication System – PECS on Understanding Instructions in Children with Autism Spectrum Disorders. Communication Disorders.
Audiology and Swallowing (CoDA S), Vol. 33, 2.

The purpose of this study was to analyze the impact of the implementation of the Picture Exchange Communication System (PECS) on the comprehension of instructions by children with Autism Spectrum Disorder (ASD).

Adkins, T. & Axelrod, S. (2002). Topography-versus selection-based responding: Comparison of mand acquisition in each modality.
The Behavior Analyst Today

This study examined the acquisition of a mand repertoire by one child with pervasive developmental disorder and ADHD. The subject was taught to request preferred items using American Sign Language (a topography based response form) and the Picture Exchange Communication System (a selection-based form). There were four types of sessions: (1) training session for PECS, (2) training session for sign language, (3) test for generalization of the PECS words, and (4) test for generalization for the sign words. The number of trials to meet criterion and the occurrence of spontaneous emissions of the taught words was recorded. Also, the same word was taught for five days in both the PECS and the sign session and the results were recorded. It was found that the selection-based verbal response technique (PECS) was more effective in all areas. This finding contradicts the results of previous studies, suggesting that further research is needed. (http://www.behavior-analyst-online.org)

Agius, M. & Vance, M. (2015). A comparison of PECS and iPad to teach requesting to pre-schoolers with autistic spectrum disorders.
AAC: Augmentative and Alternative Communication

Few studies have compared the efficacy of the Picture Exchange Communication System (PECS) and iPads used as speech generating devices (SGDs), and none have targeted preschoolers. This study compares the relative efficacy of PECS and an iPad/SGD with three preschool-aged children with autism spectrum disorder and limited functional speech who lived in Malta. The study utilized an adapted alternating treatment design embedded in a multiple baseline design, with requesting of reinforcers as the dependent variable. Visual analysis of the results indicated that all participants required more prompted trials and sessions for the iPad/SGD condition. All participants learned a three step navigational sequence on the iPad. Participant preference probes were inconclusive and were not linked to speed of acquisition of requesting skills. Results suggest that both PECS and an iPad could be appropriate for teaching requesting skills to beginning communicators.

Almeida, M., Piza, M., & LaMonica, D. (2005). Adaptation of the picture exchange communication system in a school context (original title: Adaptações do sistema de comunicação por troca de figuras no contexto escolar)
Pró-Fono Revista de Atualização Científica, Barueri

Background: alternative communication. Aim: to evaluate the efficacy of the adapted PECS and Picture Communication Symbols (PCS) in the communication of a child with cerebral palsy. Method: the participant of this study was a 9 year and 10 months old girl, with athetoid quadriplegia. All stages of the adapted Pecs were applied (Walter, 2000), using the PCS pictures (Johnson, 1998), associated with the functional curriculum proposed by LeBlanc (1991). An experimental AB Design was used in order to test the procedures. Results: the subject was able to pass through all of the adapted Pecs phases and to use her communication board in school activities. Conclusion: the adapted Pecs proved to be effective in improving the subject's communication abilities.

Alsayedhassan, B., Banda, D. & Griffin-Shirley, N. (2020). Training parents of children with autism to implement the picture exchange communication intervention
Clinical Archives of Communication Disorders

Clinical Archives of Communication Disorders, 5, 31-41.Abstract: Purpose: We investigated the effects of behavioral skills training package with parents to use picture exchange communication system (PECS) with their children with autism spectrum disorder (ASD) to develop communication skills. Methods: Two parents and their children with ASD (one child per family) participated in this study. A multiple baseline design was used during the parents' training, and a changing criterion design was used during parents' implementation of PECS with children. Results: Results indicated that both parents implemented PECS intervention with their children with high procedural integrity and required minimal feedback through Bug-in-Ear at the end of the intervention. Moreover, both children acquired independent picture exchanges with their parents who implemented PECS training and generalized and maintained the skills. Conclusions: The findings suggest that when parents receive appropriate training and feed-back, they can train their children to use PECS to independently request desired items or activities. The current study extends existing research on PECS by teaching parents as the primary PECS trainers to implement the strategy with their children. 

Alsayedhassan, B., Lee, J., Banda, D. Kim, K. & Griffin-Shirley, N. (2019): Practitioners' perceptions of the picture exchange communication system for children with autism
Journal of Disability and Rehabilitation

Background: Autism spectrum disorder impacts social-communication. Picture Exchange Communication System is one of the methods to improve communication skills in individuals with autism. In spite of numerous studies on the effectiveness of Picture Exchange Communication System, no studies were conducted to examine the perceptions of practitioners who used the strategy.Method: An online survey was conducted with 120 practitioners (44 teachers and 76 therapists; 80.8% 20–49 years old; 80.8% graduate education) who used the Picture Exchange Communication System with children with autism. Using rating scales, practitioners reported their knowledge of Picture Exchange Communication System and their perceptions about importance, benefits, and barriers of utilizing Picture Exchange Communication System.Results: Practitioners reported they were confident when implementing Picture Exchange Communication System and considered integrating Picture Exchange Communication System at school to be important. Also, the practitioners indicated that Picture Exchange Communication System was easy to use and effective to develop communication skills in children with autism. However, they found that using Picture Exchange Communication System was time consuming.Conclusion: It is important to hear the viewpoints of practitioners concerning the use of Picture Exchange Communication System for individuals with autism spectrum disorder. This study found Picture Exchange Communication System is a useful strategy but has some barriers concerning its use. Future research is needed to confirm the current findings with a larger sample.  

Alzrayer, N. (2020). Transitioning from a low- to high-tech Augmentative and Alternative Communication (AAC) system: effects on augmented and vocal requesting.

Augmentative and Alternative Communication, https://doi.org/10.1080/07434618.2020.1813196.ABSTRACT: A considerable number of studies have demonstrated that augmentative and alternative communication (AAC) is effective in increasing speech production in some children with autism spectrum disorder (ASD). Thus, this study aimed to (a) investigate the effects of a Picture Exchange Communication System (PECS) Phase IV protocol on the acquisition of spontaneous augmented requests, (b) evaluate the impact of progressive time delay and synthetic speech output on the development of vocal requests, and (c) determine the participants' preferences for each modality after reaching mastery. A multiple-baseline design across four children with ASD was used to measure the acquisition of augmented and vocal requests during the transition from low-tech to high-tech AAC systems. During a natural condition (i.e., playtime), a modified PECS Phase IV protocol was applied to teach the participants to request by producing multisymbol messages (e.g., I WANT þ names of a preferred item) using an iPad as well as vocalizations. After mastery, the participants' preference for using the modified PECS Phase IV app or the communication book was assessed by comparing the response allocations. The preliminary results suggest that the modified PECS protocol can be used to transition from a low to high-tech communication modality.

Anderson, A., Moore, D. & Bourne, T. (2007). Functional Communication and Other Concomitant Behavior Change Following PECS Training: A Case Study.
Behaviour Change

The Picture Exchange Communication System (PECS) is widely used to teach children with language delays, including those with autism, functional language. A feature of PECS is that it incorporates principles deemed by some to be pivotal, leading to broader behaviour change. In this study, a 6-year-old child with autism was taught functional language using PECS. Along with measures of language gains, concomitant changes in nontargeted behaviours (play and TV viewing) following PECS training were observed. Results show increases in manding, initiations and cumulative word counts, as well as positive changes in the nontargeted behaviours.

Angermeier, A., Schlosser, R., Luiselli, J., Harrington, C., & Carter, B., (2008). Effects of iconicity on requesting with the Picture Exchange Communication System in children with autism spectrum disorder.
Research in Autism Spectrum Disorders

Research on graphic symbol learning suggests that symbols with a greater visual resemblance to their referents (greater iconicity) are more easily learned. The iconicity hypothesis has not yet been explored within the intervention protocol of the Picture Exchange Communication System (PECS). Within the PECS protocol, participants do not point to a symbol but exchange the symbol for an object. The purpose of this study was to examine whether children learn to request more readily with PECS when the symbols involved are highly iconic versus symbols that are low in iconicity. An adapted alternating treatments design combined with a multiple baseline design across subjects was used to evaluate the effectiveness and efficiency of symbol learning under two conditions: high iconicity and low iconicity. Four students with autism or pervasive developmental disorders between the ages of six and nine years participated. Results indicated that students learned to request desired objects under both conditions, lending further support for the effectiveness of PECS. There was little to no difference, however, in the effectiveness and efficiency of requesting between the two conditions during Phases I and II of PECS training. Thus learners do not benefit from symbols that bear more resemblance with their referents during the first two phases of PECS instruction.

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