To PECS or not to PECS?
Rebecca Wright, Speech Pathologist and Pyramid Consultant
Pyramid Educational Consultants of Australia Pty. Ltd.
The idea that PECS (Picture Exchange Communication System) or other augmentative and alternative
communication strategies (AAC) such as signing might impede speech development is a common concern
amongst parents, families and other professionals working with many of the clients I am referred forintervention.
The research in this area indicates that those individuals who develop the capacity for functional use of speech
will use speech. For those who do not develop functional use of speech, they will have limited or no means offunctional communication if we choose not to teach them AAC as part of their communication intervention.
Romski and Sevcik (2005) describe it as critical that AAC be introduced before communication failure occurs andthat we often observe contextually inappropriate behaviours in individuals who have difficulty with functionalcommunication.
I recently began working with a client whose mother was unsure about PECS as an intervention for her son. Her
number one concern was that PECS would in some way stop her son from speaking. Her son had previously beenintroduced to PECS within his ABA program and she had observed him struggling. He was attempting to say
several words such as saying /b/ for “biscuit” and when she said “ready, set” he would say “go”. He was able tocount to 5 by imitation. She explained to me that she was finding it difficult to understand why therecommended intervention wouldn’t specifically focus on developing speech. This scenario raises the question
about the conditions under which we accept speech as functional communication. The following table illustrates
this point in relation to the communicative function of requesting.

AntecedentBehaviour Observed

Type of Communication

You make some popcorn and wanderaround eating it.
You make some popcorn and wanderaround eating it. The individual walks up
or looks over to you. You notice this andsay “What do you want?”
You make some popcorn and wanderaround eating it. The individual walks up
to you, looks at you, and looks at thepopcorn. You say “What do you want?”
the individual says nothing but tries tohelp himself. You say, “Say I wantpopcorn.”

Individual walks up to you and says “Iwant popcorn” and you give some.
In response to your question theindividual says “I want popcorn” and you
give some.

Spontaneous requesting

In response to asking the individual tosay “I want popcorn” they say “I wantpopcorn,” or some variation, and you
give some popcorn.

Imitative request

Responsive requesting

You will notice that although the speech output may appear identical in all three scenarios, it is only the firstscenario in which the individual has used speech spontaneously. It illustrates to us that speech does not always
equal functional communication and, in turn, functional communication does not always involve speech.
There can be much confusion about where speech production fits into augmentative and alternative
communication (AAC), however, it does not need to be an either/or choice. PECS can be both an augmentative
and/or an alternative communication system. An augmentative communication system is a system the assists
the individual to maximise their use of natural speech but also acts in place of speech in situations where theindividual cannot produce the speech required. An alternative communication system is to replace speech thathasn’t developed or has been lost.

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While every learner of PECS will have their own individual strengths and weaknesses in relation to the physicalproduction of speech the following table summarises some of the common issues and where expectations for
direct speech intervention commonly occur.
Description of learner’s speech skills

How speech fits within intervention

 Learner produces no speech Learner produces some sounds but is not clearly

producing words

 Learner used to produce speech clearly but seems tohave “lost” those skills

 Leaner tries to speak all the time and produces somewords clearly but not everything they want to say isclear to all communication partners.

 Learner’s speech is clear, he appears to construct avariety of sentences but it is predominantly echolalia(either immediate or delayed).
 Leaner produces clear words or sentences but only inresponse to being asked a question.

PECS provides an alternative communication system.
PECS allows for the individual to develop spontaneous
requesting skills and allows the communicative partner tofrequently model vocabulary that is functional for that
individual (single words Phases I-III and sentences Phase IVand beyond).
 In Phase IV of PECS the constant time delay strategy isintroduced. This is a 3-5 second delay added before thecommunication partner “fills the gap”. It is time for thelearner to attempt to talk in conjunction with the picture
exchange. Many individuals start to produce speech or
attempt more speech when they reach this phase of thePECS protocol.
 Speech is not insisted on as part of the exchange (as thelearning focus is communication), but differential
reinforcement is used for any spontaneous attempts to
speak in conjunction with exchanging (i.e. we let the student
know speaking plus exchanging is better than exchanging
alone by giving them more of what they have asked for).
 PECS provides the individual meaningful contexts within
which to attempt speech production.
 A program to stimulate the production of speech sounds
may be developed and implemented separately to theindividual communication program.
 PECS provides an augmentative system; a system thatmaximises the effectiveness of the individual's naturalspeech abilities while accommodating difficulties such as notbeing able to say everything clearly or not being able torecall the name of all the items he wants to ask for.
 As indicated above, speech in conjunction with the picture
exchange will be differentially reinforced.
 Individuals would usually be provided with intervention
specifically targeting improving speech production but for
those with significant speech difficulties, this progress can beslower than their developing language skills. PECS provides away to help avoid communication breakdown, allowing theindividual to provide as much information as possible to his
communication partners without having to rely purely on
speech that he finds difficult to produce.
 PECS would be considered an augmentative communication
system in this scenario, used to assist the individual tomaximise the use of his natural speech abilities.
 In these contexts PECS may even be a short term measure toassist teaching the individual to initiate communication andlearning what to say, to whom and when.

Page 2 of 3 The learner’s speech output alone does not match his PECS would be considered an augmentative communication

speech and language output when supported by AAC(e.g. the learner will spontaneously say two words“want ball” but with picture support can produce “Iwant the red ball”).

system in this scenario, used to assist the individual tomaximise the information he is able to include for his
communicative partner and length of utterance produced.
 Many learners in this situation will actually produce more
speech in conjunction with PECS than when relying on speech
alone.

The long term goal for all of my clients with complex communication difficulties or disorders is that they willdevelop functional use of natural speech. However, the use of AAC is seen as a tool to use on the road toreaching this goal, not as a last resort. For those individuals where speech persists as a difficulty, they will have
had the opportunity to learn to use PECS as a functional communication system. There is much evidence tosupport the use of AAC to allow an individual to continue to develop in their language and communication skills,
without a focus on speech, as these can often develop faster than speech production skills in individuals who
find speech very difficult.
I am pleased to be able to report that the young man I mentioned earlier in this article has been successfullyusing PECS for the last 6 months and has experienced even more success in the last month after an intensive
week of intervention. He has reached Phase IV of the PECS protocol and now consistently requests usingsentences. He is slowly beginning to learn to add attributes to his requests to provide even more information tohis communication partners. And while he runs a mile every time someone tries to ‘make him’ attempt‘traditional’ speech exercises, he attempts to say everything on his Sentence Strip approximately 90% of thetime. This provides a functional context within which we can continue to target speech production.

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