If your child is nonvocal or nonspeaking – meaning they don’t use vocal speech to communicate – you may wonder how you can best help your child learn to express themselves.
There is a program known as the Picture Exchange Communication System, or PECS. This is an evidence-based way of teaching nonspeaking children to communicate. We will be giving you some recommendations and guidance as to how you can utilize this communication system with your child.
Before you implement PECS training with your child, you should be familiar with potential reinforcers for your child. This just means becoming aware of the things that your child likes and what activities or items they enjoy. You can do this in a formal way, but you likely are already familiar with some of the things your child is interested in as you are the parent and you know them best.
Let’s go over the specific stages of teaching your child to use PECS to communicate.
Phase one of teaching PECS is about teaching the child how to actually use picture icons. In this phase, you will be teaching your child to exchange a picture for the item they want. The idea is, at this stage, the child will look at, reach for, or pick up and hand the picture icon to the communication partner
To accomplish this, the teacher (in the case of teaching your own child, the teacher would be you – the parent) needs to set up the environment so that there is a picture available near the child. Also, you need to have the reinforcer or the item that’s represented on the picture available nearby. And then secondly, the communication partner (which may be you unless you have a second helper available to assist with the teaching process) will get the child’s attention by getting them to notice the reinforcer. The communication partner then opens his or her hand when the learner attempts to gain access to the reinforcer. The teacher will be helping the child to pick up the picture icon and physically prompt them to give the communication partner the icon. After this physically assisted communication exchange occurs, the reinforcer is given to the child.
The goal of phase one is to physically help the child give the communication partner the picture icon and then give them the represented item with the intent of teaching them how to use this system. After the child is used to the system in terms of being physically prompted to present the icon and then receiving the represented item, the physical assistance needs to be faded. The communication partner having an open hand to receive the picture icon also should be faded so that the child learns to independently give the communication partner the picture icon.
Phase 2 of teaching PECS is to expand the spontaneous use of the system. This phase starts similarly as phase one did in that the environment is set up with having one picture icon available, the communication partner being nearby, and having the reinforcer in view of the learner. The communication partner gets the learner’s attention by getting them to notice the reinforcing item.
As time goes on and the child is utilizing the system with prompting from the teacher, the communication partner should move further and further away from the child to eventually teach them that they need to move toward the communication partner and bring the icon to them. We then want to teach the child how to pick up the icon without prompting. Additionally, eventually the communication book should be moved further from the learner so that the child has to move to the communication book to obtain the picture icon and then they need to move to the communication partner to bring it to them to access the item.
Phase 3 of teaching PECS is about being able to discriminate between different picture icons. The goal is to teach your child to select between multiple pictures. If needed, you can start with the child’s preferred item icon and a distractor icon that has no significance to them so that way they’re focusing more on the reinforcing item. Then, continue to expand the number of icons available.
Once the child has been able to differentiate between multiple picture icons, we want to teach them to expand their communication skills, so phase 4 is about building sentence structure. After the child is utilizing 12 to 20 pictures consistently at phase 3, you can begin teaching them sentence structure. The most common way to begin doing this is using an icon with the words “I want” in the communication book. You will also be using a sentence strip.
Step 1 of Phase 4 includes placing the “I want” symbol on the left side of the sentence strip. Step 2 is when the child takes the picture from the board and the teacher helps them to place the picture next to the “I want” symbol on the sentence strip. Step 3 of Phase 4 is when the teacher helps the child to take the sentence strip and hand it to the communication partner. Step 4 has to do with the communication partner reading the sentence strip, pointing to the symbols on the strip, and giving the requested item to the child. Step 5 involves the communication partner replacing the sentence strip in the communication book. Assistance and prompting is faded so the child eventually uses the “I want” sentence strip independently. If possible for your child, try to pause after saying “I want” to see if they make any vocalizations. Reinforce any vocalizations so that you are encouraging vocal speech.
Phase 5 of PECS has to do with teaching the child to respond to the question “What do you want?” To do this, the communication partner points to the “I want” card and asks the child “What do you want?” They then fade out their gestural prompt of pointing to the “I want” icon. The communication partner should also fade out always using the question of “What do you want?” as this question will only sometimes be used in the natural environment.
The primary goal of phase 6 of the PECS program is to teach the child to comment in response to a question. This includes teaching the child to respond to things like the phrase “What do you see?” This is accomplished by teaching the child to put an icon on the sentence strip in response to the communication partner saying “What do you see?” while holding up an item. You will teach your child to respond to the question “What do you see?” in a similar way that you taught them to respond to the question “What do you want?” At this phase, you will also encourage spontaneous commenting.
You can expand on your child’s communication skills as much as you feel is necessary and helpful for your child. The ultimate goal of PECS (the picture exchange communication system) is to teach your child to be independent in seeking their communication book, discriminating between the picture icons, creating sentences using the sentence strip, finding a communication partner, and completing the exchange of the preferred icon for the relevant item or activity.