Risks and side effects of PECS

PECS gives a child who isn't yet speaking a real, immediate way to ask for what they want — and a gentle worry many parents have is whether it could hold back talking. The reassuring news is that, used well, it doesn't.

In short

The Picture Exchange Communication System (PECS) is a low-risk, well-tolerated way to help a child communicate by handing over a picture to make a request. It has no medical side effects — it isn't a medicine or a procedure. The main thing to watch for is how it's used: PECS works best when delivered by a trained therapist with consistent family support, always alongside spoken-language goals. Importantly, research and clinical experience show PECS does not stop a child learning to talk — for many children it actually encourages speech.

What to be mindful of

PECS itself is safe. The "risks" are really about practice and expectations, and they're easy to manage:

• The myth that it delays speech. This is the worry parents raise most. Evidence does not support it — giving a child a successful way to communicate tends to reduce frustration and can open the door to spoken words. PECS is designed to be paired with verbal modelling throughout.
• Inconsistent use across people and places. If only one person uses PECS, the child may communicate only with them. Everyone around the child — family, school, therapists — needs to respond to the pictures the same way.
• Stopping too early or staying static. PECS moves through stages, from a single picture to building sentences and commenting, not just requesting. A child can get "stuck" if the system isn't progressed as their skills grow.
• Over-reliance without a plan to grow. PECS is a bridge, not a ceiling. A good plan keeps building towards richer communication, including speech or other systems as appropriate.
• Mild early frustration. When first learning the exchange, some children show brief frustration — this settles quickly with the right prompting and is far less than the frustration of not being understood at all.

None of these are reasons to avoid PECS — they're reasons to use it with trained guidance.

When to seek guidance

If your child is using pictures but progress has stalled, if communication only happens with one person, or if you're unsure whether PECS is the right fit alongside speech goals, a review with a speech-language therapist helps. A clinician can match the communication approach to your child's strengths and keep it growing.

The Pinnacle way

AbilityScore® is part of Pinnacle’s developmental assessment. Diagnosis, where needed, requires an appropriately qualified healthcare professional — never from an app or form. Our therapists introduce PECS as part of a broader speech therapy plan, always pairing pictures with spoken-language modelling and coaching you to use it confidently at home. Understand how your child's communication profile is assessed, and explore how we support every family on this journey.

Trusted sources

American Speech-Language-Hearing Association (ASHA) guidance on augmentative and alternative communication; American Academy of Pediatrics family resources (HealthyChildren.org) on supporting communication; WHO ICD-11 developmental framework.

Next step — Wondering if PECS is right for your child? Book a developmental assessment with a Pinnacle speech-language clinician.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.