Can PECS Be Combined With Other Therapies?

PECS rarely works alone — and that's by design; it's built to slot into a child's wider communication journey.

In short

Yes — the Picture Exchange Communication System (PECS) is designed to work alongside other therapies, not instead of them. It blends naturally with speech and language therapy, occupational therapy, behavioural and play-based approaches, and everyday parent-led routines. Used together, these supports help a child move from exchanging a picture to communicating with intent — and, for many children, towards spoken words too.

How PECS combines with other supports

• Speech and language therapy — the most natural partner. As a child learns to request and comment through pictures, a speech therapist pairs each exchange with spoken modelling, vocabulary building and, where ready, encouraging early sounds and words. PECS is often a bridge to speech, not a replacement for it.
• Occupational therapy — helps with the fine-motor skill of picking up and handing over a card, sitting and attending, and the sensory regulation that makes communication possible.
• Behavioural and play-based approaches — reinforce initiation, turn-taking and motivation, so a child wants to reach out and communicate.
• Parent-led everyday practice — the most powerful ingredient. When pictures are available at mealtimes, play and outings, communication becomes part of real life rather than a session-only skill.
• Other AAC tools — PECS can sit alongside or transition into speech-generating devices and apps as a child's needs grow.

The goal is one joined-up plan where each therapy strengthens the others, all pointed at the same outcome: a child who can tell you what they need, think and feel.

When to seek guidance

If your child has few or no words by the age peers are talking, struggles to make their needs known, or shows frustration because communication is hard, a developmental check helps. A clinician can advise whether PECS — and which combination of therapies — best fits your child right now.

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 online form. From a child's communication profile, our team builds one coordinated plan that weaves PECS into speech therapy and other supports as needed. Explore how we help children communicate across our 70+ centres.

Trusted sources

ASHA guidance on augmentative and alternative communication (AAC); WHO ICD-11 developmental framework; American Academy of Pediatrics family resources on supporting early communication.

Next step — Want a plan that combines PECS with the right therapies for your child? Book a developmental assessment with a Pinnacle clinician.

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