{"h1":"What happens during PECS sessions?","faq":[{"a":"No. PECS is designed to support communication, and research suggests it often encourages spoken words to emerge alongside picture use rather than replacing speech. Many children begin to vocalise as they exchange cards.","q":"Does PECS stop my child from learning to talk?"},{"a":"PECS is taught in six phases — from the first picture exchange, through travelling to the communication book, choosing the right picture, building sentences, answering questions, to finally commenting on the world. A therapist focuses each session on the phase your child is ready for.","q":"How many phases are there in PECS?"},{"a":"No. PECS is often used with autistic children, but it can help any child who is minimally verbal or pre-verbal and needs a clear, reliable way to express their wants and needs. A clinician will decide if it suits your child.","q":"Is PECS only for autistic children?"},{"a":"It begins with a simple exchange: your child learns to pick up a picture of something they really want, hand it to a person, and immediately receive that item. Two therapists often help at first to make this first success easy and rewarding.","q":"How does PECS start in the very first session?"}],"lang":"en","slug":"what-happens-during-the-picture-exchange-communication-system-pecs-sessions","title":"What happens during PECS sessions?","entity":{"key":"pecs","kind":"therapy_modality","name":"the Picture Exchange Communication System (PECS)","slug":null},"lenses":[{"kind":"stakeholder","label":"Parent","value":"parent"},{"kind":"domain","label":"Communication","value":"communication"},{"kind":"intent","label":"Support","value":"support"},{"kind":"lifecycle","label":"Plan","value":"plan"},{"kind":"route","label":"Speech-Therapy","value":"speech-therapy"},{"kind":"empowerment","label":"Early Clarity","value":"early_clarity"}],"parent":{"key":"therapies","label":"Therapies"},"related":[{"lang":"en","slug":"how-can-the-picture-exchange-communication-system-pecs-help-a-child-with-non-verbal-minimally-verbal-presentation","title":"How PECS Helps a Non-Verbal or Minimally Verbal Child"},{"lang":"en","slug":"what-progress-can-i-expect-from-the-picture-exchange-communication-system-pecs","title":"What Progress Can I Expect From PECS?"},{"lang":"en","slug":"what-goals-does-the-picture-exchange-communication-system-pecs-work-on","title":"What goals does PECS work on?"},{"lang":"en","slug":"what-is-the-picture-exchange-communication-system-pecs","title":"What is the Picture Exchange Communication System (PECS)?"},{"lang":"en","slug":"how-does-the-picture-exchange-communication-system-pecs-help-preschoolers","title":"How does PECS help preschoolers?"},{"lang":"en","slug":"what-techniques-are-used-in-the-picture-exchange-communication-system-pecs","title":"What techniques are used in the Picture Exchange Communication System (PECS)?"}],"summary":"During PECS sessions a speech and language therapist teaches a child to communicate by handing over picture cards to request what they want, progressing through six gentle phases from a single exchange to building sentences and commenting. Sessions are playful and led by the child's motivation. AbilityScore® is part of Pinnacle’s developmental assessment. Diagnosis, where needed, requires an appropriately qualified healthcare professional.","answer_md":"*When words are hard to find, a single picture handed to someone you love can become your child's very first 'I want that' — and that is where real communication begins.*\n\n## In short\nDuring PECS sessions, a speech and language therapist gently teaches your child to communicate by **handing over a picture card to ask for something they want**. It starts with simple exchanges — giving a picture of a favourite snack or toy to receive it — and grows, step by step, into building short sentences and commenting on the world. Sessions are warm, playful and led by what motivates *your* child, so communication feels rewarding from the very first exchange.\n\n## What happens in a session\nPECS is taught in **six gentle phases**, and a session focuses on whichever phase your child is ready for:\n\n- **Phase 1 — The exchange.** Your child learns the core idea: pick up a picture of something they want, hand it to a person, and receive that item. Two therapists often help at first — one beside your child to guide, one to receive the card.\n- **Phase 2 — Distance and persistence.** Your child learns to travel to their picture book and to a communication partner, building independence.\n- **Phase 3 — Choosing.** Your child learns to pick the *right* picture from several, discriminating between options.\n- **Phase 4 — Building sentences.** Using an \"I want\" card plus a picture, your child begins forming simple sentence strips.\n- **Phase 5 — Answering questions.** Your child learns to respond to \"What do you want?\"\n- **Phase 6 — Commenting.** Your child moves beyond requesting to sharing — \"I see\", \"I hear\" — true conversation.\n\nThroughout, the therapist follows your child's motivation, keeps pressure low, and rewards every attempt. Importantly, PECS does **not** stop speech — research suggests it can actually encourage spoken words to emerge alongside the pictures.\n\n## Who PECS can help\nPECS is often introduced for children who are minimally verbal or pre-verbal, including many autistic children, where reaching for a clear, reliable way to express needs reduces frustration. Your therapist will judge whether PECS, another communication approach, or a blend best fits your child after observing how they currently connect.\n\n## The Pinnacle way\nAbilityScore® is part of Pinnacle’s developmental assessment. Diagnosis, where needed, requires an appropriately qualified healthcare professional — never from an app or online form. Our [speech therapy](/speech-therapy) team uses your child's [AbilityScore® profile](/ask/what-is-the-abilityscore-and-how-is-it-calculated) to decide if PECS suits them and to set joyful, achievable goals. Explore how we support [communication and language](/) at every step.\n\n## Trusted sources\nAmerican Speech-Language-Hearing Association (ASHA) guidance on augmentative and alternative communication; CDC \"Learn the Signs. Act Early.\" resources; American Academy of Pediatrics (HealthyChildren.org) on supporting early communication.\n\n**Next step —** Curious whether PECS could help your child find their voice? [Book a communication assessment with a Pinnacle clinician](/speech-therapy).\n\nThis is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.","canonical":"https://pinnacleblooms.org/ask/what-happens-during-the-picture-exchange-communication-system-pecs-sessions","editorial":{"reviewed_at":"2026-06-11T20:12:18.613642+00:00","reviewed_by":null,"developed_by":"SETU Consortium · Pinnacle Blooms Network"},"alternates":[{"href":"https://pinnacleblooms.org/ask/what-happens-during-the-picture-exchange-communication-system-pecs-sessions","lang":"en","indexable":true}],"dimensions":[{"key":"therapies","label":"Therapies"}],"meta_title":"What Happens in PECS Sessions?","meta_robots":"index, follow, max-image-preview:large","everyday_tip":"Keep a few pictures of your child's favourite snacks or toys handy at home, and encourage them to give you the picture before they receive the item — turning everyday wants into joyful communication practice.","published_at":"2026-06-10T13:42:00.152482+00:00","reading_paths":[{"key":"understand","items":[{"lang":"en","slug":"what-is-the-picture-exchange-communication-system-pecs","title":"What is the Picture Exchange Communication System (PECS)?","reason":"Linked from this answer"},{"lang":"en","slug":"at-what-age-can-a-child-start-the-picture-exchange-communication-system-pecs","title":"At What Age Can a Child Start PECS?","reason":"Same topic"},{"lang":"en","slug":"how-does-the-picture-exchange-communication-system-pecs-help-a-child-develop","title":"How Does PECS Help a Child Develop?","reason":"Same topic"},{"lang":"en","slug":"is-the-picture-exchange-communication-system-pecs-backed-by-research-evidence","title":"Is PECS Backed by Research Evidence?","reason":"Same topic"},{"lang":"en","slug":"which-children-benefit-most-from-the-picture-exchange-communication-system-pecs","title":"Which children benefit most from PECS?","reason":"Same 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there any risks or side effects of PECS?","reason":"Same topic"},{"lang":"en","slug":"can-the-picture-exchange-communication-system-pecs-be-combined-with-other-therapies","title":"Can PECS Be Combined With Other Therapies?","reason":"Same topic"},{"lang":"en","slug":"can-the-picture-exchange-communication-system-pecs-be-done-online","title":"Can the Picture Exchange Communication System (PECS) be done online?","reason":"Same topic"},{"lang":"en","slug":"how-does-the-picture-exchange-communication-system-pecs-help-toddlers","title":"How does PECS help toddlers?","reason":"Same topic"},{"lang":"en","slug":"how-many-sessions-of-the-picture-exchange-communication-system-pecs-does-a-child-usually-need","title":"How Many PECS Sessions Does a Child Usually Need?","reason":"Same topic"},{"lang":"en","slug":"is-the-picture-exchange-communication-system-pecs-suitable-for-preschoolers","title":"Is the Picture Exchange Communication System (PECS) Suitable for Preschoolers?","reason":"Same 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Measured in PECS","reason":"Same topic"},{"lang":"en","slug":"how-long-does-the-picture-exchange-communication-system-pecs-take-to-show-results","title":"How Long Does PECS Take to Show Results?","reason":"Same topic"},{"lang":"en","slug":"what-progress-can-a-child-with-autism-spectrum-make-with-the-picture-exchange-communication-system-pecs","title":"What progress can a child with Autism make with PECS?","reason":"Same topic"},{"lang":"en","slug":"what-progress-can-a-child-with-childhood-apraxia-of-speech-make-with-the-picture-exchange-communication-system-pecs","title":"What progress can a child with CAS make with PECS?","reason":"Same topic"},{"lang":"en","slug":"what-progress-can-a-child-with-global-developmental-delay-make-with-the-picture-exchange-communication-system-pecs","title":"What progress can a child with GDD make with PECS?","reason":"Same 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topic"},{"lang":"en","slug":"what-qualifications-should-a-therapist-providing-the-picture-exchange-communication-system-pecs-have","title":"What qualifications should a PECS therapist have?","reason":"Same topic"}],"label":"Choose and access care","total":3}],"what_to_watch":"Watch for whether your child can show you what they want — by pointing, leading you by the hand, or reaching — and whether frustration rises because they cannot make needs understood; these signal that a structured communication support like PECS may help.","authority_links":[{"url":"https://www.asha.org/public/speech/disorders/aac/","label":"ASHA — Augmentative and Alternative Communication (AAC)"},{"url":"https://www.cdc.gov/child-development","label":"CDC — Learn the Signs. Act Early."},{"url":"https://www.healthychildren.org","label":"AAP — HealthyChildren.org"}],"last_reviewed_at":"2026-06-10T13:42:00.152482+00:00","meta_description":"PECS sessions teach your child to communicate by exchanging picture cards — through six gentle phases from first request to full sentences. Here's how it w","related_materials":[],"related_techniques":[]}