# What happens during PECS sessions?

Canonical: https://pinnacleblooms.org/ask/what-happens-during-the-picture-exchange-communication-system-pecs-sessions
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

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.

*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.*

## In short
During 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.

## What happens in a session
PECS is taught in **six gentle phases**, and a session focuses on whichever phase your child is ready for:

- **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.
- **Phase 2 — Distance and persistence.** Your child learns to travel to their picture book and to a communication partner, building independence.
- **Phase 3 — Choosing.** Your child learns to pick the *right* picture from several, discriminating between options.
- **Phase 4 — Building sentences.** Using an "I want" card plus a picture, your child begins forming simple sentence strips.
- **Phase 5 — Answering questions.** Your child learns to respond to "What do you want?"
- **Phase 6 — Commenting.** Your child moves beyond requesting to sharing — "I see", "I hear" — true conversation.

Throughout, 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.

## Who PECS can help
PECS 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.

## 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. 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.

## Trusted sources
American 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.

**Next step —** Curious whether PECS could help your child find their voice? [Book a communication assessment with a Pinnacle clinician](/speech-therapy).

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

## Sources
- ASHA — Augmentative and Alternative Communication (AAC): https://www.asha.org/public/speech/disorders/aac/
- CDC — Learn the Signs. Act Early.: https://www.cdc.gov/child-development
- AAP — HealthyChildren.org: https://www.healthychildren.org

## Connected topics and perspectives
- Therapies: https://pinnacleblooms.org/ask/therapies
- Parent: https://pinnacleblooms.org/ask/lens/stakeholder/parent
- Communication: https://pinnacleblooms.org/ask/lens/domain/communication
- Support: https://pinnacleblooms.org/ask/lens/intent/support
- Plan: https://pinnacleblooms.org/ask/lens/lifecycle/plan
- Speech Therapy: https://pinnacleblooms.org/ask/lens/route/speech-therapy
- Early Clarity: https://pinnacleblooms.org/ask/lens/empowerment/early_clarity

## Related question paths

### Understand the subject
- What is the Picture Exchange Communication System (PECS)?: https://pinnacleblooms.org/ask/what-is-the-picture-exchange-communication-system-pecs
- At What Age Can a Child Start PECS?: https://pinnacleblooms.org/ask/at-what-age-can-a-child-start-the-picture-exchange-communication-system-pecs
- How Does PECS Help a Child Develop?: https://pinnacleblooms.org/ask/how-does-the-picture-exchange-communication-system-pecs-help-a-child-develop
- Is PECS Backed by Research Evidence?: https://pinnacleblooms.org/ask/is-the-picture-exchange-communication-system-pecs-backed-by-research-evidence
- Which children benefit most from PECS?: https://pinnacleblooms.org/ask/which-children-benefit-most-from-the-picture-exchange-communication-system-pecs

### Explore therapy & support
- What techniques are used in the Picture Exchange Communication System (PECS)?: https://pinnacleblooms.org/ask/what-techniques-are-used-in-the-picture-exchange-communication-system-pecs
- What goals does PECS work on?: https://pinnacleblooms.org/ask/what-goals-does-the-picture-exchange-communication-system-pecs-work-on
- How PECS Helps a Non-Verbal or Minimally Verbal Child: https://pinnacleblooms.org/ask/how-can-the-picture-exchange-communication-system-pecs-help-a-child-with-non-verbal-minimally-verbal-presentation
- How does PECS help preschoolers?: https://pinnacleblooms.org/ask/how-does-the-picture-exchange-communication-system-pecs-help-preschoolers
- Are there any risks or side effects of PECS?: https://pinnacleblooms.org/ask/are-there-any-risks-or-side-effects-of-the-picture-exchange-communication-system-pecs
- Can PECS Be Combined With Other Therapies?: https://pinnacleblooms.org/ask/can-the-picture-exchange-communication-system-pecs-be-combined-with-other-therapies
- Can the Picture Exchange Communication System (PECS) be done online?: https://pinnacleblooms.org/ask/can-the-picture-exchange-communication-system-pecs-be-done-online
- How does PECS help toddlers?: https://pinnacleblooms.org/ask/how-does-the-picture-exchange-communication-system-pecs-help-toddlers
- How Many PECS Sessions Does a Child Usually Need?: https://pinnacleblooms.org/ask/how-many-sessions-of-the-picture-exchange-communication-system-pecs-does-a-child-usually-need
- Is the Picture Exchange Communication System (PECS) Suitable for Preschoolers?: https://pinnacleblooms.org/ask/is-the-picture-exchange-communication-system-pecs-suitable-for-preschoolers
- Is PECS suitable for toddlers?: https://pinnacleblooms.org/ask/is-the-picture-exchange-communication-system-pecs-suitable-for-toddlers
- Is PECS Usually One-on-One or in a Group?: https://pinnacleblooms.org/ask/is-the-picture-exchange-communication-system-pecs-usually-one-on-one-or-in-a-group

### At home & in everyday life
- How can I support PECS goals at home?: https://pinnacleblooms.org/ask/how-can-i-support-the-picture-exchange-communication-system-pecs-goals-at-home

### Follow progress
- What Progress Can I Expect From PECS?: https://pinnacleblooms.org/ask/what-progress-can-i-expect-from-the-picture-exchange-communication-system-pecs
- How a Child's Progress Is Measured in PECS: https://pinnacleblooms.org/ask/how-is-a-child-s-progress-measured-in-the-picture-exchange-communication-system-pecs
- How Long Does PECS Take to Show Results?: https://pinnacleblooms.org/ask/how-long-does-the-picture-exchange-communication-system-pecs-take-to-show-results
- What progress can a child with Autism make with PECS?: https://pinnacleblooms.org/ask/what-progress-can-a-child-with-autism-spectrum-make-with-the-picture-exchange-communication-system-pecs
- What progress can a child with CAS make with PECS?: https://pinnacleblooms.org/ask/what-progress-can-a-child-with-childhood-apraxia-of-speech-make-with-the-picture-exchange-communication-system-pecs
- What progress can a child with GDD make with PECS?: https://pinnacleblooms.org/ask/what-progress-can-a-child-with-global-developmental-delay-make-with-the-picture-exchange-communication-system-pecs
- Progress with PECS for Non-Verbal & Minimally Verbal Children: https://pinnacleblooms.org/ask/what-progress-can-a-child-with-non-verbal-minimally-verbal-presentation-make-with-the-picture-exchange-communication-system-pecs
- What progress can a child make with PECS?: https://pinnacleblooms.org/ask/what-progress-can-a-child-with-speech-and-language-delay-make-with-the-picture-exchange-communication-system-pecs

### Choose and access care
- How do I find a good provider of PECS for my child?: https://pinnacleblooms.org/ask/how-do-i-find-a-good-provider-of-the-picture-exchange-communication-system-pecs-for-my-child
- What PECS typically costs and what affects the price: https://pinnacleblooms.org/ask/what-does-the-picture-exchange-communication-system-pecs-typically-cost-and-what-affects-the-price
- What qualifications should a PECS therapist have?: https://pinnacleblooms.org/ask/what-qualifications-should-a-therapist-providing-the-picture-exchange-communication-system-pecs-have