Progress with PECS for Speech and Language Delay

When words are still on their way, a child can still ask, choose and connect — one picture, one exchange, one bridge at a time.

In short

With the Picture Exchange Communication System (PECS), many children with speech and language delay make meaningful progress — they learn to initiate communication by handing over a picture to request what they want, and from there often build to longer sentences and richer interaction. Far from holding speech back, PECS is associated with growing spoken words in many children, because it lowers frustration and teaches the purpose of communicating. Progress is gradual and child-led, and works best when guided by a speech and language therapist.

What progress looks like

PECS is taught in clear phases, and each one is a real milestone for your child:

• Phase 1 — the first exchange: your child learns the most powerful idea of all — that giving a picture makes something happen. This single skill turns a passive child into an active communicator.
• Phase 2 — persistence and reach: they travel to their book and to an adult to communicate, even across the room — communication becomes intentional and portable.
• Phase 3 — choosing: they discriminate between pictures to ask for the specific thing they want, reducing meltdowns born of "I can't make you understand".
• Phase 4 to 6 — building sentences: they combine pictures into phrases ("I want… biscuit"), add describing words, answer questions, and begin commenting, not just requesting.

Alongside these steps, many children begin or increase spoken words — the picture often becomes a scaffold the voice grows around. Even where speech emerges slowly, your child gains a reliable way to be understood today, which protects their confidence, behaviour and relationships while spoken language develops.

When to seek a check

A speech and language therapist should guide PECS to set the right starting phase and goals. Seek a developmental check if your child has very few or no words by around two, rarely uses gestures or eye contact to share, shows growing frustration at not being understood, or has lost words or skills they once had — the last needs prompt review.

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 there, our therapists build a communication profile for your child and decide whether PECS, alongside speech and language therapy, fits their needs and stage. You can also explore how we support speech and language development across our network.

Trusted sources

American Speech-Language-Hearing Association guidance on augmentative and alternative communication (AAC) and early language; American Academy of Pediatrics (HealthyChildren.org) on supporting late-talking children; WHO ICD-11 framing of developmental speech and language difficulties.

Next step — Want to know if PECS could help your child communicate? Book a speech and language assessment with a Pinnacle clinician.

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