# What progress can a child make with PECS?

Canonical: https://pinnacleblooms.org/ask/what-progress-can-a-child-with-speech-and-language-delay-make-with-the-picture-exchange-communication-system-pecs
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

With the Picture Exchange Communication System (PECS), many children with speech and language delay learn to initiate communication by exchanging pictures to request, then build to choosing, sentences and commenting — and many also gain or increase spoken words as frustration falls. AbilityScore® is part of Pinnacle’s developmental assessment. Diagnosis, where needed, requires an appropriately qualified healthcare professional.

*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](/ask/what-is-the-abilityscore-and-how-is-it-calculated) for your child and decide whether PECS, alongside [speech and language therapy](/speech-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](/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/
- AAP HealthyChildren.org — Toddler language development: https://www.healthychildren.org/English/ages-stages/toddler/Pages/default.aspx
- WHO ICD-11: https://icd.who.int/

## 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
- Self Sufficiency: https://pinnacleblooms.org/ask/lens/empowerment/self_sufficiency

## Related question paths

### Understand the subject
- 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
- What is the Picture Exchange Communication System (PECS)?: https://pinnacleblooms.org/ask/what-is-the-picture-exchange-communication-system-pecs
- Which children benefit most from PECS?: https://pinnacleblooms.org/ask/which-children-benefit-most-from-the-picture-exchange-communication-system-pecs

### Explore therapy & support
- How PECS Helps a Child with Speech and Language Delay: https://pinnacleblooms.org/ask/how-can-the-picture-exchange-communication-system-pecs-help-a-child-with-speech-and-language-delay
- 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 PECS Helps a Child with Autism Spectrum: https://pinnacleblooms.org/ask/how-can-the-picture-exchange-communication-system-pecs-help-a-child-with-autism-spectrum
- How PECS helps a child with Childhood Apraxia of Speech: https://pinnacleblooms.org/ask/how-can-the-picture-exchange-communication-system-pecs-help-a-child-with-childhood-apraxia-of-speech
- How PECS Helps a Child with Global Developmental Delay: https://pinnacleblooms.org/ask/how-can-the-picture-exchange-communication-system-pecs-help-a-child-with-global-developmental-delay
- 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
- 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

### 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
- 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 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 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
- 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
- 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

### 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