What techniques are used in PECS?

When words feel out of reach, a single picture handed to someone you love can open the very first door to communication.

In short

The Picture Exchange Communication System (PECS) teaches a child to communicate by physically handing a picture card to another person to make a request or comment. It is taught in six structured phases, using clear, evidence-based techniques — a motivating reward, two-person prompting, the gradual building of sentences, and a careful fading of help so your child becomes a confident, spontaneous communicator. PECS is used to support children with limited or emerging speech, and often grows alongside spoken language rather than replacing it.

The techniques used in PECS

PECS follows a deliberate, step-by-step method. Each technique builds on the one before:

• Finding what motivates — therapists first discover what your child genuinely wants (a favourite snack, toy or activity). That natural motivation drives the very first exchange.
• The physical exchange (Phase 1) — your child learns the core act: picking up a picture and placing it in a communication partner's hand to get what they want. Communication is an active, two-way exchange from day one.
• Two-person prompting & backward chaining — a second helper gently guides the child's hand to give the card, while the main partner stays inviting. Help is faded from the end of the action backwards, so the child increasingly does it alone — with no spoken prompts, to avoid prompt-dependence.
• Building distance and persistence (Phase 2) — the child learns to travel to their picture book and to a partner, so communication works across the room and across people, not just face-to-face.
• Discriminating between pictures (Phase 3) — the child learns to choose the correct picture from several, so each symbol carries real meaning.
• Building sentences (Phase 4) — using a sentence strip, the child combines an "I want" symbol with a picture — the first step towards grammar and longer messages.
• Answering and commenting (Phases 5 & 6) — the child learns to respond to "What do you want?" and then to comment spontaneously ("I see…", "I hear…"), widening communication beyond requesting.

Throughout, therapists use structured reinforcement, consistent routines, and gradual fading of support — and many children begin to use speech sounds alongside the cards as confidence grows.

When to seek a check

PECS is one tool among many. A speech and language therapist will assess whether PECS, another communication system, or a blend best suits your child. Seek a developmental check if your child has few or no words by around 18–24 months, has lost words or skills they once had, rarely points or gestures to share interest, or finds it hard to make their needs known.

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 your child receives a precise communication profile through our speech and language therapy, and a plan that may include PECS or other approaches matched to how your child learns best. You can explore how the AbilityScore® is calculated or learn more about our approach.

Trusted sources

American Speech-Language-Hearing Association (ASHA) guidance on augmentative and alternative communication (AAC); American Academy of Pediatrics (HealthyChildren.org) guidance on supporting early communication; WHO information on developmental communication support.

Next step — Wondering if PECS could help your child find their voice? Book a speech and communication assessment with a Pinnacle clinician.

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