# What techniques are used in the Picture Exchange Communication System (PECS)?

Canonical: https://pinnacleblooms.org/ask/what-techniques-are-used-in-the-picture-exchange-communication-system-pecs
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

PECS teaches communication by having a child hand a picture card to another person to make a request, taught across six structured phases. Core techniques include using a motivating reward, two-person prompting with backward chaining, fading of prompts to build spontaneity, picture discrimination, and gradually building sentences and comments. AbilityScore® is part of Pinnacle’s developmental assessment. Diagnosis, where needed, requires an appropriately qualified healthcare professional.

*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](/speech-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](/ask/what-is-the-abilityscore-and-how-is-it-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](/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/
- HealthyChildren.org (AAP) — Early language development: https://www.healthychildren.org/English/ages-stages/toddler/Pages/Language-Development-2-Year-Olds.aspx

## 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
- Family Empowerment: https://pinnacleblooms.org/ask/lens/empowerment/family_empowerment

## 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
- How Does PECS Help a Child Develop?: https://pinnacleblooms.org/ask/how-does-the-picture-exchange-communication-system-pecs-help-a-child-develop
- 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
- 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 happens during PECS sessions?: https://pinnacleblooms.org/ask/what-happens-during-the-picture-exchange-communication-system-pecs-sessions
- What goals does PECS work on?: https://pinnacleblooms.org/ask/what-goals-does-the-picture-exchange-communication-system-pecs-work-on
- How does PECS help preschoolers?: https://pinnacleblooms.org/ask/how-does-the-picture-exchange-communication-system-pecs-help-preschoolers
- 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
- 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
- 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 I Expect From PECS?: https://pinnacleblooms.org/ask/what-progress-can-i-expect-from-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 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