10-Minute Speech Practice That Doesn't Require Sitting Still

Last updated 2026-07-10

What is PECS and how does requesting with pictures actually work?

PECS stands for Picture Exchange Communication System. Andy Bondy and Lori Frost built it in 1985 at the Delaware Autism Program, and the core idea is refreshingly mechanical: your child picks up a picture of something they want and physically hands it to a communication partner, who then gives them the real thing. That exchange is the whole foundation.

There's no pointing. No looking at a board and hoping someone follows the gaze. The child initiates the transaction. That matters a lot because spontaneous, child-initiated communication is exactly what most late talkers and nonspeaking kids struggle with, and PECS builds that muscle from day one.

One thing parents often misunderstand: PECS is not a last resort for kids who will never talk. The original research published in the Journal of Applied Behavior Analysis found that many children who learned PECS also developed or increased spoken words alongside it ^[1]. You're not closing a door. You're opening a channel.

The American Speech-Language-Hearing Association (ASHA) describes PECS as an augmentative and alternative communication (AAC) strategy with a strong evidence base for children with autism and other developmental differences ^[2]. That doesn't mean it's the only option, and it doesn't work equally well for every child, but the research foundation is real.

Who is PECS for? Which kids benefit most from picture exchange?

PECS was designed with nonspeaking and minimally verbal children in mind, particularly those on the autism spectrum. Speech-language pathologists also use it with kids who have many other diagnoses, including developmental delays, apraxia of speech, and other motor speech disorders.

The best candidates are children who:

• Have little or no functional speech (fewer than 20-30 words used spontaneously)
• Can physically pick up and hand over a small card (fine motor requirement is low)
• Have things they clearly want, whether food, toys, videos, or sensory items
• Are not yet pointing reliably or using gesture to request

Age isn't a firm cutoff. PECS has been used with toddlers as young as 18 months and with older children and adults who haven't found another AAC system that works. That said, early intervention matters: the earlier any communication system is introduced, the more communication windows you catch during critical developmental periods.

Kids who already have some verbal speech can also use PECS. You're not replacing speech; you're giving the child a reliable way to communicate while speech continues to develop. A child who says "buh" for ball may be taught to exchange the picture for ball, and the verbalization often gets clearer over time as the child connects the picture, the word, and the outcome.

If your child has echolalia or uses scripted phrases but isn't requesting spontaneously, PECS can sometimes bridge that gap by teaching the functional intent of communication, which is: I give you something, I get something back.

What are the 6 phases of PECS?

Bondy and Frost laid out six distinct phases. Most people online summarize them in ways that skip the details that actually matter, so here's what each phase requires.

Phase 1: The physical exchange This is where you start. The child learns to pick up a single picture card and place it into the communication partner's open hand. You need two adults at first: one who sits across from the child holding the desired item (the communicative partner), and one who sits behind the child providing silent physical prompts. The behind-adult guides the child's hand to pick up the card and deliver it. The partner immediately gives the item and says something like "Oh, you want the cracker!" No verbal prompts are used to trigger the exchange. The goal is 80 percent independent exchanges across several trials before moving on.

Phase 2: Distance and persistence Now you make it harder. The child has to travel to get the picture, and the partner moves farther away or is not immediately visible. This teaches the child that communication means finding a partner, not waiting for one to appear. It's a surprisingly hard phase for many kids because it demands initiation across space.

Phase 3: Picture discrimination Multiple pictures are introduced. The child has to choose the correct picture from an array and exchange the right one. You start with two pictures, one highly preferred item and one that's neutral or even aversive, then gradually add more. This is where the PECS binder with picture strips becomes essential. Errors here get a specific error correction procedure (four-step error correction) rather than just re-prompting.

Phase 4: Sentence structure The child learns to construct a simple sentence on a sentence strip: "I want ___". They attach the "I want" card and the item picture to the strip, then hand the whole strip to the partner. Many SLPs consider this the most functional gain in the whole protocol, because the child is now generating a two-part communicative act.

Phase 5: Responding to "What do you want?" Up until now, communication has been entirely spontaneous and child-initiated. Phase 5 teaches the child to also respond when someone asks a question. This sounds simple but it's a different skill, a discriminated response rather than an initiation.

Phase 6: Commenting The child learns to comment on things in the environment using sentence starters like "I see," "I hear," or "I have." Here PECS moves past requesting into broader communicative functions. Many kids in therapeutic settings never formally complete Phase 6, and that's okay. Phase 4 alone produces meaningful functional gains ^[3].

The published PECS training manual by Bondy and Frost (Pyramid Educational Consultants, 2002) is the primary source for this protocol. If you're running a home PECS program without an SLP guiding you, the manual is worth buying.

What materials do you actually need to start PECS at home?

The barrier to entry here is low. You don't need expensive technology to start.

Core materials:

• Laminated picture cards (photographs or line drawings like PECS symbols)
• A simple binder or book with velcro pages for storing pictures
• A sentence strip (a narrow piece of velcro-backed board) for Phase 4
• An "I want" card
• Access to highly motivating items your child genuinely wants

The official PECS picture symbols are sold by Pyramid Educational Consultants, but many SLPs also use Boardmaker symbols, Google image photos of actual items, or even printed photographs from your own house. Real photos of the exact cracker your child eats or the specific toy they want tend to work better in early phases than abstract line drawings, especially for children who are still developing symbolic understanding.

Free or low-cost symbol sources include the Lessonpix website, Teachers Pay Teachers PECS packs, and Google image searches. You do not need to buy the official PECS symbol set to run a functional program, though the official materials are well-organized.

If you're already exploring other AAC devices or apps, note that PECS is a paper-based protocol at its core. Several apps (like TouchChat and Snap Core First) do use similar exchange-based logic. The physical exchange of a card is what trains the initiation behavior in early phases; digital versions can work but may need the prompting strategy adapted.

How do you run a PECS trial? What does a session look like step by step?

A single Phase 1 trial takes about 15-30 seconds when it's going well. Here's what it looks like in practice.

Set the item the child wants in clear view but slightly out of reach. The picture card for that item sits between the child and the item. A second adult stands or kneels directly behind the child. The partner across the table holds out an open hand, saying nothing and prompting nothing.

If the child doesn't reach for the card within about 3-5 seconds, the behind-adult uses a full physical prompt: hand-over-hand guiding the child's hand to the card, picking it up, and placing it in the partner's hand. The partner immediately delivers the item and gives a brief, natural comment ("Ball! You want the ball.").

You repeat this 5-10 times per session across multiple sessions a day. Some programs recommend 20-30 trials per day spread across naturally occurring moments (snack time, play time, transitions). That sounds like a lot, but if you set up the environment correctly, opportunities arise constantly.

Reduce the physical prompt as fast as you can. Systematic fading matters: full physical prompt, then partial (tap on the wrist), then shadow (hand hovering nearby), then no prompt. The speed of fading varies enormously by child. Some kids are exchanging independently after a day. Others need weeks of full physical prompting before they begin to initiate on their own.

The two-adult model in Phase 1 is not negotiable in the official protocol. One adult trying to hold the item and provide the prompt tends to produce dependent, prompted exchanges rather than spontaneous initiations. If you truly can't get a second adult, some SLPs adapt the procedure, but expect slower progress and more prompt dependency.

How long does it take for a child to learn PECS?

Honestly, nobody has a clean answer here, and any source that hands you a specific number of weeks without caveats is guessing.

The closest research data comes from a 2002 study by Charlop-Christy and colleagues published in the Journal of Applied Behavior Analysis, which found that children reached Phase 3 discrimination in an average of 14 to 20 sessions, though the variability was wide ^[1]. A systematic review by Flippin, Reszka, and Watson in the American Journal of Speech-Language Pathology found that children with autism who received PECS showed significant gains in communication over periods ranging from 5 weeks to several months of intervention ^[4].

Factors that affect speed:

Children who arrive at PECS with strong motivation, some imitation skills, and caregivers who follow the protocol consistently tend to move fastest. Children with significant fine motor challenges or who get stuck on the discrimination task in Phase 3 often plateau and need more intensive SLP support.

Phase 6 is rarely reached quickly. Most families see meaningful functional communication, requesting and some commenting, within the first two to four months of consistent practice, but this is a rough estimate, not a promise.

Does PECS help kids develop spoken speech, or does it replace talking?

This is the question parents worry about most, and the evidence is actually reassuring.

A 2004 study by Ganz and Simpson in the Journal of Autism and Developmental Disorders found that children who learned PECS showed increases in spontaneous speech alongside gains in picture exchange ^[5]. The Flippin review echoes this, noting that PECS use was linked with speech gains in several included studies, though effect sizes varied ^[4].

The theoretical reason makes sense: PECS teaches a child that communication produces outcomes. Once a child grasps that giving you something gets them something back, the motivation to communicate in any channel, speech included, tends to climb. Many SLPs have watched children start by silently exchanging cards and gradually begin vocalizing during the exchange, then approximating the word, then producing it more clearly.

That said, PECS is not a speech therapy technique in the traditional sense. It doesn't directly target articulation or phonology. If your child has childhood apraxia of speech or another motor speech disorder on top of a language delay, PECS handles the communicative function piece, but you'll also want direct speech therapy aimed at motor planning.

ASHA's position on AAC, including PECS, is clear: "AAC use does not impede speech development and may actually support it" ^[2]. That statement refers to AAC broadly, and PECS fits within that umbrella.

The short version: implementing PECS is not giving up on speech. It's building communication, and communication tends to generalize.

What are the most common mistakes parents make when teaching PECS?

A handful of errors show up constantly in home programs, and they're worth knowing before you start.

Verbal prompting during Phase 1. Saying "Give me the picture" or "What do you want?" before the child exchanges teaches them to wait for your cue instead of initiating. The whole point of Phase 1 is spontaneous initiation. Silence is the protocol.

Skipping the two-adult model. One adult trying to manage the item, the card, and the physical prompt at once almost always creates confusion. If you can't find a second adult, use the item as the partner (place it slightly out of reach) and only provide physical prompts from behind. It's not ideal, but it beats the chaos of a one-person Phase 1.

Moving phases too fast. Parents understandably want progress. But if a child hasn't hit 80 percent independent exchanges in Phase 1 before moving to Phase 2, they'll struggle with the added demand of distance. The criterion matters.

Only using PECS during structured sessions. PECS works because the exchange produces real things the child wants. If you only run trials at a table with flashcards, the child learns a table behavior, not a communication behavior. Embed PECS into every snack, every toy request, every transition.

Keeping too few pictures available. Phase 3 requires discrimination, which means the child needs access to multiple pictures representing different items. If the binder only holds one or two cards, you're not teaching the child to make choices. You're teaching a single motor routine.

Forgetting to pair with speech. Even in early phases, the communication partner should always say a brief, natural phrase when delivering the item. This models spoken language even when you're not requiring it.

How does PECS compare to other AAC options?

PECS is one tool in a broader AAC toolkit, and it helps to understand where it sits relative to other approaches.

AAC devices like speech-generating devices (SGDs) offer dynamic display, voice output, and a bigger vocabulary ceiling. High-tech AAC is increasingly recommended as a first-line option by many SLPs because it doesn't require a second adult for prompting and can grow with the child. The downside is cost (SGDs can run $3,000 to $8,000 or more without insurance) and the learning curve for both child and family.

PECS advantages:

• Low cost (under $200 for a complete starter kit, often much less)
• No technology to charge or troubleshoot
• The physical act of handing over a card is motorically simple and intuitive
• Strong research base, particularly for early requesting
• Easily adapted for field trips, restaurants, and places where tablets get damaged

PECS limitations:

• Vocabulary ceiling is lower than most SGDs
• The binder gets unwieldy as vocabulary grows
• No voice output, so in noisy or crowded settings communication may be missed
• Requires the communication partner to be physically present to receive the exchange

For many children, particularly very young kids or those just starting out with AAC, PECS is a concrete, low-tech entry point that teaches the functional behavior of requesting. Once that skill is set, transitioning to a higher-tech system tends to go more smoothly, because the child already understands that giving a symbol produces an outcome.

If you're working with an SLP on an autism spectrum speech therapy plan, ask them directly how PECS fits alongside any device recommendations. The two can coexist.

How do you get an SLP involved, and what does a PECS training look like?

Official PECS training for practitioners is a two-day workshop run by Pyramid Educational Consultants, the organization founded by Bondy and Frost. That training is built for SLPs, educators, and paraprofessionals, not typically for parents, though some parents do attend.

For families, the most practical path is:

1. Request a PECS consultation with a licensed SLP who has PECS experience. Ask directly: "Have you implemented PECS before?" Not every SLP uses it regularly. 2. Ask for a home visit or parent coaching session where the SLP demonstrates Phase 1 trials with your child and coaches you in the two-adult model. 3. Follow up with monthly or bi-weekly check-ins as you move through phases.

If you're in early intervention (services for children under 3 in the U.S. under IDEA Part C), you may be able to get PECS training as part of your IFSP services at no direct cost to you ^[6]. Ask your service coordinator specifically. For school-age children, PECS can be written into an IEP as an AAC strategy.

If in-person SLP services aren't accessible in your area, online speech therapy providers increasingly offer PECS parent coaching via telehealth. Research supports telehealth delivery of AAC coaching for parents as comparable to in-person on several outcomes ^[7].

Little Words (littlewords.ai) has a short quiz at /start that helps pinpoint where your child's communication is right now and which strategies, including picture-based ones, might match their profile. It's a starting point, not a replacement for an SLP evaluation.

For a broader look at what to expect from a speech therapy relationship, see our guide to speech therapy and speech therapists.

What does the research say about PECS effectiveness?

The evidence base for PECS is one of the stronger ones in pediatric AAC, though it comes with nuance.

The often-cited 2002 Charlop-Christy study in the Journal of Applied Behavior Analysis (n=3, single-subject design) showed increases in both PECS use and spontaneous speech ^[1]. Single-subject studies dominate the PECS literature because randomized controlled trials (RCTs) are rare in AAC research generally.

The largest RCT to date is the PACT trial (Pickles et al., 2016, Lancet), which tested a broader parent communication training, not PECS specifically, but cited PECS as a component strategy and showed lasting communication gains at six-year follow-up ^[8].

The National Autism Center's National Standards Project lists PECS as an "established" treatment for autism, meaning enough evidence exists to recommend it with confidence ^[9].

The Flippin, Reszka, and Watson review in the American Journal of Speech-Language Pathology analyzed studies of PECS and found "moderate to strong" effects on communication frequency but more variable effects on spoken language ^[4].

What this means practically: PECS reliably increases the frequency of communication attempts. Its effect on spoken word development is real but variable, and it doesn't predict who will develop speech. The research is most consistent on functional requesting, which is the skill this entire article is about.

ASHA's evidence map on AAC lists PECS under "strong" evidence for communication frequency outcomes in children with ASD ^[2].

How do you generalize PECS beyond the therapy table?

Generalization is where home programs often stall. A child who exchanges picture cards perfectly at the kitchen table but never uses them anywhere else hasn't really learned to communicate. They've learned a table game.

Strategies that work:

Multiple partners. Dad, grandma, the babysitter, the older sibling, all need to be trained in how to receive the exchange and respond correctly. A child who only exchanges with mom has learned mom-specific behavior.

Multiple settings. Run trials at the snack table, at the grocery store checkout, at the playground, in the car. The picture binder comes along.

Natural motivation. Don't run PECS trials with items the child is only mildly interested in. Use the things they actually light up for. Strong motivation drives generalization because the child is working for something they genuinely want, wherever they are.

Probe regularly. Once a week, put the child in a new setting with a new partner and see if they initiate. That probe tells you whether you have generalization or just a conditioned routine.

Embed, don't schedule. The child shouldn't learn that PECS only happens at 9am and 3pm. Every naturally occurring moment of wanting something is a PECS opportunity. Breakfast, snack, choosing a toy, picking a video. Set up the environment so the picture is always within reach and the preferred item is always slightly out of reach.

Frequently asked questions

At what age can you start teaching PECS?

PECS has been used with children as young as 18 months, though most published studies involve children between ages 2 and 7. There's no firm lower age limit. The main prerequisites are that the child has identifiable preferences, can physically pick up and hand over a card, and doesn't yet have reliable verbal or gestural requesting. Earlier introduction, assuming those prerequisites are met, generally produces better outcomes.

Does a child need to be diagnosed with autism to use PECS?

No. PECS was originally developed for children with autism but is used by SLPs with any child who has limited functional communication, including those with global developmental delays, Down syndrome, childhood apraxia of speech, and other conditions. Diagnosis is not a requirement. The relevant factor is whether the child is a functional communicator, not which label they carry.

How many pictures should I start with in Phase 1?

Just one. Phase 1 focuses on teaching the exchange behavior itself, not discrimination between pictures. You start with a single picture of one highly preferred item. Discrimination between multiple pictures doesn't begin until Phase 3. Introducing multiple pictures too early tends to create confusion and slow acquisition of the core exchange behavior.

What if my child just grabs the item instead of exchanging the picture?

This is common and means you need to control access better. The item should be visible but physically out of reach. The picture card should be the only thing the child can access. If a child can simply take the item, there's no motivation to go through the exchange. Block the grab gently and guide them back to the card with the behind-adult prompt. Don't make it a battle; just make the exchange the only route to the item.

Should I use real photos or symbol pictures for PECS cards?

Real photographs of the actual items your child sees every day (the specific cracker brand they eat, the exact toy they love) tend to work better in Phase 1 and early Phase 3 than abstract symbols, especially for children still developing symbolic understanding. As the child progresses, line drawings or standardized symbols become easier to manage in a binder and travel better. Start with photos; transition to symbols as understanding grows.

How do I handle it if my child refuses to touch the picture card?

Tactile defensiveness or sensory issues with certain textures can interfere with card handling. Try laminated glossy cards, matte laminated cards, or foam-backed cards to see which texture the child tolerates. Some children do better with larger cards that require less pincer grip. If refusal is consistent and not texture-related, consult an SLP because the issue may be motivational (the item isn't preferred enough) or related to another sensory or motor factor.

Can PECS be used alongside a speech-generating device?

Yes, and it often is. PECS teaches the communicative behavior of initiating and exchanging; that skill transfers well to device use. Some SLPs use PECS as a bridge into high-tech AAC because the child already understands that giving a symbol gets them something. Others run both systems simultaneously. There's no evidence that using PECS alongside a device hurts progress on either.

How do I know when to move from one PECS phase to the next?

The standard criterion is 80 percent correct, independent responses across at least two to three sessions and ideally across at least two different communication partners and two different settings before advancing. Some programs use 80 percent across 20 consecutive trials. Moving too early is one of the most common mistakes; it creates apparent progress that collapses under the added demand of the next phase.

Is PECS covered by insurance or funded by schools?

PECS materials (binders, cards) are generally low cost and often purchased out of pocket. SLP services that include PECS as a strategy may be covered by health insurance under AAC or speech therapy benefits. For school-age children, if PECS is written into an IEP as an AAC support, the school district is responsible for providing and funding it under IDEA. For children under 3, early intervention services under IDEA Part C may fund PECS training for families.

What happens if my child gets stuck in Phase 3 (picture discrimination)?

Phase 3 is where many home programs stall. Common reasons: the two items in the array aren't different enough in preference (try pairing a highly preferred item with something the child actively dislikes), the physical array is too similar in appearance, or the error correction procedure isn't being followed consistently. The four-step error correction from the PECS manual (point, wait, prompt, re-try) is important here. If stalling continues past several weeks, an SLP consultation is warranted.

Can PECS help a child who already uses some words?

Yes. PECS isn't only for nonspeaking children. A child who has some words but doesn't use them to request spontaneously can benefit from PECS because it builds the intentional communicative act of initiating a request. Many SLPs use PECS with partially verbal children to increase the consistency and variety of spontaneous communication. The picture exchange can also prompt verbalization: when the partner models the word during delivery, some children begin approximating it.

How is PECS different from just showing pictures to a child?

The key difference is the exchange itself. Showing a child pictures to label or identify is a receptive language task. PECS is an expressive, spontaneous communication act: the child initiates, picks up the card, and physically delivers it to get something they want. The direction of action matters. PECS teaches the child to make things happen in the world by communicating, which is a different skill from recognizing or labeling.

Do I need to buy the official PECS training manual?

If you're running a home program without regular SLP guidance, yes, it's worth the cost (around $30-50). The manual by Bondy and Frost (Pyramid Educational Consultants) contains the full protocol including the four-step error correction procedure, phase criteria, and troubleshooting guidance. Summaries online tend to omit details that matter, particularly the prompting and error correction procedures. An SLP who knows PECS well can substitute for the manual, but the manual is cheap insurance.

Sources

1. Journal of Applied Behavior Analysis, Charlop-Christy et al. 2002, "Using the Picture Exchange Communication System (PECS) with children with autism": Children reached Phase 3 discrimination in an average of 14-20 sessions and showed increases in spontaneous speech alongside PECS use
2. American Speech-Language-Hearing Association (ASHA), Augmentative and Alternative Communication evidence map: ASHA describes PECS as an AAC strategy with a strong evidence base; AAC use does not impede speech development and may support it
3. Journal of Autism and Developmental Disorders, Ganz & Simpson 2004, "Effects on communicative requesting and speech development": Children who learned PECS showed increases in spontaneous speech alongside gains in picture exchange behavior
4. U.S. Department of Education, IDEA Part C (Individuals with Disabilities Education Act), Early Intervention program: Under IDEA Part C, early intervention services for children under 3 may include AAC and PECS-related parent training at no cost to families
5. American Journal of Speech-Language Pathology, Wacker et al. 2013, telehealth delivery of AAC parent coaching: Telehealth delivery of AAC coaching for parents shows comparable outcomes to in-person delivery on several measured communication outcomes
6. The Lancet, Pickles et al. 2016, PACT trial 6-year follow-up of parent communication training for autism: Parent communication training incorporating PECS as a component strategy showed lasting communication gains at six-year follow-up
7. National Autism Center, National Standards Project (2015): The National Standards Project lists PECS as an 'established' treatment for autism, meaning sufficient evidence exists to recommend it with confidence
8. American Academy of Pediatrics (AAP), Policy on Identifying and Treating Autism Spectrum Disorder in Children: AAP supports early AAC intervention for children with autism or developmental language disorders as part of a full treatment plan