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<em>The fact has been established by [20] one out of every 146 newborns in UAE is affected with Autism Spectrum Disorder, and measuring the attention span using what method is difficult. It has been emphasized by [21] Children with ASD have a shorter attention span; hence the purpose of this study is to increase the attention span of autistic children in Abu Dhabi by using Picture Exchange Communication System (PECS). PECS is a picture-based communication method for people with little or no communication abilities to communicate using pictures [23]. PECS is used in the classroom by teaching the children to make their requests by handing them an exchange card representing what they want. The goal of this study is to persuade parents and teachers of the use of PECS to improve the attention span of autistic students at the Abu Dhabi Autism Center. Three samples are used in this study. The children are used as the samples of the study. Three parents and three teachers are interviewed to find out how persuaded they are about the use of PECS in increasing the attention span of the children at the Abu Dhabi center. Nine participants are involved in this study. The location of the study is the Abu Dhabi center. The experimenter will be the observer in this study. This study shows how effective the use of PECS is in improving the attention span of autistic children at the Abu Dhabi Autism Center. As a result, PECS is effective in increasing the attention span of autistic children, and parents and teachers are convinced that using PECS at Abu Dhabi Autism Center will help autistic children increase their attention span..

Communication deficits are one of the core symptoms of autism spectrum disorder (ASD). As such, individuals diagnosed with ASD are often taught to communicate using augmentative and alternative communication (AAC) systems. One of the most commonly used AAC systems is the Picture Exchange Communication System® (PECS®). Despite the prevalent use of PECS within clinical and educational settings, there exists little empirical information about the use of PECS in community settings, such as summer camps. The present preliminary investigation explored the nature of participants’ PECS use in a community setting using various sources of data from multiple respondents. Fidelity of PECS implementation was also examined. Twenty-two children and youth, the majority of whom scored substantially below average on standardized measures of cognitive and adaptive abilities and in the “severe” range of ASD symptomatology, were taught to use PECS within a therapeutic summer camp. Overall, results indicate that participants were reported to use PECS to request a diverse array of reinforcing items, across a variety of activities and environments. Increased PECS use and appropriate communicative behavior was observed, as well as reductions in contextually inappropriate behavior. Results were reported by parents to generalize to the home environment. Further, PECS was implemented with adequate fidelity by community implementors. Implications for communication training within community settings are discussed.

Research indicates that the Picture Exchange Communication System® (PECS®) is an evidence‐based communication approach for children diagnosed with autism spectrum disorder (ASD). However, little is known about PECS‐related parent training, treatment fidelity, or generalization and maintenance of skills. The purpose of the current study was to explore strategies to help parents support their child's PECS use at home. One child with ASD and both his parents participated. Researchers used behavioral skills training to teach target PECS skills and applied general case training strategies to actively program for generalization. A multiple baseline design across skills was used to monitor the primary parent trainee's fidelity during training sessions and a multiple probe design was embedded to monitor both parents' treatment fidelity in the natural environment with their child. The parent trainee demonstrated target PECS skills within the training setting. However, parents did not reliably demonstrate all target PECS skills in the generalization setting during follow‐up. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Source: journal abstract)

Communication deficits are one of the core symptoms of autism spectrum disorder (ASD). As such, individuals diagnosed with ASD are often taught to communicate using augmentative and alternative communication (AAC) systems. One of the most commonly used AAC systems is the Picture Exchange Communication System® (PECS®). Despite the prevalent use of PECS within clinical and educational settings, there exists little empirical information about the use of PECS in community settings, such as summer camps. The present preliminary investigation explored the nature of participants’ PECS use in a community setting using various sources of data from multiple respondents. Fidelity of PECS implementation was also examined. Twenty-two children and youth, the majority of whom scored substantially below average on standardized measures of cognitive and adaptive abilities and in the “severe” range of ASD symptomatology, were taught to use PECS within a therapeutic summer camp. Overall, results indicate that participants were reported to use PECS to request a diverse array of reinforcing items, across a variety of activities and environments. Increased PECS use and appropriate communicative behavior was observed, as well as reductions in contextually inappropriate behavior. Results were reported by parents to generalize to the home environment. Further, PECS was implemented with adequate fidelity by community implementors. Implications for communication training within community settings are discussed.

Research indicates that the Picture Exchange Communication System® (PECS®) is an evidence‐based communication approach for children diagnosed with autism spectrum disorder (ASD). However, little is known about PECS‐related parent training, treatment fidelity, or generalization and maintenance of skills. The purpose of the current study was to explore strategies to help parents support their child's PECS use at home. One child with ASD and both his parents participated. Researchers used behavioral skills training to teach target PECS skills and applied general case training strategies to actively program for generalization. A multiple baseline design across skills was used to monitor the primary parent trainee's fidelity during training sessions and a multiple probe design was embedded to monitor both parents' treatment fidelity in the natural environment with their child. The parent trainee demonstrated target PECS skills within the training setting. However, parents did not reliably demonstrate all target PECS skills in the generalization setting during follow‐up. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Source: journal abstract).

The objective of this research was to assess the efficacy of behavioral therapy interventions in the treatment of autism spectrum disorders (ASD). The study utilized the PubMed and Embase databases to locate randomized controlled trials, quasi-experimental treatment studies, and randomized clinical trial comparisons. The experimental group received treatment based on an applied behavioral approach, such as PECS, DTT, PRT, TEACCH, ESDM, and EIBI. After examining seventeen studies, the researchers found that each type of behavioral intervention had a positive impact. Naturalistic protocols that employed PRT and PECS improved ASD symptoms in general, despite their targeting of particular cognitive domains such as language. ESDM enhanced receptive language, particularly in preschool-aged children. Structured and integrated interventions, like EIBI and TEACCH, improved overall adaptive functioning. Combining DTT with a TEACCH program produced greater benefits in linguistic, affective-social, and personal autonomy domains. However, there is a scarcity of high-quality research available on behavioral interventions for ASD. Further comparative studies are necessary to identify cost-efficient interventions. For example, PRT and PECS significantly improved social communication skills in only 15–40 hours over six months. The authors emphasized the need for continued research and the application of evidence-based interventions in specialized settings.

The aim of this study was to evaluate a program for implementing of the PECS in children with non-verbal ASD or with minimal verbalization in a school clinic belonging to the Unified Health System - SUS.

O objetivo deste estudo foi avaliar um programa de implementação do PECS em crianças com TEA em clínica-escola pertencente ao Sistema Único de Saúde - SUS.

It is known that some autistic individuals are considered non-verbal, since they are unable to use verbal language and barely use gestures to compensate for the absence of speech. Therefore, these individuals’ ability to communicate may benefit from the use of the Picture Exchange Communication System – PECS. The objective of this study was to verify the most frequently used words in the implementation of PECS in autistic children, and on a complementary basis, to analyze the correlation between the frequency of these words and the rate of maladaptive behaviors. Methods: This is a cross-sectional study. The sample was composed of 31 autistic children, twenty-five boys and six girls, aged between 5 and 10 years old. To identify the most frequently used words in the initial perio of implementation of PECS, the Vocabulary Selection Worksheet was used. And to measure the rate of maladaptive behaviors, we applied the Autism Behavior Checklist (ABC). Results: There was a significant prevalence of items in the category “food”, followed by “activities” and “beverages”. There was no correlation between the total amount of items identified by the families and the rate of maladaptive behaviors. Conclusion: The categories of words most mentioned by the families could be identified, and it was confirmed that the level of maladaptive behaviors did not interfere directly in the preparation of the vocabulary selection worksheet for the children studied.

Sabe-se que alguns autistas são considerados não verbais, uma vez que não são hábeis para utilizar o código linguístico. E tampouco usam gestos para compensar a ausência de fala. Sendo assim, a habilidade comunicativa desses indivíduos pode ser beneficiada pelo uso do sistema de comunicação alternativa Picture Exchange Communication System – PECS. O objetivo deste estudo foi verificar os vocábulos mais frequentemente utilizados na implementação do PECS em crianças autistas. E, de forma complementar, analisar a correlação entre a frequência destes vocábulos e o índice de comportamentos não adaptativos.

Purpose: The aim of this study was to evaluate a program for implementing of the PECS in children with non-verbal ASD or with minimal verbalization in a school clinic belonging to the Unified Health System - SUS. Methods: This is a longitudinal study. The sample consisted of 22 children with nonverbal ASD or with minimal verbalization; 17 boys and 5 girls, aged 6 to 12 years old. The program consisted of 24 sessions of individual speech language therapy with the presence of the family member and followed the six phases originally proposed by the PECS Training Manual. Results: All children reached the first three phases. About 82% reached phase IV; 64% phase V and 19% phase VI. Family adherence was 96%. Conclusion: It was possible to test a PECS implementation program in 24 sessions and verify that children were able to achieve phases of discrimination and sentence construction, besides demonstrating gain in their lexical repertoire and reduction of non-adaptative behaviors.

Results: Participants who achieved high phases of PECS (≥PECS phase IIIb) differed significantly from those who mastered lower PECS phases (≤PECS phase IIIa) in terms of overall, verbal, and nonverbal mental age, matching abilities, and adaptive behavior level. Stimulus generalization was also associated with significant variation in PECS outcome. PECS outcomes could be predicted with good accuracy using a combination of these child characteristics and treatment variables. Conclusions: The findings from the current study suggest that children with relatively higher cognitive and adaptive skill levels are more likely to achieve higher phases of PECS; further, approaches to generalization training also play a role. Factors such as autism symptom severity and parental ratings of maladaptive behavior were not associated with significant differences in PECS outcomes. However, more research is needed. Implications: Gaining a better understanding of predictors of PECS outcomes is important to inform intervention, provide more accurate outcome expectations for families, and guide PECS teaching procedures. Although participants were more likely to achieve higher phases of PECS if they had a higher mental age, adaptive skill level, and matching skills, the average scores for these measures were well below those expected for same age peers. These results indicate that PECS is appropriate for use with children with clinically significant deficits in cognitive and/or adaptive abilities. Further, results suggest that even children who demonstrate more severe symptoms of autism and exhibit more challenging behavior can achieve higher phases of PECS.

The fact has been established by [20] one out of every 146 new-borns in UAE is affected with Autism Spectrum Disorder, and measuring the attention span using what method is difficult. It has been emphasized by [21] Children with ASD have a shorter attention span; hence the purpose of this study is to increase the attention span of autistic children in Abu Dhabi by using Picture Exchange Communication System (PECS). PECS is a picture-based communication method for people with little or no communication abilities to communicate using pictures [23].PECS is used in the classroom by teaching the children to make their requests by handing them an exchange card representing what they want. The goal of this study is to persuade parents and teachers of the use of PECS to improve the attention span of autistic students at the Abu Dhabi Autism Center. As a result, PECS is effective in increasing the attention span of autistic children, and parents and teachers are convinced that using PECS at Abu Dhabi Autism Center will help autistic children increase their attention span.

Results: The findings revealed that picture exchange communication systems is the most common communication system used to support the development of functional communication. The most common functions enabled by the communication systems were choice-making and making requests. Several barriers (e.g., individual factors related to adults with severe/profound intellectual disability, others' attitudes, behaviour and knowledge) to and enablers (e.g., accessibility and availability of the communication system, training for those supporting adults with severe/profound intellectual disability) of functional communication were identified. Conclusions: Removing the barriers and enabling functional communication is essential to developing the functional communication of adults with severe/profound intellectual disability.

The implementation of Picture Exchange Communication System (PECS) strategy in this research aimed to improve children’s speaking ability. The indicators of speaking ability are child understands the meaning of the word used, able to connect the word to the denoted object, and to pronounce words understood by others. In other word, child is able to repeat sentences, ask questions with the correct sentence, and express opinions to others. This study uses qualitative method with the type of action research. The study was conducted in two cycles, with 3 meetings in each. The design of this study starts from the planning, implementation, observation, and reflection. The participants were 17 children aged 4-5 years old of group A1 TK ABA 4 Mangli Kaliwates Jember. The result showed that prior to PECS the children's speaking development rate was 17%, after the PECS action the speaking ability increased from 35% in the first cycle to 88% in second cycle. This shows that the speaking ability of early childhood can be improved with PECS approach.

Purpose: The aim of this study was to analyze the repercussion of the implementation of PECS on the burden index of mothers of children with Autism Spectrum Disorder (ASD). Methods: This was a longitudinal study (CEP 0403/2017). The sample consisted of 20 mother and child with ASD. The mothers were on average 41 years and 5 months and the children were 7 years and 2 months old. Fifteen children were male and five were female. The Brazilian version of the Burden Interview scale was applied to verify the level of caregiver burden. The Autism Behavior Checklist (ABC) was applied to the analysis of non-adaptive behaviors and to analyze the lexical repertoire: Auditory and Expressive Vocabulary Tests. The PECS Implementation Program was composed of 24 sessions of individual speech therapy with the active presence of mothers. At the end all children and mothers were reevaluated with part of the instruments. Results: There was a tendency to reduce maternal overload indexes after the implementation of the PECS. There was a significant decrease in non-adaptive behaviors and an increase in the expressive and auditory vocabulary indexes of the children at the final moment of the study. We did not observe a significant correlation between the degrees of overload with age, schooling and intellectual quotient of children, nor schooling and maternal socioeconomic status. Conclusion: It was possible to analyze the repercussion of the implementation of the PECS on the burden of mothers of children with ASD assisted by the Program.

The purpose of the current study was to explore strategies to help parents support their child's PECS use at home. One child with ASD and both his parents participated. Researchers used behavioral skills training to teach target PECS skills and applied general case training strategies to actively program for generalization. A multiple baseline design across skills was used to monitor the primary parent trainee's fidelity during training sessions and a multiple probe design was embedded to monitor both parents' treatment fidelity in the natural environment with their child. The parent trainee demonstrated target PECS skills within the training setting. However, parents did not reliably demonstrate all target PECS skills in the generalization setting during follow-up.

Abstract: The purpose of this research was to compare the effectiveness of teaching two methods of image exchange communication system and matrix teaching on language skills and social skills of children with autism spectrum disorder. The method of this research was a semi-experimental method with a pre-test-post-test design along with a control group. The statistical population includes all children referred to autism centers in Qom city in 2021 who had symptoms of the disorder according to DSM criteria and were diagnosed with autism disorder according to the centers and experts. 45 people (9 girls and 36 boys) were randomly selected from autism centers in Qom province and randomly divided into two experimental groups and one control group. The experimental groups were subjected the 6-step treatment of the picture exchange communication system and matrix training individually for 3 months and 4 sessions of 15 to 20 minutes each week, and the control group did not receive any intervention. In this research, expressive and receptive and speaking language tests of Nyusha Development and Autism Social Skills Profile were used to collect data. The final results showed that there was a significant difference between the two groups of matrix training and PEC treatment (p<0.05). Based on the results, both interventions were effective, but it can be said that the communication system of image exchange is more effective in the language skills and social skills of children with autism spectrum disorder.

Background: PECS, or Picture Exchange Communication System, addressed in writing. The answers for such schemes to influence word retrieval in autism spectrum disorders in children (ASD). Objective: The objective of the current study finding out the effects of Development of the picture exchange communication system in autistic children's speech and communicative requesting was the main goal of the current study.Results: Results from the Childhood Autism Rating Scale (CARS) assessment scoring form indicated that there is a significant relationship between the Effects of Communicative PECS speech and request development in autistic children, overall analysis of the pre and post scores of CARS assessment. In which mean of pre score is 36.15 and mean of post score is 29.5. The standard deviation of pre score is 8.47 and the post score standard deviation is 5.39. The mean difference showed the improvement between CARS pre and post assessment.

The aim of the study was to empirically assess the efficacy of Picture Exchange Communication System (PECS) in 5 children with autism spectrum disorder (ASD). This study was also intended to report parental feedback on using PECS with their children. Results: Current study shows that all the children were able to use PECS spontaneously and independently without any physical prompts. Children were able to generalize PECS at home with ease and were able to initiate communication on their own using the pictures. The mothers of the children reported that they observed a drastic subsidence in children's challenging behaviours and also improvement in their attention span. The findings from our study showed that PECS training is effective in improving the socio-communication skills in children with ASD who had restricted communication. On analysing the report, mothers stated that they were able to easily incorporate PECS at home with their child as it implements the use of actual pictures for communicative exchange. As PECS training paves the way for expression of the child's needs, there was also a significant reduction in the children's behavioural problems such as tantrums and other self-injurious behaviours. Conclusion: From this study, it can be concluded that PECS training is effective in improving various communicative temptations in socio-communication skills in children with ASD who have restricted communication. It was also noted that obtaining parental feedback periodically would help in generalization and it encourages the parents' involvement in the child's learning process.

Autism spectrum disorder (ASD) is an interplay between biological, social and environmental factors that impact the development of individuals. However, core characteristics are social, communication and behaviour challenges that restrict children’s participation in society. Consequently, there are discussions regarding the need for society to develop interventions that are geared towards promoting the participation of children with ASD in societies. While the Picture Exchange Communication System (PECS) helps lessen the biological characteristics of children with ASD, its impact has rarely been explored in non-western societies, such as the United Arab Emirates (UAE). Objectives: The instant study’s purpose was to explore parents’ perceptions of the effectiveness of the PECS on the communicative, social and academic developments of children with ASD in UAE. Results: The results revealed that the parents were generally positive about employing the PECS to support the development of their children with ASD. There was also a positive association between using the PECS and improving communication, learning and social skills in children with ASD. Conclusion: It is imperative that educators and policymakers envisage parents as equal partners in providing rehabilitation services to children with ASD. Various implications, such as the need for continual engagement and empowering parents of children with ASD, are discussed.

The picture exchange communication system (PECS) is an evidence-based communication intervention designed to improve communication skills in people with limited to no functional speech. Because of this, professionals frequently look for opportunities to receive training in how to implement PECS. Though most training methodologies have included robust, and time intensive, training methodologies, one recent study used video modeling (VM) with voice-over instructions and text descriptions to train three future professionals in the implementation of PECS. Thus, to find even more efficient and effective training methodologies, this study aimed to train future professionals in the first three phases of PECS using VM alone and, if necessary, verbal feedback. A nonconcurrent multiple baseline design across three participants was used in the study. The results indicated all three participants demonstrated an immediate change in skills following VM alone, with only one participant requiring brief feedback in Phase 1. This was further evidenced by large effect sizes. Thus, results indicate that training future professionals using VM was both more efficient and equally effective when compared to previous training methodologies.

Caregivers are generally children’s primary communication partners; therefore, their ability to support their child’s use of augmentative and alternative communication systems, such as the Picture Exchange Communication System (PECS; Frost & Bondy, 2006), is critical. However, few studies explore systematic approaches to PECS caregiver training and little is known about how to efficiently and effectively support caregivers’ PECS implementation. The purpose of the present study was to evaluate the feasibility and preliminary effectiveness of a 2-week telehealth training package using behavior skills training and general case training to teach caregivers to implement PECS (i.e., the PECSperts Caregiver Training Package). Six caregivers of children on the autism spectrum participated in the study, four mothers and two fathers. Feasibility was evaluated across the areas of acceptability, service demand, community implementation, practicality, and limited effectiveness testing (Bowen et al., 2009). The training was evaluated using a modified concurrent multiple probe across behaviors research design. Caregivers reported a high degree of satisfaction with the training, and high rates of session attendance and study engagement were observed. Caregivers achieved high levels of PECS teaching accuracy for all the phases of PECS targeted in the training (i.e., phases 1 to 3b). Results persisted at 1- and 2-month follow up probes. The results indicate that a brief telehealth model may be an effective approach to PECS caregiver training and may be feasibly implemented in community settings. The results support the need for future research exploring the effectiveness of the training on children’s PECS use.

The Picture Exchange Communication System (PECS) is an Augmentative and Alternative Communication (AAC) system which is widely used to support children with developmental disabilities. In the present study, we surveyed individuals responsible for implementing PECS in special educational settings in the United Kingdom (N=283). We explored knowledge of and adherence to the intervention, with a view to identifying training and support needs. Specifically, we examined participants’ knowledge, implementation accuracy, training experiences, access to resources, and attitudes towards PECS. We developed hierarchical logistic regression models to explore the association between training experience and both knowledge and use of PECS. We pre-registered our methods, predictions and the analysis plan on the Open Science Framework (OSF). We found considerable variation in practitioner knowledge and implementation of PECS. Formal training predicted greater knowledge and more accurate implementation when practitioner role and the degree of setting support were accounted for. While PECS was rated by a large majority to be effective and practical, many participants identified that time and the availability of resources were barriers to implementation. We also found that the purpose of PECS was not always fully understood by practitioners, and we identified some consistent gaps in knowledge and implementation. This study contributes new information regarding the real-world use of PECS in educational settings and offers new insights for supporting practitioners.

Educational professionals (EPs) are expected to be knowledgeable about the use of the Picture Exchange Communication System (PECS). This study aims to explain the perspectives and experiences of EPs regarding their familiarity with and understanding of PECS, as well as the barriers to successful PECS usage. This study uses a qualitative descriptive approach to investigate PECS usage in Saudi governmental educational institutions serving children with autism spectrum disorders (ASD). In-person semi-structured interviews were conducted with 11 EPs. The inductive thematic analysis of the interview extracts reveals that EPs have limited knowledge of PECS, a lack of understanding of its implementation procedures, and insufficient training. Barriers to the successful implementation of PECS were also revealed, including a shortage of assistant teachers, low parental awareness, and limited parental collaboration. EPs expressed negativity regarding the availability of PECS tools and highlighted a need for resources. The findings suggest that there are areas for improvement in terms of PECS practices in schools and identify several barriers—organization-related, school-related, family-related, and child-related—that should be taken into consideration when implementing PECS with children with ASD. Based on the qualitative results, this study provides suggestions for further research as well as implications for practice. Barriers to the use and implementation of PECS are identified. The results will be helpful for schools regarding the provision of the necessary tools and training for PECS application as well as for policy makers who need to consider employing assistant teachers to assist EPs with the development and implementation of PECS

Background: Children with communication impairments-such as autism spectrum disorder or global developmental delay-face significant challenges affecting their emotional and behavioural development. The Picture Exchange Communication System (PECS) is an augmentative communication tool designed to enhance their skills. However, its effectiveness can vary in resource-limited settings. This study aimed to identify predictors of successful PECS training among children with communication impairments in such environments. Conclusions: In resource-limited settings, factors such as severity of impairment, intensity of intervention, socioeconomic status and caregiver involvement significantly influence the success of PECS training. Tailored interventions and strategic resource allocation are crucial to optimise communication outcomes for these children.

Introduction: It is both essential and significant to undertake research focused on the implementation of innovative educational methods within autism centers. Objective: This study seeks to investigate the impact of an intervention utilizing the Picture Exchange Communication System (PECS) within physical education (PE) settings on the physical activity (PA) levels and social skills of children diagnosed with autism. Conclusion: The findings of the current study indicate that the implementation of the PECS method facilitates the enhancement of communication abilities and increases PA levels among children with autism. This advancement in skills enables these children to achieve better control and regulation of their emotions and feelings. Consequently, this method can be regarded as an effective strategy for fostering emotion regulation skills and enhancing both social skills and PA in children with autism.

Introduction: Learners with multiple disabilities and visual impairments (i.e., blindness or low vision) stand to benefit from accessible augmentative and alternative communication such as tangible symbols, but currently no evidence-based practices exist to guide intervention decisions. This study is a replication of previous research on Phase 1 of the Picture Exchange Communication System (PECS) adapted to teach students with multiple disabilities to exchange a tangible symbol for a preferred item. Methods: A multiple-probe single-case research design was used with three participants. Data were also collected to assess generalization, maintenance, and social validity. Results: A functional relation was observed, and all three participants achieved mastery criteria within 7–15 sessions. Although limited, generalization and maintenance data were promising. Social validity data showed families and professionals alike generally perceived the procedures and outcomes positively. Discussion: Results contribute to the growing body of evidence that adapted PECS Phase 1 is effective to teach students with multiple disabilities to use tangible symbols for basic requesting. Length of time to attain mastery criterion was longer for participants who were nonambulatory. Implications for practitioners: Practitioners should use efficiency data to plan for adequate time to support skill development, which will require collaboration and embedding opportunities into natural routines

Picture exchange communication system is an effective tool for improving communication skills in children with ASD in Malawi. Its adoption can facilitate learner independence, enhance classroom participation, and reduce frustration-related behaviors. Future research should explore long-term outcomes and strategies to scale PECS implementation across diverse Malawian settings

The Picture Exchange Communication System (PECS) is widely recognised as initially developed for children with autism and has since been identified as beneficial for individuals with hearing impairments. This study, therefore, seeks to explore the adaptation of PECS for toddlers with hearing impairments in inclusive classroom settings. The structured six-phase protocol of PECS, emphasising visual and tactile supports, is examined for its potential to bridge communication barriers and foster independent interaction. Special attention is given to integrating situational visual cues, such as photographs and tangible symbols, to enhance engagement and contextual understanding during playtime, a critical developmental activity for young children. Parental involvement and environmental adjustments are pivotal factors in successfully implementing PECS for toddlers with hearing impairment. Training parents to use PECS in naturalistic contexts, such as play, improves communication consistency and motivation. The paper highlights the role of customised PECS strategies in supporting communication development and toddlers' social and emotional well being. Despite promising outcomes, this study underscores the need for further research to validate the effectiveness of PECS adaptations for this specific population, particularly in fostering spontaneous communication and joint attention.

For children with autism spectrum disorder (ASD), communication difficulty is one of the three “core” difficulties. Therefore, intervention to help children with ASD develop communication skills is a key goal that many intervention programs for children aim for. This study conducted a survey on the current status of communication skills development for 4-5 year old ASD children through the picture exchange communication system - PECS through questionnaire survey, observation method, and in-depth interview method. The results of the study showed that most teachers perceived that PECS is an appropriate method to develop communication for children with ASD but not for all children with ASD and that PECS should be used in combination with other methods. Teachers had a correct understanding of the requirements for using PECS and the requirements for PECS picture books.

Background and aims: Although there are several published systematic reviews and meta-analyses of the effectiveness of the Picture Exchange Communication System (PECS) protocol, no previous review has focused on factors affecting its implementation. The present review attempted to identify potential barriers and facilitators in implementing PECS, as well as examining authors’ and stakeholders’ views and experiences in terms of implementation.r Conclusion and implication: The identification of potential barriers or facilitators affecting the implementation of PECS is not currently possible. The present review’s identified implementation factors were extracted from qualitative analysis of previous researchers’ anecdotal remarks or from the social validity measures. Implications in terms of previous PECS literature findings are discussed.r

Background: This research examined the perceptions of parents and professionals in Serbia regarding the Picture Exchange Communication System (PECS) as an alternative communication system designed for people with autism and/or other developmental disabilities. Purpose: The study aimed to determine differences between these two groups in terms of knowledge, experience, and attitudes, focusing on perceived benefits and obstacles to the implementation of PECS. Research Design: The research included 93 participants (45 parents and 48 professionals) who completed an online questionnaire. Results: The results indicate that parents more frequently attend formal training and report a higher level of confidence in using PECS compared to professionals. Parents also value the practical aspects of implementation and the availability of support more than professionals do. Both groups recognize the benefits of PECS for communication development, as well as obstacles such as a limited vocabulary, the need for additional training, and the necessity to involve others. Conclusions: The findings highlight the need for systemic support in Serbia through organized training, supervision, and support for both parents and practitioners, in order to ensure effective and sustainable use of PECS in everyday contexts.

This mixed-methods study explored the implementation of the Picture Exchange Communication System (PECS) by families of children with Autism Spectrum Disorder (ASD) in Saudi Arabia. Quantitative data were collected through a multiple-intervention (ABAB) design with five families, assessing parent implementation accuracy and child communication outcomes across baseline, online training, and in-person training phases. Results indicated steady improvement in both parent accuracy and child correct responses, with the highest gains following in-person training.

This systematic review and meta-analysis aimed to investigate the efficacy of the Picture Exchange Communication System (PECS) in improving communication skills and related collateral outcomes among children with autism in Mainland China, and to identify potential moderators.

This study examines the effect of the Picture Exchange Communication System (PECS) on a child's attention span, communication skills, and behavioral changes in children with ASD at the Abu Dhabi Autism Centre. The research employed a mixed-method approach by observing six children quantitatively for four months and then qualitatively interviewing the children’s parents and teachers. Results showed that PECS significantly shrunk task completion time and lowered variability in performance related to higher attention and more task engagement. Qualitative results showed participants' responses with improved communication skills, decreased negative behavior, and increased attention spans, mainly using visual stimuli. However, consistent usage of PECS at home and individual variable responses were noted. This study emphasizes the necessity of using suitably tailored interventions, delivery across environments, and use of highly preferred reinforcers when implementing PECS. These findings add to the growing body of research on autism interventions in non-Western contexts to help educators and families in the UAE. Research into ways of overcoming implementation challenges and increasing the sample to include children with differing ASD severity and co-occurring conditions is suggested for future research.

Introduction: The aim of this study was to examine the effect of the Picture Exchange Communication System (PECS) protocol in teaching individuals with moderate/severe autism spectrum disorder (ASD) the ability to initiate spontaneous communication and request food.r Method: In the study, a single-subject research model, multiple probe design with across-participant was used. The participants of the study were three boys diagnosed with moderate/severe ASD attending a special education practice school. The independent variable of the study was the first three phases of the PECS protocol, and the dependent variable was the child's ability to initiate spontaneous communication and request food. The study included baseline, intervention, generalization and follow-up sessions.r Results: The first three phases of the PECS protocol were found to be effective in children with moderate/severe ASD in learning the skill of requesting food. The children were able to maintain the food-requesting skill they learned one and three weeks after the last intervention session and were able to generalize this skill to different environments and people. Teachers who participated in the study as communication partners expressed positive opinions about the study.r

Picture-based communication systems can effectively convey meaning to a listener regardless of the listener's language fluency. In other words, picture-based communication systems can serve as a means of cross-lingual communication. The current study employed a concurrent schedule assessment to measure the allocation of responses between two languages of four pre-kindergarten students with autism. We reversed contingencies (i.e., switched the language with which we responded) to ensure the allocation was due to the researcher's language use rather than some other variable (i.e., preference for the left side). Results showed three response patterns: two students consistently allocated to Spanish (i.e., had a preference), one student consistently chose pictures from the left side regardless of the language (suggesting either a side bias or no language preference), and one student began allocating to one language but did not maintain this allocation following several contingency reversals. These results suggest that users of picture-based augmentative and alternative communication systems may prefer the language used by their communication partner, and that a concurrent schedule arrangement can help identify the student's language preference. We discuss limitations and future directions for assessing language preferences.

This study aims to determine the effectiveness of the Picture Exchange Communication System (PECS) method in improving the listening skills of children with Attention Deficit Hyperactivity Disorder (ADHD). The study was conducted at SD Negeri 113 Pekanbaru in the 2025/2026 academic year for four weeks, starting from the implementation of the pretest, intervention during four learning sessions, to the posttest. The study population was all students with Attention Deficit Hyperactivity Disorder (ADHD) at the school, while the research sample consisted of four students selected using a purposive sampling technique based on expert diagnosis and initial observation results. The instrument used in the study was a listening skills test developed based on five indicators according to Rangkuti (2024), namely understanding the storyline, understanding characters and roles, the ability to answer factual questions, actions or physical movements, and the ability to conclude moral values. Data analysis was carried out quantitatively by calculating the average score, gain score, N-Gain, and a paired sample t-test using the SPSS program to determine the significance of the difference in pretest and posttest scores. The results showed an increase in the average score from 6.75 in the pretest to 9.25 in the posttest. The paired sample t-test obtained a significance value of 0.030 (p < 0.05), indicating a significant difference between the scores before and after treatment. However, the N-Gain value of 0.198 is considered low, indicating that the increase was not significant. Overall, the PECS method was found to be effective in improving the listening skills of children with ADHD, although this improvement still requires reinforcement through more optimal training duration and intensity.

Although researchers have applied the Picture Exchange Communication System (PECS) protocol to teach communication skills on a speech generating device (SGD; e.g., King et al., 2014; Wendt et al., 2019), the majority of this literature base focuses their evaluation on communication initiation (taught in Phase 1), but not on the other communication skills that the PECS phases teach (e.g., finding the communication book, finding the communication partner, discriminating between pictures, and building sentences). We taught a 9-year-old individual with autism spectrum disorder to use a SGD using the PECS protocol and explicitly evaluated the effects on all of the target communication skills. Our findings suggested that the adapted PECS protocol successfully increased all target communication skills. However, when we removed the protocol, the individual did not exhibit the previously exhibited communication skills. We also found that the individual increased novel vocal requests, but only during the PECS teaching conditions.