Let's talk about PECS, baby.....and why we don't use it anymore

7 Minute Read

Ah, the infamous PECS. What is it, and why would I not recommend it for your autistic child?

PECS stands for Picture Exchange Communication System. It’s one of the most widely used communication techniques for autistic individuals with minimal or no verbal language, especially within traditional therapy spaces.

Here’s the oversimplified version: a child is taught to hand a picture of something (say, a toilet) to a communication partner when they need to use the bathroom. PECS aims to teach children to initiate interactions by making requests, asking questions, and even making comments. It uses pictures as a means to access those functions of language. On paper, that sounds pretty great, right?

In theory—yes.
In practice—not so much.

The problem? Communication is so much more than just making requests.

Think about all the ways that we use language every day. Sure, you ask questions, make comments, and request things. But you also greet people, share stories, protest, refuse things, express emotions, label items, describe experiences, answer questions, and call attention to things that matter to you. These are all important and valid functions of communication. PECS, in its structure, centers heavily on requesting. And that’s a pretty limited view of what communication actually is.

PECS was created in 1984 by Lori Frost, MS, CCC-SLP, and Dr. Andrew Bondy. It was designed as a tool within the framework of Applied Behavioral Analysis (ABA)—a model rooted in behavior modification. The goal? To teach autistic individuals how to “appropriately” request things, thereby reducing “undesired” behaviors.

As someone who is committed to a neurodiversity-affirming approach, this model raises several red flags.

So why don’t I use the PECS technique in my therapy?

• It’s compliance-based.
  PECS is designed to reduce behaviors by replacing them with picture-based requests. This focus on compliance doesn’t center the child’s autonomy or emotional experience. In contrast, more neurodiversity-affirming practices prioritize connection over compliance, meaning we aim to build trusting, respectful relationships rather than focusing on getting a child to perform a specific behavior. The goal is meaningful communication, not just following instructions.

• It’s limiting.
  Communication is rich and diverse, but PECS often restricts it to a narrow set of functions, primarily requesting. Even then, a child can only request what pictures are available in their book, which greatly limits their ability to express themselves. Plus, the PECS binder itself is often bulky and cumbersome to carry around, making spontaneous, real-world communication even harder to support.

• It lacks flexibility.
  Real communication is dynamic. PECS is often taught in highly structured drills, which don’t reflect the natural flow of conversations or interactions.

• It doesn’t support true self-expression.
  Kids aren’t given space to share what they want to say; only what they’re taught is appropriate or useful in the moment.

• It doesn’t teach grammar or support natural language development.
  PECS relies heavily on single-picture exchanges. This often prevents children from learning how to build sentences, use grammar, or express more nuanced and complex ideas over time.

• It can impede bodily autonomy.
  PECS frequently uses hand-over-hand prompting (physically guiding a child’s hand to complete a task), which can feel invasive and violate consent. Communication should be empowering, not something done to a child.

This is why I advocate for a total communication approach that honors every way a person might express themselves - gestures, signs, pictures, vocalizations, speech-generating devices, etc.

I often recommend a robust speech-generating device (SGD). These devices offer access to a full vocabulary, not just a handful of pictures. They support real language development, things like grammar, sentence-building, and expressing complex thoughts.

We’re also seeing more and more that kids are naturally more motivated to communicate when they can talk about things that light them up (like dinosaurs, favorite foods, or characters they love). Those kinds of rich, specific topics just aren’t available in a PECS binder, but they are available on a robust SGD. When a child can talk about what matters to them, communication becomes joyful, not just functional.

Instead of viewing communication as something that needs to be “trained,” I view it as something that needs to be supported, honored, and co-created.

PECS might be familiar. It might even be the first tool handed to you as a parent or caregiver. But familiarity doesn’t always equal effectiveness or empowerment.

Every autistic child deserves access to communication that reflects their whole self, not just their ability to request a snack or ask for a break.

Communication is connection. It’s not a task to be performed—it’s a right to be honored.

~Chloe