A review of the efficacy of the picture exchange communication system intervention

Deborah Preston, Mark Carter*

*Corresponding author for this work

Research output: Contribution to journalReview article

94 Citations (Scopus)


The Picture Exchange Communication System (PECS) is a communication program that has become widely used, especially with children with autism. This paper reports the results of a review of the empirical literature on PECS. A descriptive review is provided of the 27 studies identified, which included randomized controlled trials (RCTs), other group designs and single subject studies. For 10 appropriate single subject designs the percentage of nonoverlapping data (PND) and percentage exceeding median (PEM) metrics were examined. While there are few RCTs, on balance, available research provides preliminary evidence that PECS is readily learned by most participants and provides a means of communication for individuals with little or no functional speech. Very limited data suggest some positive effect on both social-communicative and challenging behaviors, while effects on speech development remain unclear. Directions for future research are discussed including the priority need for further well-conducted RCTs.

Original languageEnglish
Pages (from-to)1471-1486
Number of pages16
JournalJournal of Autism and Developmental Disorders
Issue number10
Publication statusPublished - 2009

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