Picture Exchange Communication System and Autism Ranking:

Future Research

Summary of Existing Research

There is a very small amount of high quality research evidence (five controlled trials) and a small amount of low quality research (19 single-case design studies with three or more participants) into the use of PECS for autistic individuals.

This research suggests that PECS may be an effective way to increase the social communication skills (particularly requesting) of some young autistic children who are non-verbal or who have limited functional speech.

There is insufficient evidence to determine if PECS provides any benefits in other areas (such as a reduction in challenging behaviours) to young autistic children.

There is insufficient evidence to determine if PECS provides any benefits to autistic adolescents and adults.

Recommendations for Future Research

Future studies should

• Use more scientifically robust, experimental methodologies with larger numbers of participants.
• Involve a wider range of participants (such as adults, females, individuals from ethnic minority groups).
• Provide more details about the participants, such as whether they had a formal diagnosis of autism, their level of intellectual ability, ethnicity etc.
• Provide separate assessment and outcome data for those participants who were autistic where those studies include participants with a range of disabilities.
• Identify if there any prerequisite abilities and skills (such as cognitive ability or linguistic skills) that may make some individuals more likely to benefit from PECS.
• Include standardised measures for outcomes such as speech and other vocalisations.
• Investigate the effects of PECS in other areas such as academic skills.
• Identify which elements, if any, of the training protocol established by Bondy and Frost are the most effective for which groups of people. 
• Identify if PECS can be delivered successfully by a wider range of providers, such as parents and carers.
• Compare PECS with other interventions which are designed to achieve similar results, such as sign language and voice output communication aids.
• Determine if PECS can be used as one of the elements within comprehensive, multi-component, treatment models.
• Identify if PECS provides any benefits in the medium to long term and in real world settings.
• Involve autistic people and parents and carers in the design, development and evaluation of those studies.

Updated

17 Jun 2022

Last Review

01 Sep 2017

Next Review

01 Dec 2023