Speech & Language
About This Intervention
What is PECS (Picture Exchange Communication System)?
Visual communication system using picture cards to facilitate functional communication.
Research
Evidence Summary
PECS has six studies examining its effectiveness for autism. Two studies show emerging evidence, two show limited evidence, one shows moderate evidence, and one shows strong evidence. The quality of evidence varies, suggesting PECS may help some individuals communicate, though more research involving more participants could strengthen what we know about how well it works and for whom.
Evidence last reviewed: 9 June 2026
Research
Linked Studies (6)
The Predominant Focus Is Still on Teaching Children to Make Requests: A Systematic Review of AAC for Autistic Adults and Children.
Mifsud Selena, Thomas Donna, Bowron Ruth et al.
Plain-English summary
This review looked at 69 studies about communication devices and supports for autistic people. Most research focuses on teaching children to make simple requests rather than broader communication skills. Very few studies looked at autistic adults or measured whether AAC improves quality of life or social relationships. The researchers say we need better studies that include adults and look at how AAC affects overall wellbeing, not just basic communication.
Summary by AutismInsights from published abstract.
Efficacy of the Picture Exchange Communication System for children with autism in Mainland China: A systematic review and meta-analysis of randomized controlled trials.
Huang Huan, Zhu Han, Tang Hailan et al.
Plain-English summary
This large study looked at PECS (Picture Exchange Communication System) - a method using pictures to help children communicate. Researchers reviewed 37 studies with over 2,300 autistic children in China. PECS significantly improved communication skills and had positive effects on thinking abilities, autism symptoms, quality of life, social skills, and behavior problems. However, it didn't significantly help with spoken language development. The program worked best when delivered by medical professionals in clinical settings.
Summary by AutismInsights from published abstract.
Avatar-Based Picture Exchange Communication System Enhancing Joint Attention Training for Children With Autism.
Ren Yongjun, Liu Runze, Sang Huinan et al.
Plain-English summary
Researchers created a new version of PECS (picture communication cards) that uses virtual characters instead of just therapists. This helped children with autism feel less anxious and stay more focused during communication training. The study also developed better eye-tracking technology to measure how well children pay attention during social activities. Results showed children improved their focus and responses when using the avatar-based system.
Summary by AutismInsights from published abstract.
Psychological behavioral therapies to improve autistic children's behaviors during dental visits: A systematic review and meta-analysis.
Pui Ying Lam Phoebe, Hoi Wan Fok Elise, Tung Megan Chan Yuen et al.
Plain-English summary
Researchers looked at 18 studies to see if special behavioral techniques help autistic children behave better at the dentist. They found that about half of children could cooperate with dental exams on their first visit, with slightly more cooperating on their second visit. However, most techniques like visual aids, communication systems, and behavioral programs didn't show clear benefits. The studies were too small and poorly designed to give us strong answers about what really works.
Summary by AutismInsights from published abstract.
Picture exchange communication system as a behavior modification technique for oral health assessment in autistic children.
Renuka P, Singh Subash, Rathore Monika
Plain-English summary
Researchers tested whether using picture cards (PECS) could help autistic children with dental visits and tooth brushing. They worked with 30 children with autism over 6 months. The children got better at understanding dental care through the picture cards, and their teeth became cleaner over time. The study shows that using pictures to communicate about dental care can help autistic children feel more comfortable and take better care of their teeth.
Summary by AutismInsights from published abstract.
The feasibility of implementing autism intervention methods in formal education settings welcoming refugee and asylum-seeking children: A systematic review of the literature.
Larran Julie, Schuster Isabell, Hein Sascha
Plain-English summary
Researchers looked at whether teaching methods designed for autistic children could help refugee children adapt to new schools. While no studies had tried this before, they found some evidence suggesting these structured teaching approaches might be helpful. Schools are important places for refugee children to learn and adapt, so using proven teaching methods from autism support could potentially benefit them.
Summary by AutismInsights from published abstract.
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Compare with PECS (Picture Exchange Communication System)AutismInsights presents published research for informational purposes only. This is not medical advice. Always consult your child's paediatrician, psychologist, or allied health team before making decisions about therapies or interventions.