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A Review of the Efficacy of the Picture Exchange Communication System Intervention

Abstract

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.

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Notes

  1. For pre-test post-test designs, effect sizes were calculated by subtracting the pretest mean from the post-test mean and dividing by the pooled standard deviation. For studies involving a comparison group, effect sizes were calculated by subtracting the mean of the control or alternate treatment group from the mean of the PECS intervention group and dividing by the pooled standard deviation.

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Appendix

Appendix

See Table 6.

Table 6 Quality criteria for single subject research adapted from Horner et al. (2005)

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Preston, D., Carter, M. A Review of the Efficacy of the Picture Exchange Communication System Intervention. J Autism Dev Disord 39, 1471–1486 (2009). https://doi.org/10.1007/s10803-009-0763-y

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Keywords

  • Picture exchange communication system
  • Augmentative and alternative communication
  • Autism