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Brief Report: Randomized Test of the Efficacy of Picture Exchange Communication System on Highly Generalized Picture Exchanges in Children with ASD


A randomized control trial comparing two social-communication interventions in young children with autism examined far-transfer of the use of picture exchange to communicate. Thirty-six children were randomly assigned to one of two treatment conditions, one of which was the Picture Exchange Communication System (PECS). All children had access to picture symbols during assessments. Post-treatment measurement of the number of picture exchanges in a far-transfer, assessment context favored the PECS intervention. These findings were interpreted as support for the hypothesis that the PECS curriculum can successfully teach a generalized means of showing coordinated attention to object and person without requiring eye contact to children with ASD.

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  • Bates, E., Benigni, L., Camaioni, L., & Voterra, V. (1979). The emergence of symbols: Cognition and communication in infancy. New York, NY: Academic Press.

    Google Scholar 

  • Beck, A. R., Stoner, J. B., Bock, S. J., & Parton, T. (2008). Comparison of PECS and the use of VOCA: A replication. Education and Training in Developmental Disabilities, 43, 198–216.

    Google Scholar 

  • Bondy, A. S., & Frost, L. A. (1994). PECS: The Picture Exchange Communication System training manual. Cherry Hill, NJ: Pyramid Educational Consultants.

    Google Scholar 

  • Charlop-Christy, M. H., Carpenter, M., Le, L., LeBlanc, L. A., & Kellet, K. (2002). Using the Picture Exchange Communication System (PECS) with children with autism: Assessment of PECS acquisition, speech, social-communication behavior, and problem behavior. Journal of Applied Behavior Analysis, 35, 213–231.

    Article  PubMed  Google Scholar 

  • Ganz, J. B., & Simpson, R. L. (2004). Effects on communicative requesting and speech development of the Picture Exchange Communication System in children with characteristics of autism. Journal of Autism and Developmental Disorders, 34, 395–409.

    Article  PubMed  Google Scholar 

  • Ganz, J. B., Simpson, R. L., & Corbin-Newsome, J. (2008). The impact of the Picture exchange communication system on the requesting and speech development in preschoolers with autism spectrum disorders and similar characteristics. Research in Autism Spectrum Disorders, 2, 157–169.

    Article  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Jr., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.

    Article  PubMed  Google Scholar 

  • Mullen, E. M. (1995). Mullen scales of early learning. Minneapolis: Pearson Assessments.

    Google Scholar 

  • Mundy, P., Hogan, A., & Doehring, P. (1996). A preliminary manual for the abridged early social communication scales (ESCS). Coral Gables, FL: University of Miami.

    Google Scholar 

  • Sidman, M. (1960). Tactics of scientific research. New York: Basic Books.

    Google Scholar 

  • Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349–367.

    Article  PubMed  Google Scholar 

  • Tincani, M. (2004). Comparing the picture exchange communication system and sign language training for children with autism. Focus in Autism and Other Developmental Disabilities, 19, 152–163.

    Article  Google Scholar 

  • Yoder, P., & Lieberman, R. G. (2008). What does teaching declaratives tell us about the criteria by which we can judge the developmental importance of treatment outcomes? Evidence-Based Communication Assessment and Intervention, 2, 225–234.

    Article  Google Scholar 

  • Yoder, P. J., & Munson, L. J. (1995). The social correlates of co-ordinated attention to adult and objects in mother-infant interaction. First Language, 15(44, Pt 2), 219–230.

    Article  Google Scholar 

  • Yoder, P., & Stone, W. L. (2006). Randomized comparison of two communication interventions for preschoolers with autism spectrum disorders. Journal of Consulting and Clinical Psychology, 74, 426–435.

    Article  PubMed  Google Scholar 

  • Yoder, P., & Warren, S. F. (2002). Effects of prelinguistic milieu teaching and parent responsivity education on dyads involving children with intellectual disabilities. Journal of Speech, Language, and Hearing Research, 45, 1158–1174.

    Article  PubMed  Google Scholar 

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These data were collected with the support of National Institute for Deafness and Other Communication Disorders grant R01CD03581 and the core grant support to the Vanderbilt University Kennedy Center NICHD grant HD15052. The 2nd author was supported by grant #T32HD07226 from the National Institute of Child Health and Human Development to Vanderbilt University. Deep thanks are given to the families who participated, the research staff on the study, and to Wendy Stone, the primary collaborator on this work.

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Correspondence to Paul J. Yoder.

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Yoder, P.J., Lieberman, R.G. Brief Report: Randomized Test of the Efficacy of Picture Exchange Communication System on Highly Generalized Picture Exchanges in Children with ASD. J Autism Dev Disord 40, 629–632 (2010).

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  • Autism
  • Communication
  • PECS
  • Intervention
  • Generalization
  • Generality