Deborah Carr and Janet Felce, two researchers in Wales, United Kingdom, recently published an article in the Journal of Autism and Developmental Disorders describing an experiment they conducted. The experiment investigated the results of PECS training through Phase III on speech production in children diagnosed with Autism (Carr & Felce, 2007). 

The Picture Exchange Communication System (PECS; Bondy & Frost, 1994) is an augmentative communication system designed to increase functional communication in children.  Bondy and Frosty (1994, p. 3) define the fundamental goal of PECS: "Children are taught to approach and give a picture of a desired item to a communicative partner in exchange for that item.  By doing so, the child initiates a communicative act for a concrete item within a social context."  PECS is taught in six phases.  Phase I focuses on the initial exchange. Phase II teaches the child to travel to a communicative partner to initiate a request and Phase III focuses on discrimination between pictures.  Phase IV teaches using a sentence strip to communicate. Phase V teaches the child to respond to the question, "What do you want?", and Phase VI teaches the child to use pictures to comment both spontaneously and responsively (Carr & Felce, 2007).

In Carr and Felce's study, children between the ages of 3 and 7 who were diagnosed with Autism were divided into two groups. One group, the experimental group, received 15 hours of PECS training through Phase III in their school environment.  The control group did not receive any PECS training or any treatments beyond the interventions they were already receiving in school.  Assessments for use of language for all children were conducted at three points: five weeks prior to treatment, one week prior to treatment and one week after the completion of treatment.  Treatment lasted approximately 4 to 5 weeks. The observations of the experimental group and control group were compared.

Results indicated that overall the children who received the PECS training acquired more spoken words during the treatment phase than those who didn't receive the training.  Specifically, three children who already used some spoken words during the first two observations increased their total words produced at the post-treatment observation.  Two children in the PECS group, who did not speak words at the first two observations, used spoken words at the post-treatment observations.  In the control (non PECS) group, one child demonstrated a small increase (two words) in total words at the post-treatment observation.  The four other children in the control group demonstrated decreases in total words spoken at the final observation.  The number of participants was too small to conduct statistical analyses of the data; however, the results reinforce the current view that teaching the use of picture exchange could promote speech in some children. 

It is worth noting that the teaching protocols were applied according to the PECS program which precludes the purposeful teaching of speech.  Yet, despite the fact that there was no deliberate attempt to teach spoken language, the children who received PECS training demonstrated increases in spoken words.  The authors speculate that the reason this increase in spoken language is observed is because, in PECS training, the person who is receiving the picture from the child repeats the item clearly to the child during the exchange.  Therefore, the combination of the spoken word, physical item and picture of the item all at once may clarify the meaning of the word for the child. This might facilitate the eventual use of the spoken word without the picture.