ABA Inside Track – Episode 329

Tutorial: PECS with Judy Southey

Release Date: December 10, 2025
Host(s): Robert Perry Crews, Diana Perry Crews, Jackie McDowell
Guest: Judy Southey, MSc, SLP

Episode Overview

This episode features a comprehensive tutorial on the Picture Exchange Communication System (PECS) with guest Judy Southey, a seasoned speech and language pathologist. The hosts and Judy dive deep into PECS, its history, practical assessment and implementation, the nuances of alternative and augmentative communication (AAC), and strategies for collaboration between practitioners and families. The episode is packed with step-wise explanations of PECS, research highlights, real-world anecdotes, and practical advice for both newcomers and seasoned professionals in applied behavior analysis and speech-language pathology.

Key Discussion Points & Insights

1. Introduction to PECS and AAC

• PECS Origins & Endurance:
  • PECS was developed in 1985 by Andy Bondy and Lori Frost and "nothing has replaced it yet, which is impressive." (Judy, 02:05)
  • The strength of PECS lies in its robust research base and longevity despite advances in technology.
• What is AAC?
  • Definition: Alternative and Augmentative Communication refers to all forms of communication (other than oral speech) that are used to express thoughts, needs, desires, and ideas. Includes sign language, gestures, picture symbols, or high-tech devices.
  • Types:
    • Unaided: No additional materials needed (e.g., gestures, sign language)
    • Aided: Involving external devices or symbols (e.g., PECs, speech-generating devices (SGDs))
    • [07:29] “AAC stands for alternative and augmentative communication. It can be anything from sign language, gestures, symbols... or it can be a completely alternative system.” (Judy)
  • Advances in iPad technology have made AAC options more accessible, but technology alone is not sufficient—structured teaching is crucial.

2. PECS as a Protocol – Not Just Pictures

• Distinguishing PECS from Devices or Symbols:

  • PECS is a protocol for teaching communication, not simply a set of picture cards or a generic term for any symbol.
  • [23:04] “One of my pet hates being a lover of PECS is when people call symbols PECs… That's a picture and it's singular. It's not the system.” (Judy)

• Key PECS Features:

  • Affordability: Easy to implement with inexpensive materials (pictures, Velcro, laminator)
  • Focus on Bidirectional Communication: Emphasizes the back-and-forth nature of effective communication and the importance of a communication partner.
  • Shares Foundations with Other AAC: The “exchange” (physically handing a symbol) cannot be replicated with generic device use but can inspire device-based adaptations.

3. The Value of PECS in Diverse Contexts

• Suitability & Flexibility:
  • PECS works well for a wide variety of learners, especially young or minimally verbal individuals.
  • [09:38] “It also teaches everybody what communication is... The protocols of PECS really focus on teaching that communication is two way…” (Judy)
• No Strict Prerequisites:
  • [17:23] “Andy Bondy and Lori Frost maintain that there are no prerequisites for starting PECS.” (Judy)
  • Object-to-picture correspondence is not necessary for the initial stages; early phases teach the process of communication rather than symbol-object matching.

4. How to Conduct an AAC Evaluation

• Comprehensive Assessment:
  • No one-size-fits-all; evaluation should involve observation, interviews with families and teachers, and physical/occupational therapy input.
  • Key considerations:
    • The individual’s physical abilities (e.g., fine/gross motor, eye gaze),
    • Environments where communication will take place,
    • Needed vocabulary breadth,
    • Family/student priorities,
    • Ongoing re-evaluation as the individual’s skills progress [15:24].
• Continuous Process:
  • Recommendations and system choices should be revisited as skills improve or needs change.

5. Moving Between AAC Systems

• Hierarchy Myths:
  • Critiques the notion of rigid hierarchies (e.g., "master PECS Phase 3 before a device"); individual needs and contexts matter more.
  • [16:52] “It is often a big concern like we need to have prerequisite skills or we need to be at a certain level… Andy Bondy and Lori Frost maintain that there are no prerequisites for starting PECS.” (Judy)
• Speech Development:
  • PECS and other AAC systems do not inhibit the likelihood of speech emergence; research supports that structured AAC does not delay speech.

Detailed Walkthrough: The Six Phases of PECS

Phase 1: Physical Exchange – “Pick Up, Reach, Release”

• Objective: Establish the fundamental communicative act—seeing what you want and handing over a symbol to a communication partner.
• Requirements:
  • Two adults: A prompter (behind the child) and a communicative partner (receiving the message)
  • 3-5 individually motivating reinforcers [27:18]
• Key Points:
  • Teaching the motor skill before true discrimination.
  • “Mastery” is attained when the learner consistently initiates an exchange independently across environments and with different people.

Phase 2: Distance & Persistence

• Objective: Increase independence and communicative persistence; the learner consistently seeks out the right communication partner.
• Strategies:
  • Gradually increase distance between learner, symbol, and communication partner.
  • Fade prompts so the individual travels further to make an exchange.
• Memorable Metaphor:
  • [36:13] “I walk in the store and I go, buttermilk. And I'm hoping someone's going to come running with buttermilk, right?... But I'm going to be way more successful finding someone who's in a store close and say, hey, where's the buttermilk?” (Judy)

Phase 3: Symbol Discrimination

• Objective: Learner discriminates between symbols—for example, choosing between “cookie” and “crayon.”
• Approach:
  • Start with a preferred and a blank symbol, then move to preferred & non-preferred, finally preferred vs. preferred.
  • Employ correction procedures and “correspondence checks” to ensure the right symbol aligns with actual choice/action.
• Challenge:
  • [40:07] “Phase three is where we are starting to teach the students that the symbol actually means something... probably the hardest level of PECS to train.” (Judy)

Phase 4: Sentence Structure

• Objective: Move from single-symbol requests to multi-symbol sentences (e.g., "I want cookie").
• Rationale:
  • Lays groundwork for later commenting and more complex communication.
  • Sentence strip is introduced here, not earlier.
  • “If a child comes up to you with a sentence that says, I want the iPad... you're going to know what it means.” (Judy, 53:21)

Phase 5: Responsive Requesting

• Objective: Teach learner to respond to questions (e.g., "What do you want?").
• Skills Targeted:
  • Understanding questions as communicative cues.
  • Distinguishing between spontaneous and prompted requests.
  • Sets up for responding to more generalized questions in varied social settings.

Phase 6: Commenting

• Objective: Expand communication to include comments and answers to questions, not just requests (e.g., "I see cat," "I hear music").
• Key Strategies:
  • Teach symbolic distinctions (I want vs. I see vs. I hear).
  • Introduce commenting in situations where the object/activity is visible/heard but not directly accessible (to avoid confusion with requesting).
  • [60:53] “When you request you get something and teaching that distinction... corresponds really well with tact training and mand training.” (Jackie & Diana)

Adjectives & Attributes (Advanced – after Phase 4)

• Expanding Detail in Utterances:
  • Add specificity (e.g., “I want chocolate chip cookie” vs. just “cookie”).
  • Use generic symbols over specific photos to promote generalization.

Research, Implementation Hurdles, and Best Practices

1. Fidelity and Training

• Requires Proper Training:
  • Fidelity to PECS protocols is essential—untrained or improvized implementations are unlikely to succeed; errors are usually teacher-driven, not learner-driven [63:12].
• Collaboration Matters:
  • Buy-in from families and support staff is crucial.

2. Common Pitfalls

• Mistaking “PECS” for “Pictures” or “Device”:
  • PECS is the process, not the tool.
• Rushing to High-Tech Solutions:
  • Technology is tempting but not intrinsically superior.
  • PECS provides structure and foundational concepts often missing from device-based approaches.
• Reluctance to Progress between Phases:
  • [48:31] “The biggest success was the kids that managed to make it to the hospital more times…the more you practice something, the better you're going to get at it. And that's with anything you're learning.”
• Not Building Generalization:
  • Practice requests across many items, partners, and environments from day one.

3. When to Move On

• Re-examine the communication method after establishing commenting and more complex skills—this may be the right time for a speech-generating device.
• Continuous evaluation and individualization are necessary; there’s no “perfect” number of symbols or pace—successful PECS users may move on to other systems as their needs and skills evolve.

Memorable Quotes & Key Moments

• On the universality of PECS:

  • “Pictures are universal...you can use any language as the written part on the picture. But pictures are universal.” —Judy (06:00)

• On prerequisites:

  • “There are no prerequisites for starting PECS...We’re just teaching them that if you see something you want, you hand over a magic ticket.” —Judy (17:23, 17:47)

• On family and team buy-in:

  • “If you don’t have buy-in by family, you’re not going to be successful. And then staff buy-in.” —Judy (20:26)

• On avoiding misinformation:

  • “A lot of people don't really know and it's okay to not know. It's okay to find out more.” —Judy (23:42)

• On the speed of acquisition:

  • “I’m fascinated by how quickly kids can move on if you really push them, versus how we just are okay with...moving them slowly.” —Judy (69:42)

• On device use:

  • “PECS has become kind of the Kleenex of AAC. Like you’re just like, it's all PECS. I'm just calling it PECS, whatever. It's a very specific thing.” —Rob (23:53)

Timestamps for Key Segments

• [02:05] – PECS origins and continued relevance
• [07:29] – Introduction to AAC modalities and PECS as a protocol
• [13:16] – Components and steps for an AAC evaluation
• [17:23] – Clarifying PECS prerequisites (or lack thereof)
• [27:18] – How to start PECS Phase 1
• [36:13] – The “buttermilk in the grocery store” communication analogy
• [40:07] – Phase 3 discrimination and correction procedures explained
• [44:37] – Moving from discrimination to requesting with multiple preferred items
• [52:05] – Phase 4 (sentence structure) and rationale
• [58:39] – Teaching commenting and advanced phases
• [63:12] – Troubleshooting: red flags and errors in implementation
• [65:36] – Advice for BCBAs working without an SLP
• [69:42] – The role of practice frequency and pace
• [72:09] – Judy’s contact info for further questions

Resources & Further Reading

Articles & Websites Discussed:

• Gans et al. (2014): "Interaction of Participant Characteristics and Type of AAC with Individuals with ASD" (AJIDD)
• Wanapasha et al. (2025): "Predictors of Successful Picture Exchange Communication System Training in Children with Communication Impairments" (BMJ Pediatrics Open)
• Robertson & Harris (2024): "How to Best Determine if an Autistic Individual is Using an Effective Communication System" (Autism Spectrum News)

Advice for Practitioners

• Learn and practice the first three phases deeply; watch training videos if possible.
• Always conduct regular reinforcer assessments and print/laminate relevant symbols.
• Secure family and staff buy-in; without it, progress is unlikely.
• Seek consultation with SLPs or other specialists as soon as complexity increases or progress slows.
• Remember: Not responding to non-targeted communication is part of shaping PECS use, but always reinforce communicative intent.
• Monitor for teacher error versus learner limitations—make adaptations as needed (e.g., manipulate the symbol size, backing, or velcro strength).
• Collaborate across disciplines for best outcomes and ongoing system refinement.

Final Thoughts

This episode offers an authoritative yet relatable deep dive into PECS and broader AAC strategies, debunking common myths, emphasizing the importance of structured teaching, and promoting ongoing collaboration. Judy’s experience and stories reinforce the flexible yet systematic approach needed for success in AAC, making this a must-listen (and must-read) for BCBAs, SLPs, educators, and families alike.

Contact Judy Southey:
Email: judysouthey@hotmail.com

Snack Pairing: Sushi (for reasons not fully explained – send in your guesses!)

Related Past Episodes:

• Episode 22: Introduction to AAC
• Episode 171: Professional Collaboration SLP Edition with Dr. Aaron Michaux
• Episode 220: Facilitated Communication
• Episode 259: Next Level Collaboration with Rose Griffin
• Episode 255: Scope of Comfort with Landria Seals Green

Notable Quote for Reflection:
“PECS is the protocol. The point is the exchange—the social act, not just the symbol.” —Judy (22:46)