The Autism Little Learners Podcast

Episode #154: Is PECS Still the Best Option? Rethinking AAC for Autistic Communicators

Host: Tara Phillips
Guests: Paulina Elias and Dr. Amanda Blackwell (Natural Communication)
Release Date: December 23, 2025

Episode Overview

In this thought-provoking and practical episode, host Tara Phillips invites speech-language pathologists (SLPs) Paulina Elias and Dr. Amanda Blackwell to critically examine the Picture Exchange Communication System (PECS) and its place in augmentative and alternative communication (AAC) for autistic children. The conversation delves into how approaches to AAC have evolved, reasons PECS is no longer widely considered the gold standard, and why child-led, autonomy-affirming methods are gaining momentum. The episode is rich with real-world examples, expert insights, and actionable strategies for educators, families, and support staff committed to connection over compliance.

Meet the Guests (04:04–13:03)

Paulina Elias

• Multilingual SLP based in Ontario, Canada, specializing in multilingualism, gestalt language development, and autism.
• Passionate about adapting—not just translating—resources for cultural and linguistic validity.
• Regular international presenter and consultant.

“The intersection of speech pathology and multilingualism is my main interest.” (06:29, Paulina Elias)

Dr. Amanda Blackwell

• Bilingual SLP, based in Guatemala for over 11 years.
• Founder of Guatemala’s Speech Therapy Association; passionate about making resources accessible in Spanish and other languages.
• Teaches postgraduate courses in the US and internationally, conducts research, and promotes evidence-based autism support.
• Active globally, expanding AAC resources and postgraduate opportunities in Latin America and beyond.

“There’s no lack of wanting more information—just a lack of access. All the latest evidence-based information is in English.” (09:00, Amanda Blackwell)

Key Discussion Points & Insights

1. What Is PECS and Why Is It Controversial? (15:18–18:24)

• Definition:
  PECS (Picture Exchange Communication System) is a behaviorally-based, structured protocol for teaching communication to autistic children through picture exchange.
  • Developed in 1985, rooted in B.F. Skinner’s Verbal Behavior and ABA principles.

“When we talk about PECS, it’s this very, very structured system where a person is trained to exchange a symbol for something they want.” (15:18, Paulina Elias)

• Controversy:
  • Focuses narrowly on requesting, not broader communication.
  • Based on behavioral methodology (ABA) that can conflict with affirming, autonomy-centered practice.
  • “Hand over hand” prompting is standard but problematic.

“The behavioral methodology—they say themselves, it’s based in ABA off of Skinner’s work. That’s a key reason why it’s fallen out of favor.” (17:58, Tara Phillips)

2. PECS vs. Other Visual Supports: Critical Distinctions (18:24–21:32)

• Not all low-tech AAC is PECS.
  Using pictures, visuals, and communication books can be positive and flexible if they're not bound to a rigid exchange protocol.

“We want to differentiate between this behavior-based exchange system and using visual supports, which we know is a great, great, great strategy.” (18:27, Amanda Blackwell)

• The “model without expectation” approach is recommended—offering tools, modeling use, but not requiring or prompting communication.

3. Hand-Over-Hand Prompting: Why It’s Problematic (21:32–26:47)

• Standard in PECS but can violate bodily autonomy and create prompt dependency.
• Many autistic individuals and families report negative experiences, with children becoming reliant on adult “help” or developing avoidance behaviors.

“Hand over hand prompting...could even sometimes...lead to this violation of someone else’s bodily autonomy.” (24:24, Paulina Elias)

• The alternative: Hand-under-hand support, where the child stays in control and can disengage at any time.

“If you are under, they can break away easily when it doesn’t feel comfortable to them.” (25:02, Tara Phillips)

4. Limitations and Outcomes of PECS (26:47–31:24)

• Research shows minimal, often short-term, gains with PECS.
• Generalization (using communication skills in different environments) is rarely achieved.
• Most users plateau at the “requesting” phase—very few reach spontaneous commenting or conversational skills.
• PECS isn’t seen used by adults in the community—a sign of its limits.

“Who wants to hang out with someone who’s just asking for things all day long?” (27:39, Amanda Blackwell)

5. Communication Books: Pitfalls and Best Practices (31:24–37:26)

• Not all communication books are bad; the danger is in restricting true autonomy.
• Adults must ensure communication books offer rich, broad vocabulary—including ways to protest (“no,” “I don’t want that”).
• High-tech AAC is often preferable due to greater vocabulary and personalization, but light-tech can be vital in resource-limited settings.

“We have to be very aware...you are still controlling their communication, deciding what they're able to say and what they’re not.” (33:37, Amanda Blackwell)

6. Honoring Multimodal Communication & Child Autonomy (37:26–44:01)

• All actions—gestures, pushing away, leading by hand—are communication and should be honored.
• Adults should accept whatever means a child uses instead of requiring a specific form (e.g., “Show me with your book”).
• Modeling alternatives and “pivoting” in response to protests respects the child’s autonomy and builds trust.

“If people have one big takeaway from today, it’s make sure your students, your clients have some way to protest.” (43:18, Tara Phillips)

7. Relationships & Connection Over Compliance (44:01–50:14)

• Building trust and connection is foundational—communication emerges from genuine relationship, not transactional exchanges.
• Educators should invest time in observing and connecting with each student; find out their interests and preferred ways to engage.

“Give yourself permission to sit back, get down on the floor with the child and just get to know them and what they love.” (47:07, Tara Phillips)

• Anecdote: Tara describes a student using AAC to say “This is boring”—and how honoring that message led to richer engagement. (38:38–40:16)

8. Practical Alternatives & Free Resources (44:01–47:07)

• Many robust and customizable low-tech AAC boards are available for free (e.g., from AssistiveWare, PRC Saltillo, Project Core, Smarty Symbols, Arisac) and in multiple languages.
• Start small, model use, and build from the child’s own interests, avoiding overwhelming or over-controlling the process.

“AssistiveWare...has that communication board that people can just print out...even in parks, which is so exciting.” (45:02, Paulina Elias)

Notable Quotes & Memorable Moments

• On adapting, not just translating:

  “If we just translate, a lot of times the information will change and it might not even be applied the same way in another culture.” (07:48, Paulina Elias)

• On the limitations of PECS:

  “Nobody got to the final stage of commenting...but communication is so much more than those two reasons why.” (26:47, Amanda Blackwell)

• On honoring protest as communication:

  “I try to teach people, like if I have a student that...pushes it away, that is communication.” (33:49, Tara Phillips)

• On modeling multimodal communication:

  “Imagine if you were talking to someone and they’re like, nah, can you just text it to me instead?” (37:26, Tara Phillips)

• On connection as the heart of education:

  “You don’t remember what every teacher taught you. But you remember the ones that made you feel really good.” (48:37, Tara Phillips)

Resources & Where to Find the Guests (51:32–53:01)

• Natural Communication:
  • naturalcommunication.com (English)
  • Comunicacion Natural (Spanish)
• Free crash course on Gestalt Language Processing available in English, Spanish, Italian, and soon French/Portuguese.
• Follow on Instagram and Facebook for updates and AAC resources.

Key Takeaways

• PECS is a structured, behavioral AAC system focused primarily on requesting—modern evidence and lived experience reveal significant limitations.
• Best practice AAC now emphasizes child autonomy, protest, and flexible, multimodal communication; hand-over-hand prompting is discouraged.
• Rich relationships and genuine connection are the cornerstone of effective, affirming communication support.
• Start with what the child is already doing, honor all forms of communication, and model rather than require new skills.
• Many robust, inclusive AAC resources are available for free and in various languages—don’t let resource barriers stop you.
• Every autistic child deserves the tools to say what they want, how they want, when they want—communication is more than requests, it's connection.

For free AAC resources and further learning, check the episode show notes or visit autismlittlelearners.com and naturalcommunication.com.