Effects of the Picture Exchange Communication System (PECS) on Maladaptive Behavior in Children with Autism Spectrum Disorders (ASD): A Review of the Literature

Dana Battaglia, Ph.D.
Adelphi University


Mary E. McDonald, Ph.D.
Hofstra University



This paper provides an overview of the literature investigating the functional relationship between the use of the Picture Exchange Communication System (PECS) and maladaptive behavior (i.e., aggression, tantrums) in individuals with autism spectrum disorders (ASD).  Digital searches were conducted to identify single subject design studies published between 1994 and 2012. While nine studies were identified, only three explicitly addressed the collateral effects of PECS training on reduction of maladaptive behavior. Of the seven participants across these three studies, four demonstrated an inverse relationship between PECS exchange and reduction of maladaptive behavior. Results are promising in terms of functional communication. However, the authors suggest caution due to limited number of publications to date. 

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