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44 %u00a9 Elklan Training Limited 2025Elklan Supporting Gestalt Language Processing %u2013 a Total Communication ApproachPECS (Picture Exchange Communication System)PECS (Frost and Bundy, 1994) is used to support individuals with many different communication needs and is widely used with autistic children and young people, including non-speakers.There has been extensive research to support the use of PECS. Gordon K et al (2011) concluded %u2018Overall, PECS appeared to enhance children%u2019s spontaneous communication for instrumental requesting using pictures, speech, or a combination of both. PECS appears to have increased spontaneous speech in children who could talk a little at baseline.%u2019When PECS is used effectively the child or young person may have their own PECS book which is used in school, home and the community. The PECS user has a range of picture symbols which support their functional communication so they can independently navigate their book to find the pictures they need to communicate their needs.PECS is a structured approach with six stages, the first of which is for the child or young person to exchange an object or a picture for a desired object with the support of two adults to model and support the exchange. A disadvantage of PECS is that the child or young person%u2019s request is contingent upon a prescribed action, such as passing over a picture to another person. Furthermore the introduction of PECS can include the adult putting their hand over the child or young person%u2019s hand to achieve the exchange. The introduction and application of PECS can be rigid so that a child or young person is only responded to when they have adhered to the %u2018rules%u2019. An example of this is when the adult does not accept the child or young person looking at a real banana to request it and only accepts the request when the symbol of %u2018banana%u2019 is placed onto a sentence strip and handed to the adult. None of this represents neuro-affirming practice. However, rather than discarding the PECS folder, it can be used in a different neuro-affirming way.With slight adaptations, the PECS folder can become a Communication Book and be available as part of a Total Communication Approach. The following recommendations might be helpful:%u2022 Use the folder as a Communication Book where the pictures/symbols are fixed and available for the child or young person to use when they choose to. Prioritise pages with pictures of their areas of interest%u2022 Include their gestalts and mitigated gestalts%u2022 No hand over hand guidance should be used%u2022 There should be no instances where a request is contingent upon a rigid set of behaviours e.g. picture exchange must occur before the desired food/object is given. The child or young person%u2019s intended meaning, however this is communicated, should be responded to.%u2022 Recognise the use of a Communication Book as part of a Total Communication Approach.