A variety of strategies have been used to help children with autism acquire functional communication skills. The Picture Exchange Communication System (PECS) is a unique communication training program that was developed as a means of circumventing some shortcomings associatd with these strategies. A description of the steps within PECS is provided. Long-term group data have indicated that a large proportion of children started on PECS as preschoolers acquire speech. Individual and group data supporting the use of PECS are provided.

The Picture Exchange Communication System (PECS) was developed as a means to teach children with autism and related developmental disabilities a rapidly acquired, self-initiating, functional communication system. Its theoretical roots combine principles from applied behavior analysis and guidelines established within the field of alternative and augmentative communication. This approach has several potential advantages relative to imitation-based strategies (both vocal and gestural) and symbol selection strategies. The system begins with the exchange of simple icons but rapidly builds "sentence" structure. The system also emphasizes developing the request function prior to developing responding to simple questions and commenting. The development of requesting with a sentence structure also permits the rapid development of attributes more traditionally taught within a receptive mode. The relationship between the introduction of PECS and various other behavioral issues (i.e., social approach and behavior management) as well as its relationship to the codevelopment of speech are reviewed.

The Picture Exchange Communication System (PECS) is an alternative/augmentative communication system that was developed to teach functional communication to children with limited speech. The approach is unique in that it teaches children to initiate communicative interactions within a social framework. This article describes the advantages to implementing PECS over traditional approaches. The PECS training protocol is described wherein children are taught to exchange a single picture for a desired item and eventually to construct picture-based sentences and use a variety of attributes in their requests. The relationship of PECS's implementation to the development of speech in previously nonvocal students is reviewed.

The negative side effects of aversive control have been extensively discussed in clinical literature and textbooks. The symmetry between aversive and appetitive control in basic experimental research implies that parallel negative side effects of reward exist. These negative side effects are described and their implications for clinical practice and research are discussed.DESCRIPTORS: reinforcement, punishment, iatrogenic illness, symptom substitution, generalization A behavioral psychologist, Dr. B, once had a student, N, who was quiet and withdrawn. He decided to try to encourage N to participate in research discussions. He consulted all of the latest behavior therapy textbooks and designed an intervention program. Each time N spoke of research, Dr. B said enthusiastically how nice it was to hear N's opinion and what good points N was making (all of which were true). Soon N's rate of verbal behavior had increased enormously. Unfortunately, N also began talking about topics other than research. In fact, N's major topics of discussion were about the relative merits of different kinds of dog food and which city had the best mass transportation system. N spent several hours each day seeking out Dr. B at the office, the lab, and on the phone. N spent so much time looking for and talking to Dr. B that N's interaction with other students was virtually eliminated. Dr. B's life became miserable. This time Dr. B consulted a clinically oriented colleague who suggested that he punish N for all of the excessive verbal behavior. Dr. B, of course, abhorred the use of this method forThe order of authorship was determined by a random process. We thank

We thank Liliana Mayo and Judith LeBlanc for their feedback on an earlier draft ofthis manuscript. We also express our gratitude to them for their efforts to bring us to Peru. Our appreciation is extended to the staff of the Ann Sullivan Center, especially for their efforts to integrate us into their "family." We thank the parents and the students of the Center for their warmth and generosity of spirit. Finally, we thank the Christina School District for their support of our efforts.

Originally designed to enable young children with autism lacking functional communication to initiate requests and to describe what they observed, the Picture Exchange Communication System (PECS) has been the subject of an ever-expanding body of research and development. Thirty-four peer-reviewed published reports on PECS are analyzed in this article with documentation of research questions, methodology, and results. Findings suggest that PECS is providing people around the globe who have no or impaired speech with a functional means of communication. Refinements in methodology and additional questions that might be addressed in future research are discussed.

This paper presents Skinner's (1957) analysis of verbal behavior as a framework for understanding language acquisition in children with autism. We describe Skinner's analysis of pure and impure verbal operants and illustrate how this analysis may be applied to the design of communication training programs. The picture exchange communication system (PECS) is a training program influenced by Skinner's framework. We describe the training sequence associated with PECS and illustrate how this sequence may establish multiply controlled verbal behavior in children with autism. We conclude with an examination of how Skinner's framework may apply to other communication modalities and training strategies.

This study investigated the effectiveness of graduated exposure, verbal mping skills, and their combination in treating fear of the dark in 4and 5-year-old normal children, using both be-, havioral and subjective measures of fearfulness. Only those groups which received direct exposure to the dark during treatment demonstrated significant changes in dark tolerance. Non-significant differences in dark tolerance for high versus low instructiond demand conditions in two posttests were obtained. Analysis of subjective fear ratings suggested questionable validity in the children's abilities to label subjective fearfulness. The effectiveness of behavioral techniques in modifying adult fears has been well documented (Leitenberg, 1976; Marks, 1974). However, relatively little research has been reported comparing various approaches to the treatment of fears and phobias in children (Graziano, DeGiovanni , & Garcia, 1979). Generally, approaches to treating children's fears have sought to provide either direct exposure to fear stimuli or to dter verbal or coping skills related David V. Sheslow is affiliated with the Child Diagnostic and Development Clinic, Alfred I. dubat Institute, Andrew S. Bondy is with Rutgers University, and R o s a r y 0. Nelson is with the University of North Camfina at Greensboro. Portions of this paper were presented at the meeting of the Southeastern Psychologicat Assmiation, Miami, May, 1977. Requests for reprints should be sent to: David V. Sheslow; A l f d I. duPont Institute; P. 0. Box 269; Whington, DE 19869. SpeciaI thanks are extended to the children and staff at Baynes Happy Day Nursery, Greensborn, NorthCamha, for their support and cooperation, and to Susan CorriberSheslow for her assistance in completing this study.