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