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A survey was conducted to examine the perceptions of parents who use the Picture Exchange Communication System (PECS) to help improve the communication abilities of their children with autism spectrum disorder and/or other developmental disabilities. Methods: This online survey gathered demographic information and employed a scale that parents could use to rate their perceptions of PECS in four areas: their knowledge of PECS, the usefulness of PECS, the benefits of PECS, and barriers to the implementation of PECS. The responses of 40 parents were analyzed. Results: The results revealed that parents with higher levels of education reported more knowledge of PECS and integrated PECS into their home lives to a greater degree than did parents with lower levels of education. However, both groups reported that PECS was easy to use and effective in developing the communication abilities of their children with autism. Conclusions: Parents' perceptions are important to building strong, collaborative relationships between parents and professionals who work with children with ASD. Current findings show that parents found PECS to be effective in improving their children's communication skills. Future research is recommended to further examine parents' perceptions of PECS.

We investigated the effects of behavioral skills training package with parents to use picture exchange communication system (PECS) with their children with autism spectrum disorder (ASD) to develop communication skills. Methods: Two parents and their children with ASD (one child per family) participated in this study. A multiple baseline design was used during the parents' training, and a changing criterion design was used during parents' implementation of PECS with children. Results: Results indicated that both parents implemented PECS intervention with their children with high procedural integrity and required minimal feedback through Bug-in-Ear at the end of the intervention. Moreover, both children acquired independent picture exchanges with their parents who implemented PECS training and generalized and maintained the skills. Conclusions: The findings suggest that when parents receive appropriate training and feedback, they can train their children to use PECS to independently request desired items or activities. The current study extends existing research on PECS by teaching parents as the primary PECS trainers to implement the strategy with their children.