AAC vs PECS: What's the Difference? Picture Cards vs Communication Devices
Direct answer
AAC vs PECS is not a contest between equals. AAC (augmentative and alternative communication) is the broad group. PECS is one low-tech AAC method that uses picture cards. A speech-generating device or app is another, and it speaks aloud. Ontario's ADP can help eligible residents pay for approved devices. A speech-language pathologist can help match the tool to your child.
The numbers behind the answer
- PECS Evidence
- Promising, not yet established
- Flippin et al., 2010
- ADP Share (Communication Aids)
- 75% of the ADP price
- Ontario ADP, updated February 18, 2026
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AAC vs PECS: what's the difference?
PECS vs AAC is a question that mixes two levels. AAC is the whole group of ways to communicate without speech or alongside it. PECS, the Picture Exchange Communication System, is one method inside that group. So the useful question is usually which tool, or which mix of tools, fits your child right now.
With PECS, a child hands a picture card to a partner to ask for something. With a speech-generating device or app, a child touches symbols or words on a screen and the device says them aloud. PECS has no voice output and needs a partner who is close by. A device can hold far more words, but it needs charging, setup, and a partner who learns to use it too.
Neither tool is better for every child. Some children use both, or use one at home and the other at school.
What does AAC stand for? Is PECS a type of AAC?
AAC stands for augmentative and alternative communication. Augmentative means adding to the speech a child has. Alternative means replacing speech when it is not enough. AAC can be unaided, such as gestures and signs, or aided, such as picture cards, boards, and devices.
Yes, PECS is a type of AAC. Pyramid Educational Consultants, which publishes PECS, describes it as an alternative and augmentative communication system with six phases. It starts with a child giving one picture of a wanted item to a partner. Later phases teach sentences, answering questions, and commenting.
- What AAC stands for and the main types of AAC
Our Ontario guide to AAC: no-tech, low-tech, mid-tech, and high-tech options, with cost and funding.
- How the six PECS phases work
The phases in order, and how PECS is used in Ontario.
PECS vs AAC device: side by side
This table compares PECS with a tablet app or speech-generating device, because those are the two choices parents most often weigh. Other AAC, such as signs or a core board, can sit beside either one.
| What to compare | PECS (picture cards) | AAC tablet app or speech-generating device |
|---|---|---|
| How the child communicatesThe main action | Hands a picture card to a partner | Touches symbols or words on a screen |
| Voice outputDoes it speak? | No. The partner reads the card and responds | Yes. The device or app says the message aloud |
| Room for wordsHow the vocabulary grows | Grows by adding cards, within what a book can hold | Can hold many more words, and can be set up for the child |
| What a partner must doWho else is involved | Be close by and respond to each card | Learn the layout and show the child how to use it |
| Learning pathHow a child moves forward | Six set phases, from one card to sentences and comments | Set up and adjusted by the speech-language pathologist |
| Carrying and durabilityDay-to-day use | No battery. Cards and a book are easy to carry | Needs charging, a case, and care. Some people use a mount |
| Who sets it upThe professional involved | A speech-language pathologist, teacher, or team trained in PECS | A speech-language pathologist with AAC training, plus the seller for setup |
| Paying for it in OntarioFunding route, not an amount | Materials are low cost. Ask your school team or clinic what they supply | ADP may help with approved devices. OAP lists augmentative communication devices as eligible expenses for childhood budgets and interim funding |
Low-tech vs high-tech AAC
Low-tech AAC needs no battery. Cards, boards, and books are low-tech. High-tech AAC uses electronics and speaks aloud. Mid-tech sits between them, such as a simple button that plays one recorded message.
Low-tech tends to fit when a child is just starting to link pictures with wants, when a backup is needed, or when a device would be at risk, such as at a pool or a park. High-tech tends to fit when a child is ready for many words, needs a voice that others understand, or has a team ready to model the words on the device. These are tendencies, not rules.
PECS board and core board (low-tech AAC)
A PECS book holds picture cards that the child hands to a partner. A core board is a fixed page of common words, such as go, more, and stop, that a child points to. Both need no battery and are easy to carry. Neither speaks aloud.
High-tech AAC: apps and speech-generating devices
A tablet app or dedicated device shows symbols or letters and speaks them aloud. Apps named on this site include Proloquo2Go, TouchChat, and LAMP Words for Life. Dedicated devices come from makers such as Tobii Dynavox and PRC-Saltillo. We do not rank or endorse products.
- AAC apps and devices in Ontario
Device types, what drives cost, and how to get an assessment.
PECS or AAC device: how to choose for your child
No single age, test score, or symbol count decides this. An AAC-trained speech-language pathologist looks at the whole picture. These five questions can help you prepare for that talk.
Five questions to bring to an AAC assessment
- Can my child reach, point, or press?
Touching a card or a screen takes hand control. If reaching is hard, ask about other ways to use a device.
- Does my child connect pictures to real things?
A child who is just learning that a picture can get a wanted item may start well with cards.
- Is my child starting to combine ideas?
A child who is ready for longer messages may need more words than a card book can hold.
- Where will it be used?
Think about home, school, outdoors, and car rides. Ask how the tool will be charged, carried, and kept safe.
- Who will show my child how to use it?
Parents, teachers, and educational assistants all need practice. Ask who will teach them and how often.
Can a child use PECS and an AAC device together?
Yes. AAC is a group of tools, so a child can use more than one. A child might use picture cards at snack time and a device at school, or keep cards as a backup when a battery runs out.
Using several tools together is sometimes called multimodal AAC. Ask the speech-language pathologist how the tools will fit together, so your child is not learning two separate systems with no link between them.
Will AAC or PECS stop my child from speaking?
No evidence shows that AAC stops speech. A 2006 research review by Millar, Light, and Schlosser found 23 studies. In the six with enough rigour (27 cases), none showed a drop in speech after AAC, 11% showed no change, and 89% showed gains, which were mostly modest. Most of those participants were taught manual signs or non-electronic aided systems, and the authors said more research is needed.
For PECS on its own, a 2010 meta-analysis by Flippin and colleagues found small to moderate gains in communication and called PECS promising but not yet established as an evidence-based approach. Gains in speech were small to negative. That means PECS has not been shown to build speech, so ask how speech goals will be tracked whichever tool you choose.
Who pays for AAC in Ontario?
This is a short summary. Check each program’s own page before you buy anything, because rules and amounts can change.
ADP, the Assistive Devices Program, helps cover approved communication aids, including speech-generating devices. On its Communication Aids page (updated February 18, 2026), ADP lists who qualifies. The list includes being an Ontario resident with a valid health card, being unable to speak or having speech that is very hard to understand, and being unable to use a pen and paper to write because of a physical disability. Income is not considered. Not every autistic child will meet these conditions, so ask an ADP-registered clinician.
ADP pays 75% of the ADP price and you pay the rest (25%). ADP says people who receive Ontario Works, the Ontario Disability Support Program, or Assistance for Children with Severe Disabilities can get 100% coverage. ADP also warns that if you order a device before its application steps are finished, you pay the full cost.
Ontario’s list of eligible expenses for OAP childhood budgets and interim one-time funding (updated March 10, 2026) names augmentative communication devices, a touch-screen tablet and software, and speech and language therapy, which can include assessments and consultations. That page covers those two kinds of funding only, and it does not name AAC training. Ask OAP what applies to your child.
School boards may be able to provide equipment for school use. Ask your school team, in writing, what they can provide and whether it can go home. Private insurance and charities may also cover some costs, so ask them first.
An active Core Funding Agreement does not mean a child is receiving services.
- Does OAP fund AAC devices?
The full answer on OAP, ADP, and school funding for AAC.
- How much an AAC device costs in Ontario
What drives the cost, and how the ADP price works.
You can start AAC before OAP core funding starts
You do not need an OAP funding invitation to begin. Low-tech tools such as picture cards or a communication board can start now. A private speech-language assessment can also start now, and the family pays for it. Reported wait context: 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026). Ontario publishes no regional wait times.
- Verified provider directory
Providers we have checked, so you can ask about AAC experience.
- Parent navigator
A guided route to the next step for your family.
Why Timing Matters
A wait spans childhood.
Early support can help autistic children develop skills. Age six is not a clinical cutoff, and support can be beneficial at any age. Illustrative arithmetic only: registration at age three plus a five-year wait reaches age eight. Age six is a reference marker, not a clinical cutoff. This is not a prediction of funding, service access or developmental outcomes.
Example: an illustrative child's journey through the Ontario Autism Program
An assumed five-year wait from registration at age 3 reaches age 8. This is an example, not a typical or predicted service date.
| Measure | Age range |
|---|---|
| Illustrative age reference | Birth to age 6 |
| Example wait using the OAC-reported minimum (registered age 3) | Age 3 to age 8 (5 years) |
| Age at the end of this illustrative wait | Past age 6 |
Toddler treatment study
Dawson et al. (2010) randomly assigned 48 autistic toddlers aged 18–30 months to the Early Start Denver Model (ESDM) or community intervention for two years. The ESDM group had greater improvements in cognitive and adaptive outcomes. This study compared treatments for toddlers; it did not compare intervention before versus after age six or establish a universal multiplier for gains.
Support across ages
NIH notes that treatment can help at any age. Support should reflect the person’s needs; a wait does not determine an individual child’s future outcomes.
Ontario does not publish an age-at-registration breakdown for registrations without an active Core Funding Agreement. This example does not describe the age distribution of that group.
SourceDawson et al. (2010) · NIH: autism and support across ages. The illustrative wait uses the community report: 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026). This is not a provincial average.
Frequently asked questions
AAC is the broad group of ways to communicate without speech or alongside it. PECS is one low-tech AAC method where a child hands over picture cards. A speech-generating device or app is another AAC method, and it speaks aloud. So PECS is a kind of AAC, not a rival to it.
Neither is better for every child. PECS often suits a child who is starting to link pictures with wants. A device often suits a child who is ready for many words and needs a voice others understand. An AAC-trained speech-language pathologist can weigh reach, language, settings, and partners.
There is no set age or symbol count. Ask an AAC-trained speech-language pathologist to review the move when a child outgrows the card book, starts combining ideas, or needs a voice others can hear. Some families keep picture cards as a backup after adding a device.
No. A core board is a fixed page of common words that a child points to. With PECS, a child hands a picture card to a partner, in six phases. Both are low-tech AAC and neither speaks aloud. A speech-language pathologist can say which fits, or whether to use both.
No evidence shows that it does. A 2006 research review found no drop in speech after AAC in the studies with enough rigour, and most cases gained some speech. For PECS alone, a 2010 meta-analysis found speech gains were small to negative, so ask how speech goals will be tracked.
It can, depending on the program and the device. ADP helps eligible residents with approved communication aids and pays 75% of the ADP price. Ontario’s OAP expense list for childhood budgets and interim one-time funding names augmentative communication devices. Confirm with each program before you buy.
Usually the device costs more, because it adds hardware or software, mounts, and setup. PECS needs cards and a book. We do not print prices because they change and differ by product. ADP sets the price a registered business can charge for approved aids. Our Ontario AAC guide explains what drives the cost.
Yes. Low-tech AAC, such as picture cards or a communication board, does not need a funding invitation. A private speech-language assessment can also start now, and the family pays for it. Ask your school team what it can provide, and check ADP if a device is recommended.
Sources
Ontario Ministry of Health, Communication aids (updated February 18, 2026; read October 13, 2026)
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Ontario Autism Program: eligible and ineligible expenses for childhood budgets and interim one-time funding (updated March 10, 2026; read October 13, 2026)
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Pyramid Educational Consultants
What is PECS? The six phases of PECS (read October 13, 2026)
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Flippin et al. (2010), "Effectiveness of the Picture Exchange Communication System (PECS) on communication and speech for children with autism spectrum disorders: a meta-analysis," American Journal of Speech-Language Pathology, 19(2), 178-195
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Millar, Light & Schlosser (2006), "The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review," Journal of Speech, Language, and Hearing Research, 49(2), 248-264
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Frolli et al. (2022), "AAC and Autism: Manual Signs and Pecs, a Comparison," Behavioral Sciences, 12(10), 359 (further reading)
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Next steps
Keep going with related guidance, tools, and evidence.
Related questions
PECS picture communication for autism in Ontario
A structured, low-tech communication system for minimally verbal autistic children. Ontario schools may use it, and OAP funding may cover it through SLP services.
AAC devices for autism - OAP funding in Ontario
OAP can fund AAC assessment and SLP services. The Ontario ADP pays 75% of the approved price of covered communication aids. Many school boards provide AAC through special education. Here is how each route works.
AAC Devices for Nonspeaking Autistic Children in Ontario
Guide to augmentative and alternative communication (AAC) devices for nonspeaking autistic children in Ontario. Covers funding, device types, and how to access AAC through OAP.
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