PECS vs AAC Devices: Choosing a Communication System
Direct answer
The Picture Exchange Communication System (PECS) uses picture cards to help children communicate. Augmentative and Alternative Communication (AAC) includes speech-generating devices and tablet apps. PECS often works well for early communicators. AAC can support more complex language. OAP can fund speech-language assessment and AAC training in a funded plan. OAP funding can also buy technology that a regulated professional recommends in the treatment plan. Dedicated devices often use ADP, school boards, insurance, charities, or private payment.
The numbers behind the answer
- PECS Evidence
- Promising, not yet established
- Flippin et al., 2010
- OAP SLP Coverage
- Yes, core clinical
- MCCSS
Why Timing Matters
The wait outlasts the window.
Clinical research (American Academy of Pediatrics; Hyman et al., Pediatrics 2020) identifies birth to age six as the peak neuroplasticity window for autism intervention. Ontario's reported minimum wait is 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026).
Example: an illustrative child's journey through the Ontario Autism Program
Registered at age 3. Services begin at age 8, after 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026), most of it inside the intervention window.
| Measure | Age range |
|---|---|
| Early-intervention window (AAP) | Birth to age 6 |
| Example wait using the OAC-reported minimum (registered age 3) | Age 3 to age 8 (5 years) |
| Age when services begin in this example | Past age 6 |
✓ Intervention before 6
Research shows 2× greater gains in cognitive and adaptive functioning. Some children lose their diagnosis entirely. The brain's plasticity makes early therapy dramatically more effective.
◌ Intervention after 6
Reduced neuroplasticity means slower progress, higher lifetime costs, and poorer outcomes. Every year of delay narrows the range of achievable milestones. Ontario's waitlist guarantees this for most families.
Of the 71,263 children on the unfunded backlog, the majority were registered between ages 2 and 4. At the current pace, most will age past 6 before receiving any core funding , missing the window that the American Academy of Pediatrics and every major autism research body identifies as critical.
SourceAmerican Academy of Pediatrics (Hyman et al., Pediatrics 2020) · Ontario MCCSS OAP data via FOI · Wait: 5+ years for families registered in August 2021 (community-reported, Ontario Autism Coalition, July 2026).
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Understanding PECS
- PECS is a structured six-phase communication system where children learn to exchange picture cards for desired items. Developed by Andy Bondy and Lori Frost in 1985, it uses ABA principles (reinforcement, prompting, shaping) to build functional communication. A 2010 research review by Flippin and colleagues found small to moderate gains in communication and called PECS promising but not yet proven.
- PECS is low-cost (Pyramid Canada sells a PECS Starter Kit for $119), requires no technology, and can be used across settings. It is often a first-step communication system for children who are pre-verbal or early in their communication development. The structured phases (from single picture exchanges to sentence strips) provide a clear learning progression.
AAC Devices and Apps
- High-tech AAC includes dedicated speech-generating devices (SGDs) and tablet-based communication apps like Proloquo2Go, TouchChat, and LAMP Words for Life. These tools allow for more complex language expression, including multi-word sentences, questions, and comments.
- Under OAP, speech-language pathologist (SLP) assessment and AAC training can be funded when they are part of the therapy plan. OAP funding can also buy a device when a regulated professional recommends it in the treatment plan. Ontario asks families to check other programs first. Dedicated speech-generating devices are often funded through the Ontario Assistive Devices Program (ADP), which pays 75% of the approved cost, or through school boards, insurance, charities, or private payment. A qualified SLP should match the device to the child's motor, thinking, and communication needs.
Frequently asked questions
This depends on your child's age, motor skills, cognitive level, and communication goals. PECS is often a starting point for young or early communicators. AAC devices suit children ready for more complex language. A speech-language pathologist can assess which system fits best.
OAP can fund SLP assessment and AAC training when they are part of the funded therapy plan. OAP funding can also buy a device when a regulated professional recommends it in the treatment plan, but Ontario asks families to check other programs first. Dedicated speech-generating devices are often funded through the Ontario Assistive Devices Program (ADP), school boards, insurance, charities, or private payment.
No. Research reviews show that AAC does not hold back speech, and most studies found modest gains in speech. For PECS alone, a 2010 review found little gain in speech.
Sources
Research
Flippin et al. (2010), "Effectiveness of the PECS for Children with ASD: A Meta-Analysis," American Journal of Speech-Language Pathology, 19(2), 178-195
MCCSS
Ontario Autism Program: guidelines for core clinical services and supports (updated September 10, 2026)
Next steps
Keep going with related guidance, tools, and evidence.
Related questions
Speech Therapy Options for Autistic Children in Ontario
Overview of SLP approaches for autism: traditional articulation, AAC, social pragmatic, and PROMPT. Learn OAP coverage, costs, and how to choose.
PROMPT Speech Therapy for Autistic Children
PROMPT is an SLP technique for motor speech planning difficulties. Learn who benefits, how it works, and OAP coverage for speech-language pathology.
Does the Ontario Autism Program Cover ABA Therapy?
Yes. OAP core clinical services include ABA therapy. AccessOAP sets each child's allocation by age and support needs, from $6,600–$65,000/year.
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