Direct answer

PECS vs AAC Devices: Choosing a Communication System

Verified answerVerified 2026-05-13

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. Dedicated devices usually use ADP, school boards, insurance, charities, or private payment.

RCT supported
PECS Evidence
Flippin et al., 2010
$200-$8,000
AAC Device Cost
ISAAC Canada
Yes, core clinical
OAP SLP Coverage
MCCSS
FOI & Government Data
Last verified: May 13, 2026Sources: FAO Report 2023-24 (Financial Accountability Office of Ontario) · 2026 Ontario Budget (tabled March 26, 2026) · CBC News FOI investigation — bi-weekly OAP progress reports, Jun 2024 – Jan 2026, published Mar 30, 2026 (Nicole Brockbank & Angelina King) · MCCSS bi-weekly OAP Core Clinical Services progress reports, Dec 10, 2025 – Mar 4, 2026, obtained under Freedom of Information (release CSS2026-0749) · MCCSS Ontario Autism Program figures as of May 13, 2026, released under Freedom of Information to the Ontario Autism Coalition and published in the OAC "OAP At A Glance" update, July 2026 (ontarioautismcoalition.com)
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Founder & Autism Advocate

Parent of autistic child navigating OAP system

PECS vs AAC Devices: Choosing a Communication System

  • PECS Evidence: RCT supported (Flippin et al., 2010)
  • AAC Device Cost: $200-$8,000 (ISAAC Canada)
  • OAP SLP Coverage: Yes, core clinical (MCCSS)

Understanding PECS

PECS is a structured six-phase communication system where children learn to exchange picture cards for desired items. Developed by Lori Frost and Andy Bondy in 1994, it uses ABA principles (reinforcement, prompting, shaping) to build functional communication. Research meta-analysis by Flippin et al. (2010) supports PECS effectiveness for increasing communication initiations in autistic children.

PECS is low-cost (starter kits around $200-$400), 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. Costs range from free apps to $8,000+ for dedicated devices.

Under OAP, speech-language pathologist (SLP) assessment and AAC training can be funded when they are part of the therapy plan. Dedicated speech-generating devices are usually funded through the Ontario Assistive Devices Program (ADP), 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

Sources

1

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

2

MCCSS

Ontario Autism Program Service Guidelines - Speech-Language Pathology (2024)

Next step near you

Local route

Where to be assessed near you

Assessment routes, local providers and school boards are tracked city by city. Pick the one closest to you.

See every Ontario city we track

The clock

Where the wait clock starts

A child's place in the Ontario Autism Program queue is set by the AccessOAP registration date. 71,263 children are registered and still waiting for core funding (MCCSS FOI via OAC · May 2026).

Evidence for this answer

Updated:

Government Reports & Data

  • [2024]
    Ministry of Children, Community and Social Services: Spending Plan ReviewVerified FAO Data
    Financial Accountability Office of Ontario (FAO)Report 2024-06-05
  • [2026]
    Ontario Autism Program figures as of May 13, 2026 (MCCSS, released under Freedom of Information to the Ontario Autism Coalition; published in the OAC "OAP At A Glance" update, July 2026)Verified FAO Data
    Ministry of Children, Community and Social Services (Ontario), obtained by the Ontario Autism CoalitionReport 2026-05-13

Official Organizations

  • [2023]
    Autism Spectrum Disorders Fact SheetOfficial Source
    World Health Organization (WHO)Official 2023-11-15

Commitment to Accuracy: Our data is verified against official government reports (FAO, MCCSS), peer-reviewed scientific literature, and accessible public records. Last updated: March 24, 2026.

Next Steps

Next Steps

These statistics represent real children missing their critical developmental windows.

Citable source facts(3)Question-and-answer pairs with their source and verification link.

How many children are on the Ontario autism waitlist in 2026?

Verified

As of May 13, 2026, 91,974 children are registered with the Ontario Autism Program. However, only 20,711 (22.5%) have an active Core Funding Agreement. This represents ~300% growth in registrations since 2019, with 71,263 children still waiting for essential funding.

Source: MCCSS FOI via OAC · Mar 2026, FAO Report 2024 · Verify Link

How long do families wait for Ontario autism services?

Verified

Ontario autism wait times for core clinical services now exceed 5+ years (Ontario Autism Coalition, July 2026). Funding invitations are currently reaching families who registered in August 2021 (Ontario Autism Coalition, July 2026 (reported from community intake)). This delay far exceeds the sensitive early intervention window recommended by developmental specialists.

Source: MCCSS FOI via OAC · Mar 2026, FAO Report 2024 · Verify Link

Is the Ontario Autism Program underfunded?

Verified

Yes. The Financial Accountability Office (FAO) determined that $1.35 billion annually is needed to serve all registered children at 2018-19 service levels. The 2026-27 Ontario Budget allocated $965 million, leaving an estimated $385M+ annual shortfall. This gap is the primary driver of the perpetual 91,974+ child waitlist.

Source: Financial Accountability Office of Ontario [FAO] · Verify Link

About This Article

Written by

Founder & Autism Advocate

Parent of autistic child navigating OAP system