Talk:Picture Exchange Communication System

Wiki Education Foundation-supported course assignment

This article is currently the subject of a Wiki Education Foundation-supported course assignment, between 5 January 2022 and 29 April 2022. Further details are available on the course page. Student editor(s): Israghanim.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 12:19, 18 January 2022 (UTC)

Wiki Education assignment: Addressing Misinformation in Special Education

This article was the subject of a Wiki Education Foundation-supported course assignment, between 5 January 2022 and 29 April 2022. Further details are available on the course page. Student editor(s): Israghanim (article contribs). Peer reviewers: Mm17t, AmariHau.

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Current state of article

Because I just left three new article tags, I'm starting this discussion.

The first thing I want to address is the long history of conflicted editing of this article. While Wikipedia's conflict-of-interest policy may have changed over the decades and there's no evidence of recent conflicted editing, I just want to make something very clear. If you are one of the developers of PECS or you are in any way affiliated with Pyramid Educational Consultants Inc., there are very few situations in which it would be appropriate for you to directly edit this article. If that describes you, see the talk-page tag I left above for further instructions. Unfortunately, while many of the edits previously conflicted editors have made over the decades have been reverted or overwritten, not all have, and it's seriously compromised the neutrality and quality of this article.

Regarding the medical citations and update tags, virtually all the citations in this article fail MEDRS, due to excessive age alone. I find it exceptionally difficult to believe there have been no meta-analyses or other notable research developments on this topic in 10+ years. I've also individually tagged some sources that are not independent or reliable that need attention.

I've gone ahead and made some article improvements, as described in my edit summary, but I can't bring this article up to snuff alone. If anyone has any constructive feedback, please comment below. Otherwise, feel free to start sifting through the article and tackling some of the remaining issues. DoItFastDoItUrgent (talk) 04:24, 11 September 2025 (UTC)

I made some edits that I hope are helpful. I don’t think I have the expertise to rewrite or move the content to Wikihow. Philosophically, today I’m an inclusionist and I love ‘how-to-content’ so I don’t trust my judgement to rewrite the Pecs Protocol section. I would happily read someone else’s rewrite. Bogwife (talk) 21:56, 13 September 2025 (UTC)@bogwife

Thanks for helping polish the article. DoItFastDoItUrgent (talk) 14:51, 14 September 2025 (UTC)

Are PECS a form of Psychotherapy?

I am looking for a citation for Psychotherapy in the following sentence.

Children or adults who do not engage in verbal communication (or not in the usual way) are not excluded from psychotherapy; indeed some types are designed for such cases.

Can something be an assistive technology AND a psychotherapy or is it exclusive? FWIW from my point-of-view I think it is a therapy. I want to get a peer-review from someone on the PECS side first. Bogwife (talk) 21:56, 13 September 2025 (UTC)

I don't work in either field. However, I would say that PECs or any other form of AAC wouldn't qualify as psychotherapy. The Mayo Clinic defines psychotherapy as "an approach for treating mental health issues by talking with a psychologist, psychiatrist or another mental health provider." Speech therapy would be more closely related to AAC, but I wouldn't say that AAC would be defined as a type of speech therapy either. DoItFastDoItUrgent (talk) 14:58, 14 September 2025 (UTC)

=Non-verbal Psychotherapy Ideas =

Can you help me think of other ideas of ‘psychotherapies that aren’t verbal’? The only one that comes to mind now I think about it is sandplay[Play therapy#Sandplay(Sand Tray) ]. Do you have other ideas @DoItFastDoItUrgent? I worry about putting that one near the top of the Psychotherapy wiki because it gives the vibe that I worry about with psychotherapy in general — it is full of weird vibes and symbols and is TOO FRIVOLOUS to create real change (beware: this is probably internalized reductionism speaking). Honestly, I can’t come up with any other examples.

=Does an ABA count as a mental health provider?=

Huh, that surprises me! How do you define mental health provider@DoItFastDoItUrgent? Most people learn PECS in a 1-1 with a person who has training in that system (e.g an ABA[Applied behavior analysis#Autism intervention]) I guess philosophically I think anyone who is using an approach guided by a body of theory and who acts on others and reflects or receives supervision is a ‘mental health provider.’ So I have a broad definition. Bogwife (talk) 19:08, 14 September 2025 (UTC)

Regarding types of psychotherapy that don't rely (or don't have to rely) on spoken, written or alternative forms of language, this article by the Cleveland Clinic mentions play therapy, creative arts therapy and animal-assisted therapy as "additional therapies" used in combination with psychotherapy (not psychotherapy in their own right), although the Wikipedia article for play therapy that you linked goes as far as classifying play therapy as a form of psychotherapy (haven't had a chance to sift through the cited sources to see if that tracks). In my opinion, if you can find a reliable and undisputed medical source that explicitly labels something psychotherapy, you'd be O.K. to label it such on Wikipedia (with an accompanying citation). Just be cautious when assessing the reliability of any specific source. If the source advocates for a view outside the mainstream medical consensus, probably better to err on the side of not labeling it that way on Wikipedia.

As far as what qualifies as mental healthcare or who qualifies as a mental-health practitioner, not being in the fields of psychology or psychiatry myself, my definition would be far more informal than that of an expert in either field. I think the current Wikipedia definition of mental health, which describes it as encompassing emotional, psychological and social well-being, is a pretty succinct one. In a philosophical sense (as opposed to a technical one), you could be far more flexible regarding who or what you put the label "mental health" on, but that would be beyond the scope of our work here on Wikipedia.

I wouldn't label ABA as a "mental health" field, both because I don't consider someone being autistic equivalent to being mentally unwell (the vast majority of ABA practitioners work with autistic people) and because I don't think ABA as a field is focused on improving mental health directly or indirectly. In fact, I'm unaware of any major body of research conducted by ABA practitioners or researchers that evaluates the short-term or longterm impact of ABA on mental health. One would think that, if mental health were a priority, the industry would have responded to external criticisms that ABA worsens mental health by conducting studies of their own to investigate those claims (and to disprove them if they weren't true). To date, that hasn't happened. ABA industry studies almost exclusively focus on autistic children and don't follow up with their test subjects years or decades after the study ends to either evaluate their mental health or to see if any changes to behavior documented during the studies were permanent.

As far as PECS, its basis in ABA aside, I wouldn't consider it or any form of AAC training to be mental healthcare, since AAC is intended to help people communicate. While one could argue that helping someone communicate indirectly improves their mental health, again, that falls more into the realm of philosophical debate than anything technical. DoItFastDoItUrgent (talk) 21:33, 14 September 2025 (UTC)

ABA and Mental Health

ABA is effective at improving communication. Communication skills improve mental health!

Example therapies

I want to support the view that Psychology is practical and effective. I love and support creative-expression and play. And the neutrality and focus on objectivity of Wiki has me hesitating to use examples that I associate with leisure. Are my associations with animal-assisted therapies, play-based therapy, creative-expression therapy different than yours?

When I think about how this article looks to someone who is unfamiliar with Psychology I worry readers will think, Those are therapies for rich kids without real problems. My kid is playing with the cat is that animal-assisted therapy? I handed my kid some markers we’re done with creative-expression therapy for today. I hope this is outdated thinking that only I hold but I have a suspicion it is not.

My desire to have a reputation-enhancing example, one that has solid empirical-backing and is something people haven’t heard of, has me leaning toward including PECs as the example in the lead of Psychotherapy.

Outcome Studies

I agree outcome studies are important! Finding comparison groups for ABA, and good places to run that research, and funding it is hard. Running great studies that integrate academic rigor and what is happening in industry is unusual. Getting rigorous studies in industry is also unusual. And I believe ABA’s outcomes are longitudinally effective.

PECS is non-verbal psychotherapy and an AAC (imo)

I’d like to see a broader sample represented than our individual opinions so I am going to hold off until I get a few more opinions.

I’d like a societal approach that didn’t over medicalize or stigmatize folks on the Autism Spectrum. Folks on the spectrum are treated as unwell when they are not. And I think great psychotherapy is something anyone can pay for to see positive changes.

The CDC represents ‘behavioral’, and ‘psychological’ approaches for treatment of ASD . And both are billed as ‘therapeutic behavioral serivce (H2019) providers’ for insurance . Using the insurance definition of someone who uses PECs as a mental-health provider when they use H2019 seems like an okay place to add PECs as a ‘psychotherapeutic approach’ to me. Any thoughts about this?

https://pmc.ncbi.nlm.nih.gov/articles/PMC1284381/

https://pmc.ncbi.nlm.nih.gov/articles/PMC9458805/

1

https://www.dhcs.ca.gov/Documents/SMHS-Billing-Manual-v-1-4.pdf Bogwife (talk) 04:11, 7 March 2026 (UTC)

I suspect (but have not checked) that most reliable sources would not call PECS psychotherapy, though some may call PECS or the act of teaching it therapy (probably most often something in the speech-language therapy ballpark, if I had to guess without going to look--more sources would probably describe the act of teaching PECS as SLP stuff than I imagine would describe the act of using PECS as that). Perhaps I am reading this wrong but you seem to be approaching this topic in a kind of WP:POINTy way (that guideline mentions disruption; I want to clarify that I do not think you have done anything disruptive (so far as I can tell from this singular point of interaction)). You seem to have a desire for people to come out of the article feeling a certain way and using that to guide sources that support the ways of writing you think will lead to that. I don't think that's a good way to approach this article, but again, maybe I'm misunderstanding you. (Also: ABA is also currently described by Wikipedia as controversial, because across the the breadth of reliable sources describing it, opinions are split on its benefits and risks; sources describe many autistic people opposing the practice, for instance. But that's more of a thing for the ABA talk page rather than this one; the only crossover PECS has is that sometimes people with ABA training teach it. And sometimes people with less or minimal training in ABA teach it, like some of the teachers I sub for.) - Purplewowies (talk) 06:42, 7 March 2026 (UTC)