A Systematic Review of Picture Exchange Communication System Interventions for Children and Adolescents on the Autism Spectrum in Mainland China

The picture exchange communication system (PECS) is an evidence-based intervention used to improve communication for people on the autism spectrum. Little is known, however, about the extent to which PECS is currently used with Chinese-speaking persons. Our systematic review identified 13 single-case design studies reporting on PECS interventions with a total of 22 participants. The results indicated that PECS increased non-vocal communication behavior for 19 participants, increased speech for six participants, and decreased problem behavior for five participants. Five studies reported social validity, three studies programmed for generalization, and nine studies reported maintenance effects. According to Reichow’s (2011) evaluation standards, thirteen studies met only weak criteria indicating that they did not provide good evidence for the effectiveness of PECS in Chinese-speaking persons on the autism spectrum. Implications for future research and practice are discussed.