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While the system is commonly used as a communication aid for children with autism spectrum disorder (ASD), it has been used with a wide variety of learners, from preschoolers to adults, who have various communicative, cognitive, and physical impairments, including cerebral palsy, blindness, and deafness.

They noted that traditional communication techniques, including speech imitation, sign language, and picture point systems, relied on the teacher to initiate social interactions and none focused on teaching students to initiate interactions.

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However, evidence from meta-analyses indicate that PECS does not result in equal communicative outcomes for all children with ASD.

Based on these observations, Frost and Bondy created a functional means of communication for individuals with a variety of communication challenges.

PECS is designed to teach functional communication skills with an initial focus on spontaneous communication.

With regard to the intervention setting for AAC training, there is evidence that PECS is most readily learned when instruction takes place in a general education setting.

An initial concern was that PECS might delay or inhibit speech development.

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