The aim in the current study was to investigate the efficacy of the PECS (Picture Exchange Communication System) in a sample of children with Autistic Disorder (AD) in the development of the communication, alternating gaze and pointing in children with Autistic Disorder (AD).

The sample included 5 children diagnosed with AD (DSM-IV-TR), no verbal language, followed by the team of the Rehabilitation Centre belonging to Scientific Institute “E. Medea”, Association “La Nostra Famiglia” Branch of Ostuni (Italy). The children were tested on their ability with neuropsychiatric, psycholinguistics and psychological assessment at the pre and post of the trial.

The treatment PECS has gone on for two years with a frequency of three times a week (45 minutes each one).

The observed behavioral variables were: spontaneous request of objects using the notebook PECS, alternating gaze, pointing, and possible vocalizing and verbalizing on imitation.

The data were collected at the beginning and at the end of the trial, using play-interaction videotapes, lasting 20 minutes each. Segments (10 min) of videos were randomly selected for coding.

The behaviours were coded using the Observer XT. 7 and the results were analyzed statistically with the SPSS programme.

The results show a significant increase in the number of spontaneous requests, in the capacity of alternating gaze, pointing, vocalizing and verbalizing on imitation.

Finally the PECS seems to allow not only to develop a functional communication in AD, but also to increase social communicative behaviours of children with AD. Nevertheless further studies are necessary.