透過個案研究，本文記錄了一位5歲11個月之多重障礙女童學習圖卡兌換溝通系統（the picture exchange communication system，簡稱PECS）的過程及其在溝通行為上的變化情形。此位女童接受了PECS前4個階段的訓練，訓練過程嚴格遵循PECS訓練手冊上的規定(Frost & Bondy, 2002)。訓練場地主要在女童的家中進行。女童接受PECS訓練以後，不僅學會了圖卡兌換溝通技術，且進步神速。隨著能辨識之圖卡量的增加，女童具溝通功能的負向行為則大幅減少。

Through a case study, this paper recorded the process of training a 5-year 11-month old girl with multiple disabilities to use the picture exchange communication system (PECS) and the changes of this girl’s communication behaviors at each training session.The procedures of each training phase developed by Frost and Bondy (2002) were strictly followed. The training sessions mainly took place in this girl’s home and in that of her aunt. After receiving the 4- phase PECS training, the girl not only learned the skill of using PECS but also made persistent progress at each training phase.Additionally, results also showed that the more pictures the girl learned, the less her disruptive behaviors affected her communicative functions.