For young children with limited speech I immediately implement sign language to make sure we can fully help them understand the power of communication. I will use visual schedules and timers to help them understand what we are doing and what is expected as well as give them some choices. I have several children that we began using TouchChat with at a young age to work on labeling, commenting and requesting. I typically reserve PECS for children that have lower receptive language skills. My view is that all modalities are best early on and we continue with what works best for each individual child and family as needed.