The Picture Identification Task was developed to estimate the word-recognition performance of nonverbal adults. Four lists of 50 monosyllabic words each were assembled and recorded. Each test word and three rhyming alternatives were illustrated and photographed in a quadrant arrangement. The task of the patient was to point to the picture representing the recorded word that was presented through the earphone. In the first experiment with young adults, no significant differences were found between the Picture Identification Task and the Northwestern University Auditory Test No. 6 materials in an open-set response paradigm. In the second experiment, the Picture Identification Task with the picture-pointing response was compared with the Northwestern University Auditory Test No. 6 in both an open-set and a closed-set response paradigm. The results from this experiment demonstrated significant differences among the three response tasks. The easiest task was a closed-set response to words, the next was a closed-set response to pictures, and the most difficult task was an open-set response. At high stimulus-presentation levels, however, the three tasks produced similar results. Finally, the clinical use of the Picture Identification Task is described along with preliminary results obtained from 30 patients with various communicative impairments.