What is it?
A visual schedule is a set of pictures that communicates a series of activities or the steps of a specific activity (1, 2). Visual schedules are meant to help children understand and manage the daily events in their lives (3). Visual schedules may be created using photographs, pictures, written words, or physical objects. Ideally, they communicate clear expectations for the child and decrease the need for constant adult involvement in the activity (4). Most visual schedules are introduced with adult guidance that gradually decreases with time (3). They can be used in speech therapy, at school, and at home (1, 4, 5).
What's it like?
Schedules may be placed into notebooks or on a schedule board, or also presented with the aid of or on computers. The figure below represents an example visual schedule for the last portion of a child’s school day.
When designing a visual schedule, consider the following questions (2):
- Will the child understand or recognize the pictures or words?
- Is the activity represented by the visual schedule obvious to the child?
- Can the schedule be made clearer by the use of words, more images, or objects?
- Does the child know and have available the tools required to successfully complete the activity?
What is the theory behind it?
Children with autism frequently have trouble paying attention to, adapting to, and understanding auditory input. They also tend to have strengths in rote memory and the ability to understand visual information (6). Visual schedules take advantage of these strengths by efficiently communicating information that allows children to better predict and plan within their environment (2, 3, 7). Some children with autism benefit from the use of computers to generate and present visual schedules, and may prefer getting visual schedule information directly from a computer rather than from a person (8).
Most behavioral problems associated with children with autism seem to stem from poor communication (2). While visual schedules can be useful at home, they may be especially useful for children transitioning into a school environment (4, 7). Visual schedules facilitate communication and therefore may minimize behavioral problems (3, 4).
Does it work?
Many studies have demonstrated that visual schedules are effective in helping developmentally disabled, and specifically, autistic children. These studies show visual schedules to be effective in helping children to gain independence and increase on-task behavior at school, at home, and in community settings (1, 2, 6, 7). In younger children, this can translate into improved play skills, and a decrease in disruptive and aggressive behavior (5, 7). Specifically, use of visual schedules has been associated with a decrease in disruptive behavior, aggression, tantrums, and property destruction (1).
In older children, use of visual schedules can enhance learning and improve a child's ability to perform the skills required for daily living (1, 3, 4, 6, 7). Visual schedules have also been effectively used to improve physical activity in a physical education setting (7). With time, some children are able to independently use visual schedules to achieve on-task behavior and self-management without supervision (3-5, 7).
The most effective way to use visual schedules is to have them readily available and used consistently (7). Most children seem to enjoy the use of schedules and appear to be excited to see what will be coming next (3, 4). This enthusiasm has been shown to translate into increased peer to peer interactions (3, 4).
Is it harmful?
There are no reports of visual schedules being harmful.
Cost
Visual schedules can be included as a component of speech therapy (1). The cost of speech therapy is covered by the government through the Individuals with Disabilities Education Act (IDEA). The amount of speech therapy provided in this setting may be suboptimal and may need to be supplemented with private therapy. Private speech therapy can be expensive (approximately $100/hour).
Activity schedules can be designed and made at home inexpensively, and are easy to transport (5). They can be made by hand on note cards by drawing or gluing cut-out pictures from magazines. They can also be made on the computer using clipart and the PowerPoint TM program.
When used at home, visual schedules require an initial parental investment of time. With time, the child should achieve an improved ability for self-management and should require less parental supervision.
Resources
Healing Thresholds has partnered with Natural Learning Concepts. They sell several visual schedules that can be used at home.
Healing Thresholds has also partnered with Flag House. Flag House sells computer software for creating customized visual schedules, communication display boards such as worksheets, picture instruction sheets, reading books, journals, posters, and more.
Clipart can be used to generate homemade schedules. One source of clip art is the Graphics Factory: http://www.graphicsfactory.com/.
A book that may be useful:
Activity Schedules for Children With Autism: Teaching Independent Behavior
References
- Bopp, K.D., et al. 2004. "Speech-Language Pathologists' Roles in the Delivery of Positive Behavior Support for Individuals with Developmental Disabilities." Am.J Speech Lang Pathol. 13(1):5-19.
- Wheeler, J.J., and S.L. Carter. 1998. "Using Visual Cues in the Classroom for Learners with Autism as a Method for Promoting Positive Behavior." B.C.Journal of Special Education 21(3):64-73.
- Kimball, J.W., et al. 2003. "Lights, Camera, Action! Using Engaging Computer-Cued Activity Schedules." TEACHING Exceptional Children. 36(1):40-45.
- Bryan, L.C., and D.L. Gast. 2000. "Teaching On-Task and On-Schedule Behaviors to High-Functioning Children with Autism via Picture Activity Schedules." J Autism Dev.Disord. 30(6):553-567.
- Morrison, R.S., et al. 2002. "Increasing Play Skills of Children with Autism Using Activity Schedules and Correspondence Training." Journal of Early Intervention 25(1):58-72.
- Massey, N.G., and J.J. Wheeler. 2000. "Acquisition and Generalization of Activity Schedules and their Effects on Task Engagement in a Young Child with Autism in an Inclusive Pre-School Classroom." Education & Training in Mental Retardation & Development Disabilities. 35(3):326-335.
- Zimbelman, M., et al. 2006. "Addressing Physical Inactivity Among Developmentally Disabled Students Through Visual Schedules and Social Stories." Res.Dev.Disabil, 28(4):386-396.
- Stromer, R., et al. 2006. "Activity Schedules, Computer Technology, and Teaching Children with Autism Spectrum Disorders". Focus on Autism and Other Developmental Disabilities. 21(1):14-24.
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Please comment on this autism topic.
Picture-Based Communications on the iPhone/iPod
Jul 21, 2009 by AnonymousHi there,
My name is Dan, and my wife Carey and I are parents to a four-year-old boy (with autism) and a two-year-old girl (neurotypical). Both of our kids are adorable and keep us laughing!
Our son is verbal, though his expressive language is weak and he struggles with sensory processing, particularly in new environments. We were turned on to picture-based communication aids by the Connecticut Birth to Three system -- laminated strips of pictures, notebooks, magnet boards, etc.
These tools worked. They helped Evan a good deal. Unfortunately, though, they weren't the most "workable" solution. Carrying around notebooks and boards is inconvenient. We'd lose the symbols, or not have the right one on hand when needed.
So, we invented an application for the iPhone and iPod Touch that lets caregivers customize and present visual schedules, social stories, timers and choices -- all right there in the palm of your hand. It's called iPrompts -- check it out at http://www.iprompts.com. We've gotten some incredible feedback about it. Hope it helps!
- Dan
Visual Schedules
Jul 27, 2007 by AnonymousCheck out these fabulous visual schedule bracelets: http://www.qcharm.com/index.html
You really have to see them to realize what a great idea they are and how beautifully realized. Kudos to the inventors!
A great source of visual schedule boards is: http://activityclock.com/default.aspx.
The site sells18"x18" boards that are completely magnetic, less than 3 lbs, can be hung on the wall, and come with activity magnets that the customer can pick and choose from the "magnet gallery" on the website. All the pictures are original artist drawings.
So happy I could cry
Jul 9, 2007 by AnonymousIt’s been hot here! Swimming has been our main activity, which is usually fine with Thomas and Hayley. Thomas is doing a great job going underwater! Today I was watching him (he can actually go under for about five seconds) and saw that he was opening his eyes, so I put on a mask and went under with him. He was so cute, waving to me and grabbing my fingers. He kept bringing me over by the ladder to go underwater with him. He also likes operating one of the Super Soaker water-guns at my uncle’s pool, narrating as the water goes “up and down.” Both Thomas and Hayley have very nice tans in spots where their life jackets aren’t and we’ve escaped with no sunburns so far. Both Thomas and Hayley prefer hand-applied lotion over the non-aerosol spray sun block. Actually, I do too, but there’s no one here who can be counted on to sufficiently lather my back during the day when we go swimming, so I have to use the spray for convenience. I use a really thick lotion which allows for some good calming sensory therapy as I rub the lotion into Thomas’ shoulders, arms and legs.
Thomas has been helping us teach Hayley to use the potty lately. I was getting her dressed yesterday when I realized that putting a diaper on her seemed ridiculous. We were very lax in our toilet-training of Thomas, giving his body what we considered enough time to mature, and hoping his brain would be able to handle it. Of course, he picked it up right away. Anyway, I was getting Hayley dressed and she just seemed too old for diapers all of a sudden. I showed her a pull-up next to a pair of Sleeping Beauty underpants and asked which one she would prefer to wear. She chose the princess undies of course, and so we began again. She’s been doing pretty well with only two real accidents so far. The problem is that she will sit on the toilet for ages and not do anything. After a while, she might let a few drops go. However, she has filled the little training potty a couple times and we hope that now we’re on our way.
As I said, Thomas has been helping by congratulating Hayley when she does what she’s supposed to, and he’s obliged us by demonstrating this most basic of bodily functions for his sister. Last night, however, I had to explain to Hayley why she can’t stand up in front of the potty to urinate. We had the “girls don’t have penises” talk, and again, Thomas was happy to oblige with visual aids. I think Hayley understands that aspect now, since she has never seen me use the toilet without sitting down.
I broke down and took the kids to Chuck E. Cheese’s last Monday. For some reason, Thomas had it in his head that we were going to go that day, and Hayley was only too happy to agree with him that yes, we should definitely go. I took them once by myself before; I think it was last winter sometime. That time, everything went okay (it was really crowded, as I recall) until it was time to go. I remember having to run Hayley out to the car and then run back in to carry Thomas out while he was hitting my face really hard. After that, I swore that I’d never take them by myself again. Of course, we forget the sharpness of those wounds in the fullness of time (like forgetting how much labor really hurts) so I decided to try again.
For an entire hour before we left and in the car on the way to the restaurant, I had the kids play “Finish This Sentence” with me:
Me: When Mommy says it’s time to go, you say…
Kids: OKAY, MOMMY!
Me: And then you hold my hand and we walk to the…
Kids: CAR!
I was assured that we had this routine down as we walked into the blessedly un-crowded restaurant. The kids had fun and were very good. After a couple hours, I wasn’t even thinking when I said, “Okay, are you guys about ready to go?” Before I even finished my sentence, Thomas said, “Okay, Mommy!” They both grabbed my hands and we walked out to the car. I was so happy I could have cried.
We finally had that appointment with the pediatric cardiologist last Thursday. Thomas has what is called a “stills” murmur; just a vibration in one of the sections of his heart. There are no holes and nothing to be concerned about and the cardiologist said that Thomas should grow out of it within three years. She said that murmurs are rated on a scale of 1-6 in terms of loudness, and Thomas’ is a two. Thomas was actually very good for the appointment. They did an EKG for which they had to apply stickers all over his body, and he complied and even sat still while the EKG was being taken. When the doctor asked Thomas not to talk while she listened to his heart, he complied! Even Hayley didn’t talk! When we walked into the waiting room, they had several cars and trucks there and I was immediately on high alert, knowing (or so I thought) that getting Thomas out of there without one of those trucks would be a fight to the death. He did take a couple of trucks in and out of the exam rooms with him (there was a separate room for the EKG and the examination, and we had to go back to the waiting room in between), but when it was time to go, Thomas had no problem with me putting the cars back in the toy box! Again, so happy I could’ve cried.
I called the neurologist last Tuesday to update her on Thomas’ progress with the Clonidine, and she advised us to give him an entire 0.1 mg pill at night. Thomas is still not sleeping through the night in his bed, however. His behavior, as referenced above, has been really good in public (not so much improvement at home), but I’ll take what I can get. We’ll go to the neurologist again on the 18th, so we’ll see if she has any other ideas, pharmaceutical or not.
We had a lot of fun on the Fourth of July at Uncle Tom’s house. Parties there (especially in the summer) are really great for us because Thomas is very comfortable there and is usually content to swim until nightfall. We stayed for fireworks, which is when Thomas started to have trouble. We brought his headphones, which he didn’t want to wear. He kept going in and out of the house, but Jonathan followed him and actually got him to sit on his knee and watch fireworks for a minute (Uncle Tom, besides having a fabulous pool, has a clear view of the park district’s fireworks display from his deck). Jonathan said that Thomas was smiling and seemed to enjoy the fireworks while he watched them. We had a really good time that day.
Coming up we have my grandmother’s 80th birthday party on Saturday (it’s a surprise, so if you know her, don’t tell her!) which is also at Uncle Tom’s. Hopefully, it will be another successful social activity! Luckily, we’ve been blessed with many of those lately.