By Catherine Davies for the Indiana Resource Center for Autism
There is clear research evidence regarding the benefits of using visual schedules with individuals with autism spectrum disorders (ASD) (e.g., Mesibov, et al, 2002; Massey & Wheeler, 2000; Bryan & Gast, 2000).
Additionally, a wealth of anecdotal evidence exists. For example, a parent was asked to share the most helpful thing that she had tried with her son (a 15 year old with a diagnosis of High Functioning Autism). She replied that a visual schedule has been the key to increasing his independence and managing his anxiety. She reflected that she wished more parents knew about the difference this would make for both their lives and for that of their child. This article will therefore outline both a rationale for using schedules at home with individuals across the autism spectrum (ASD) (both children and adult children) and the steps parents can take to do so.
Rationale
Most of us do not follow a visual schedule for our time at home. However, individuals with ASD have greater difficulties coping with unstructured time than neurotypical people and benefit from increased structure in their lives (Van Bourgondien et al. (2003)
The advantages to using a visual schedule with individuals with ASD include (Mesibov et al., 2005):
- It utilizes the individual’s visual strengths and therefore provides a receptive communication system to increase understanding;
- It helps the individual to learn new things and broaden their interests;
- It provides tools that allow the individual to use skills in a variety of settings;
- It can increase the individual’s flexibility;
- It helps the individual remain calm and reduces inappropriate behaviors; and
- It helps the individual to develop independence and resulting self-esteem.
Reasons that parents may not use visual schedules
Despite these advantages, setting up a visual schedule can seem like a daunting, time-consuming task for many families. Keep in mind that the schedule doesn’t have to be perfect, computer printed and laminated like the ones you often see at workshops or that teachers make work just fine. Your son or daughter is equally likely to respond to stick figure pictures that you draw on post-it notes as they are to printed images.
Additionally, the time you invest in putting together the schedule will result in saving you time in the form of dealing with behavior problems and leading your over-dependent son or daughter through activities. It is also likely to save your son or daughter time by increasing their skills.
What Does a Visual Schedule Do?
It tells your son or daughter what is going to happen and the order of events. Some of you may have children that are able to memorize a sequence of events. The problem with this is that (especially as they get older) most things in life do not happen in the same order or at the same time every day. This can then lead to behavior problems when unexpected changes occur. Using a visual schedule can develop a positive routine of looking for information and thus increase flexibility and the ability to cope with life’s ups and downs in the future.
As the above research has shown, an additional positive aspect of using a visual schedule is that it can increase your son or daughter’s independence. They can learn to move from one activity to another using the schedule rather than relying on someone else to lead them or verbally prompt them to the next activity.
Steps for Setting Up a Visual Schedule
1. Decide on the format of the schedule.
All types can be used with all ages and all types of ASD. The schedule types to consider are:
A. Object Schedules: These are most appropriate for individuals who have few language skills and are mostly non-verbal. The simplest way to use an object schedule is for the parent to hand an object to their son or daughter just before they are about to move to the next activity. The individual then takes the object and uses it in the activity. The main thing to think about with an object schedule is making a list of which objects you are going to use to represent each activity.
B. Picture or photograph schedules: You will know if your son or daughter is ready for a picture or photograph schedule if they can consistently match pictures or photographs (such as in a simple lotto game). Some individuals find photos easier to recognize while others do better with line drawing. You can either draw these yourself or use computer generated pictures from the resources below.
Your son or daughter pulls off the first picture and then goes to the activity that it represents. If your son or daughter is distractible, and likely to lose focus on the way to an activity, you can use a matching picture schedule. In this type of schedule, you place an identical picture in the area they are going to (or at the doorway if for example they are going outside). They then take their picture and match it to the one you have mounted in the area. Velcro can be used to make the pictures stick to each other.
C. Written Schedules: These schedules are best for readers. If your son or daughter is just beginning to learn to read you can add some words to a picture schedule.
For more advanced learners, you can move to a more complex written schedule format such as day planners and electronic organizers.
For more information about using written schedules with your son or daughter see Faherty (2000).
When choosing a schedule type, the important thing to remember is that the schedule has to work for your son or daughter when they are having a really bad day. As most of us don’t perform at our best when we are stressed, this means that the schedule format is likely to be more effective if you make it easier than you think your son or daughter can handle.
2. Decide on the length of the schedule.
Again this will be based on your son or daughter’s needs and abilities. Some may be able to use a whole day schedule while others will be overwhelmed by this amount of information and will need to see just one or two items at a time. You can take a guess at the number of items that you think will work and then try it out making modifications, if needed.
3. Decide on the cue you are going to use to get your son or daughter to their schedule.
Since verbal instruction and cues are not the most effective way for individual’s with autism to learn (Mesibov et al., 2005), it can be helpful to use a visual method of telling your son or daughter that it is time to check their schedule. This can also be an especially useful tool when your son or daughter is stressed. As giving verbal instruction during a crisis is likely to cause difficult behaviors to increase.
If your son or daughter is using an object schedule, then you are their visual cue as you hand them the object.
For written schedules, you can use ‘check schedule’ cards or for more able individuals, just hand them a pencil. Both picture and written cues can be mounted on index cards that you hand to your son or daughter when you want them to check their schedule.
If your son or daughter is managing a more advanced schedule such as a day planner or electronic organizer, they can set an alarm on their watch or organizer that reminds them to check it at key times.
4. Teach schedule use.
Like any new concept, using a schedule is something that you need to teach your son or daughter. For an individual with little or low verbal understanding, you can do this by placing the schedule object or picture in their hand and gently physically prompting them (from behind) to go to the desired area. It is important not to be in front of them leading them to the area as this can cause them to become overly dependent on you rather than looking at the schedule.
For individuals with more verbal skills, you can explain (briefly) the concept of schedules, For some individuals, this will be most effective if you do it in writing. You can also show them your schedule and pictures of schedules that other adults use to increase their motivation to use a schedule.
5. Monitor how your son or daughter is doing.
Once your son or daughter is using their schedule, notice whether they are independent in using it. Your son or daughter is independent when they go to the schedule on their own once you hand them their visual cue to ‘check schedule’ and then use the next schedule item to go independently to the next activity.
6. Make changes to the schedule format if needed.
If you have been teaching the schedule for a couple of weeks and find there is no progress in independence, this is a sign that you may need to modify the schedule. For example, reduce the number of items or change the format from pictures to objects.
7. Be consistent in putting down all the activities on the schedule – especially if unexpected things happen.
A characteristic of individuals with ASD is that they are quick to develop routines and are intolerant of change (Mesibov et al., 2005). This can often lead to behavioral difficulties. By using the schedule to show upcoming changes, you are teaching your son or daughter to become more flexible and more accepting of change because it is happening within the familiar routine of checking the schedule.
8. As your son or daughter grows and develops new skills, you may decide to change the schedule format.
Avoid the temptation to eliminate the schedule. Individuals with autism are likely to regress back to over-dependence or loss of skills if your aim is to gradually fade the support of the schedule. However, for most individuals, the schedule format is likely to change as new skills emerge.
Summary
Visual schedules have many advantages both to the individual with ASD and to their families. Faherty (2000) has suggested that visual schedules may be more important to use at home than at school. This is due to the routinized nature of the school day and the fact that many children with ASD are unable to maintain the intense effort they need to function successfully at school when they return home. Time spent making visual schedules now will not only save you time in the future but can increase your son or daughter’s skills and independent functioning while decreasing anxiety and difficult behaviors.
References
Bryan,L. & Gast, D. (2000). Teaching on-task and on-schedule behaviors to high functioning children with autism via picture activity schedules. Journal of Autism and Developmental Disorders, 30, 553-567.
Faherty, C. (2000) Aspergers: What Does it Mean to Me? Arlington, TX: Future Horizons
Massey, G. & Wheeler, J. (2000). Acquisition and generalization of activity schedules and their effects on task engagement in a young child with autism in an inclusive preschool classroom. Education and Training in Mental Retardation and Developmental Disabilities, 35, 326-335.
Mesibov, G., Browder, D., & Kirkland, C. (2002). Using individualized schedules as a component of positive behavior support for students with developmental disabilities. Journal of Positive Behavior Interventions, 25, 58-72.
Mesibov, G., Shea, V., & Schopler, E. (2005). The TEACCH® approach to autism spectrum disorders. New York, New York:: Plenum Press.
Van Bourgondien, M., Reichle, N. & Schopler, E. (2003). Effects of a model treatment approach on adults with autism. Journal of Autism and Developmental Disorders, 33, 131-140.
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