Recently, a flustered colleague arrived at a scheduled meeting more than 30 minutes late. This was out of character for my typicaly punctual co-worker, and it was clear that being late was quite upsetting to her . She quickly offered an explanation to the group, “I lost my calendar two days ago! I have missed a haircut appointment , forgot to drop off my library books, and have been late to two meetings.” She described how lost and anxious she felt , and how her sense of independence was gone, as she now needed to rely on her spouse and friends to remind her of her daily activities .

Her frustration level was so high that she said she felt like just staying home for the next few days to regroup (and to buy and organize a new calendar).

This experience reminded me of what a typical school day might feel like for a student with autism, if specific visual supports are not in place. Students with ASD may feel lost or anxious, if daily activities are not clearly indicated, or if the sequence of events is not understood. Students may become prompt-dependent if adults are constantly required to move them from activity to activity, and students may want to shut down, as my co-worker wished she could, due to frustration. Many of these challenges could be alleviated through the use of a visual schedule, which is similar to my colleague’s calendar.

What is a Visual Schedule?

A visual schedule communicates the sequence of upcoming activities or events through the use of objects, photographs, icons, words or a combination of tangible supports. A visual schedule tells a student where she should be and when she should be there. Visual schedules are designed to match the individual needs of a student and may vary in length and form. Just as my colleague used a calendar, others may choose to use a Blackberry™ or Day Timer™ when scheduling activities.

Why Should I Use a Visual Schedule with Students with ASD?

Visual schedules enhance receptive language and assist in providing meaning to students. Years of research has indicated that students with autism have a number of strengths, including visuospatial skills and sustained attention (Quill, 1997). Although students with ASD may have difficulty attending to and processing lengthy verbal requests, such as directives on where to go in the classroom or when an activity will begin, research has shown that students are able to attend to visual information more successfully (Garretson, Fein & Waterhouse, 1990). If an adult provides verbal information on the upcoming sequence of events, students with ASD may have difficulty with the rapid comprehension required and the fleeting nature of verbal language. If a student forgets the information, there is no concrete system to which the student can refer. Visual schedules assist with comprehension, providing another channel for learning, and are easily accessible should a student need to be reminded of the day’s events.

Visual schedules also help students with ASD become independent of adult prompts and cues (Mesibov, Shea & Schopler, 2005). Teaching students with autism to follow visual schedules, rather than being moved around the classroom or through activities by staff members, increases the likelihood that students will become independent of adult-delivered prompts. Recent research confirms that shifting from verbal prompts to visual prompts can increase student independence and engagement, as well as decrease the need for adult supports (Green, 2001). Although students may continue to rely on the visual stimulus to direct them to appropriate locations, it is not unlike my colleague (or most of us) who needed her calendar to help her stay organized and punctual.

Visual schedules also are an important tool in reducing anxiety in students with ASD, while teaching flexibility. Students with autism may feel anxious if the expectations are not understood or if predictable routines are not in place. A visual schedule provides a clear external structure for the school day, and may be physiologically calming for students. Although activities should vary throughout the day and week, the routine of using a visual schedule can provide safety and predictability. Classroom staff is responsible for varying the sequence of events regularly (i.e., math is first on Mondays, Wednesdays and Fridays and reading is first on Tuesdays and Thursdays), while ensuring that the visual schedule is used consistently to provide information to students. Ultimately, the visual schedule can teach students that a change in the sequence of activities is acceptable because the routine of using the visual schedule is consistent and reliable.

How Do I Use a Visual Schedule with Students with ASD?

The first step in using visual schedules is to design the format of the schedule based on the needs of the student. Teachers may consider the comprehension level, attention span, sequencing abilities and other skills a student demonstrates. Division TEACCH (Treatment and Education of Autistic and related Communication- handicapped Children) identified five areas to consider when designing visual schedules for students (Cox & Boswell, 1999):

1. Form of Representation

Consider what form of information would consistently be most meaningful to the student. Staff may determine that objects, photos, icon drawings or words (or a combination of forms) are most easily understood by the student. For example, with a concrete learner, using Lego blocks to represent the play area may be most meaningful, while a photo of the play area may be appropriate for other students, and an icon representation of the play area may be meaningful for still others. It is important to select a form that would be understood by the student on his worst day (i.e. when there is a substitute teacher, when the bus is late, when recess is cancelled), as a student’s comprehension skills often may be compromised in times of stress or anxiety.

2. Length of schedule and presentation format

After determining how the information will be represented, staff must consider how much information will be presented to the student at one time. Some students may be most successful with one piece of information at a time, while others are able to be successful with a short sequence of activities or up to a full day of information presented at a time. It is important to assess the student’s ability to sequence information, the anxiety level of the student (presenting too little or too much information may cause a student to worry) and the student’s ability to handle changes in the information presented (if a full day of information is presented, it is more likely that unforeseeable changes will occur). Once length is determined, the classroom team must decide how to present the information to the student—one piece at a time, in a left-to-right or top-to-bottom format or multiple rows of information.

3. Methods of manipulating the schedule

The next step is determining how the student will move the schedule materials throughout the day. If the student is using objects to depict where to go, staff also may decide that the objects will be used in the activity (i.e., student will play with the Legos after arriving in the play area). Staff also may decide that students will carry the schedule item and match it to an identical item (e.g., object, photo, icon, word card) upon arriving at the assigned destination. Carrying schedule items to the location can often assist students in remembering where they are headed without additional adult reminders (i.e., asking students, “Where are you supposed to be?”), and provides reinforcement for students when they match the item to the corresponding container. If students no longer need to carry schedule information with them to a location, they may mark off the activity when it is finished.

4. Location of the schedule

When initially teaching a student how to use a schedule, staff may decide to bring the schedule information to the student. As students become familiar with the schedule, and understand where to go, schedules may be posted in a central location in the classroom, such as a table, shelf, wall or desk. When it is time to transition, students can go to this central and neutral location (a “transition area”) to get their schedule information. Or if students are independent in their schedule usage, they may begin to carry a portable schedule with them from activity to activity. The visual schedule may be placed in a binder or on a clipboard that students carry with them throughout the day.

5. Initiating use of the schedule

Finally, staff need to determine how a student will know when it is time to check his schedule. Initially, staff may bring schedule information to the student at the culmination of an activity; however, most students eventually will go to a transition area when cued. Visual cues often are most effective to signal to students that a transition is occurring and that information about an upcoming activity can be found on their schedules. Staff may decide to use a card with the student’s name on it or a favorite picture as the cue. When students are given this cue, they may carry it to their schedule, place it in a matching pocket or container and refer to the next activity on the schedule. Using this cue consistently is an excellent tool in helping students know when to transition and when to remain in an activity or location. The use of a visual cue also reduces dependency on adult prompts during transitions.

What Do I Do Next?

After matching the design of the visual schedule to the student’s strengths and needs, and making all of the schedule materials, staff then need to begin to teach the student how to use the schedule. Students must be explicitly taught how to manipulate the materials, where the designated locations are, and how and when to transition throughout the day. When teaching a student to use the schedule, it is most effective to minimize adult-delivered prompts (Green, 2001). The teacher should prompt the student from behind so the schedule materials are in the student’s visual field and plan to fade the prompts as quickly as possible. Only relevant language should be used, identifying the location where the student is going (i.e., “play area” instead of, “Come on, Steve, we’re going over to the play area. I think you are going to love it.”). This promotes student independence, as a primary goal of schedule use is independent movement throughout the classroom and school building when appropriate. O nce a student has mastered independent usage of the visual schedule, staff can decide how to continue to improve the student’s skills. Staff may decide to change the form of the schedule from pictures to words, if the student has become a fluent reader, or to increase the length of the schedule from part-day to full-day. It is important for everyone to remember, however, that a more complex visual schedule is not necessarily “better.” The goal is independent usage, so the types and forms of schedules used may vary widely in one classroom. Staff should make sure to have back-up schedules available so that students continue to attend classes on-time— a tip I will need to pass on to my colleague when she makes her next calendar purchase.

About the Author

Kara Hume, Ph.D., is a former classroom teacher for students on the spectrum and is an adjunct professor at Indiana University.

References

Cox, R., & Boswell, S. (1999). Checklist for the individualization of visual schedules. TEACCH Level 1 Seminar.

Garretson, H., Fein, D., & Waterhouse, L. (1990). Sustained attention in children with autism. Journal of Autism and Developmental Disorders, 20, 101-114.

Green, G. (2001). Behavior analytic instruction for learners with autism: Advances in stimulus control technology. Focus on Autism and Other Developmental Disabilities, 16, 72-85.

Mesibov, G., Shea, V., & Schopler, E. (2005). The TEACCH approach to autism spectrum disorders. New York: Plenum Press.

Quill, K. (1997). Instructional considerations for young children with autism: The rationale for visually cued instruction. Journal of Autism and Developmental Disorders, 27, 697-714. The Picture Communication Symbols© 1981, 2005 by Mayer Johnson, LLC. All Rights Reserved Worldwide. Used with permission. Credit to Division TEACCH for several photos.