Why Use Visual Schedules?

Information compiled by Nicole Caldwell, M.Ed.

Visual schedules have been used successfully for a variety of purposes.
•Preventing challenging behaviors before they happen (called an “antecedent intervention”).
•Reducing unpredictable transitions, frequently a cause of stress for individuals with autism.
•Increasing participation in learning activities.
•Promoting maintenance and generalization of skills.
•Reference: O’Reilly, Sigafoos, Lancioni, Edrisinha, & Andrews, 2005

Visual schedules may meet the learning needs of individuals with autism.
•Individuals with autism may have difficulty with processing and understanding auditory input.
•Visual prompts may enhance communication with individuals with autism.
•Reference: Bryan & Gast, 2000.

Visual schedules do more than help the student with autism.
•Schedules keep a classroom organized and provide all students with a sense of routine and structure.

References

Bryan, L. C. and Gast, D. L. (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(6).

O’Reilly, M., Sigafoos, J., Lancioni, G., Edrisinha, C., and Andrews, A. (2005). An examination of the effects of a classroom activity schedule on levels of self-injury and engagement for a child with severe autism. Journal of Autism and Developmental Disorders, 35(3).

What is a Visual Schedule?

by Nicole Caldwell, M.Ed.

A visual schedule is a visual representation of tasks to be completed. A series of tasks, events, or activities can be presented in one or more of the following ways:

•Photographs
•Drawings
•Icons
•Objects
•Text

As many individuals with autism learn much better with visual than with auditory input, visual schedules may be considered an effective method for teaching and communicating with students with autism. A picture schedule may be used to communicate a series of events that must be completed (such as a math worksheet, reading a book, then outside play), a daily schedule (such as breakfast, school, homework, outside play, dinner, bath, and bed), a school schedule (math, literature, science, P.E.), a reinforcement contingency (first work, then play), etc.

You will see examples of these schedule types in this issue of Positively Autism. To get started, below is an example of part of a visual schedule I started using with my son when he was two-and-a-half years old. I searched Microsoft Word clip art for pictures representing activities that we needed to complete.

I have not included them for copyright reasons, but I also would include logos of specific stores that we needed to go to. When using the schedule, I would show him the pictures in the document on my computer screen. I would tell him, “Here are the things we need to do today.” Then I would explain each picture to him. This helped him transition between activities and increased his willingness to get in the car when we needed to go somewhere.

Example morning schedule (eat breakfast, take a bath, then read a book):

July Topic - Visual Schedules

Visual Schedules are one of my most frequently used tools for teaching students with Autism. This month, Positively Autism's focus will be articles, resources, and free printables related to visual schedules. Follow us on Facebook or Twitter to see when I've added new resources!

Amazon.com recommends...

Learn more about Self-Management (Links)

I'm about to wrap-up our series on self-management, so here are some links if you're interested in learning more.

Association for Science in Autism Treatment: Self-Management -  http://www.asatonline.org/intervention/procedures/self.htm

Autism Research Institute: Self-Management - http://www.autism.com/ind_self-management.asp

Case Study: Self-Management of Stereotypic Behaviors - http://www.brookespublishing.com/store/books/koegel-1804/casestudy.htm

Best Practice Autism Blog: Self Management, A Proactive Strategy (scroll down for article) - http://bestpracticeautism.blogspot.com/2010/01/self-management-proactive-strategy.html

Best Practice Autism Blog: Steps to Developing a Self-Management Plan (scroll down for article) -
http://bestpracticeautism.blogspot.com/2010/01/steps-to-developing-self-management.html

Teaching Self-Management Skills to Children with Autism - http://www.brookespublishing.com/email/archive/june01/june01ED4.htm

Outsmarting Explosive Behavior: Interview with Judy Endow

Note: If you're joining us from the Autism Asperger Publishing Company's website, thanks for visiting! You can follow us on Facebook at http://www.facebook.com/pages/PositivelyAutismcom/133524426684006 or Twitter at http://www.twitter.com/positiveautism . Thanks!

Positively Autism: Let’s start with your background. What lead you to the field of Autism and how did that inspire you to write Outsmarting Explosive Behavior, A Visual System of Support and Intervention for Individuals with Autism Spectrum Disorders?

Judy Endow: My son who was diagnosed with Asperger’s.  His story is in Outsmarting Explosive Behavior near the front of the teacher manual.  I myself  grew up having difficulties and was in fact institutionalized for some years as a youngster, diagnosed with a smorgasboard of psychiatric labels.  My brand of autism wasn’t understood back then. When my son was diagnosed with Asperger’s the doctor then turned to me and said we should talk about my autism.   Autism describes me better than and accounts for all the other diagnosis over the course of my lifetime.  To read my story please see Paper Words: Discovering an Living With My Autism (2009, AAPC) In addition, my professional background in the field. I have a masters degree in Social Work and used to work in a homeless shelter.  Today I have a private practice devoted exclusively to autism. I continue to write and speak on a wide variety of autism related topics.

PA: Give us a brief overview of Outsmarting Explosive Behavior and how it works.

JE: Explosive behavior is defined as having four distinct stages, followed by a clearly defined recovery period. In addition, the physiological fight/flight mechanism is triggered immediately prior to the explosion.
In this model, the four stages of explosive behavior are the same for all experiencing explosive behavior and are depicted by four train cars called Starting Out, Picking Up Steam, Point of No Return, and Explosion. The idea is to try to prevent the train cars from hooking up because when they do we have a runaway train that ends in explosion.

Working backwards, the Explosion is the stage where the meltdown behavior is evident. Immediately prior to this is the Point of No Return, which is exactly what it implies -- there is no going back from the meltdown because this stage is where the fight/flight response is triggered. The pupils dilate, and breathing and heart rates increase. Physiologically, our bodies respond as if our very lives are at stake, and we automatically behave accordingly: We fight for our lives. It is entirely impossible to reason with anyone in this survival mode. As soon as you see the child’s identified Point of No Return behavior you can know the Explosion is coming and need to do your best to quickly create and maintain a safe environment.

The place to impact explosive behavior is ahead of when it occurs. In the Starting Out phase, whispers of behaviors are evident. The Picking Up Steam phase is just that—the whispers become louder. Though you can learn to successfully intervene at these stages, the most effective way to manage explosive behavior is proactively, before the whispers even start.

Strategies to Prevent Meltdowns Before They Start

An individual mix of three major supports and interventions is usually most effective in preventing the first stage of meltdown behavior from starting. These three major supports include proactive use of a sensory diet to maintain optimal sensory regulation, visual supports, and managing emotions that are too big (Endow, 2010).

People with AS usually do not have sensory systems that automatically regulate; instead, they must discover how to keep themselves regulated. This is most often accomplished by employing a sensory diet. A sensory diet for a person with autism is like insulin for a person with diabetes. It is easy to understand that a person with diabetes has a pancreas that is unable to regulate insulin effectively. We can measure blood sugar and know the exact state of affairs, and from there figure out how much insulin the person needs.

Sensory Diet: Unfortunately, medical science does not allow us to take a blood sample to measure sensory dysregulation. However, we can figure out and employ a sensory diet to prevent dysregulation, and just like insulin prevents serious consequences for a diabetic, a sensory diet prevents serious troubles for an individual with ASD. As an adult with autism, I spend time every day on sensory integration activities in order to be able to function well in my everyday life. A sensory diet employed proactively goes a long way in preventing the Starting Out stage of explosive behavior from ever occurring (Brack, 2004).

Visual Supports: Another crucial area of support to put in place proactively is that of visual supports. As an autistic, I can tell you the saying “A picture is worth a thousand words” is the monumental truth. Although each person with ASD has a unique experience, processing written and spoken words is not considered by most of us to be our “first language.” For me, the meaning I get from spoken words can drop out entirely when I am under stress, my sensory system is dysregulated or my felt emotions are too big. Visual supports can be anything that shows rather than tells. Visual schedules are very commonly used successfully with many individuals with ASD. Having a clear way to show beginnings and endings to the activities depicted on the visual schedule can support smooth transitions, thus keeping a meltdown at bay. For maximum effectiveness, visual supports need to be in place proactively rather than waiting until behavior unravels to pull them out.

Managing Felt Emotions: A third area in which many with ASD need proactive support is in managing felt emotions. Most often, felt feelings are way too big for the situation. An example in my life is when I discover the grocery store is out of a specific item; I get a visceral reaction very similar to the horror I felt when first hearing about the 9/11 tragedy. I know cognitively the two events have no comparison and, yet, my visceral reaction is present and I need to consciously bring my too big feelings down to something more workable in the immediate situation. Managing felt emotions does not come automatically, but can be learned over time with systematic instruction and visual supports such as The Incredible 5-Point Scale (Buron & Curtis, 2004).

The good news is that explosive behavior can be positively impacted. With proactive supports, explosive behavior can be outsmarted so individuals with ASD can move on to living purposeful and self-fulfilling lives. 

References

Brack, J.C. (2004). Learn to Move, Move to Learn! Sensorimotor Early Childhood Activity Themes. Shawnee Mission, KS: Autism Asperger Publishing Company.

Buron, K.D., & Curtis, M. (2004). The Incredible 5-Point Scale. Shawnee Mission, KS: Autism Asperger Publishing Company.

Endow, J. (2009). Outsmarting Explosive Behavior: A Visual System of Support and Intervention for Individuals with Autism Spectrum Disorders. Shawnee Mission, KS: Autism Asperger Publishing Company.

Endow, J. (2011). Practical Strategies for Stabilizing Students With Classic Autism: Getting to Go. Shawnee Mission, KS: Autism Asperger Publishing Company


PA: What ages of students have used this system successfully? Does this system work best for students with any particular characteristics or needs? 

JE: Among those I have worked with the youngest child was 3 and the oldest adult in his 50’s. This train model to outsmart explosive behavior has also been used by non-readers by constructing it totally in pictures rather than using words, as in the written book example, and it has been found to be effective in both the picture and the words versions.  In addition, as the train model began appearing in classrooms, teachers noticed that students for whom the train was not originally intended began using it to show their teachers the difficult they were encountering. So, although Outsmarting Explosive Behavior Visual System was intended to be used when working with individuals with autism, it has been successfully used with individuals with other diagnosis who struggle with explosive behavior.

PA: One aspect of this program that I think is wonderful is that it may fit into a student’s special interest area. Many students on the autism spectrum (and kids in general) often enjoy trains. How would having a familiar or preferred item, such as a train, featured in a behavior support program help students learn to manage their behavior?

JE: We all attend more readily to those things we like.  We gravitate towards those things that make us happy. This is how human beings are; people with autism are no different in this regard.

PA: What other tips do you have for parents or teachers of students who may have difficulties with “explosive” behavior?

JE: If the youngster has classic autism he will likely need to be stabilized before employing the explosive behavior train model.  Please refer to Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go (2011, AAPC) for more information on this.

PA: Do you have a website where readers can learn more about your publications?

JE: http://www.judyendow.com/

PA: Thank you for sharing your time and expertise with Positively Autism!

JE: You are welcome!

Note from Positively Autism: This book is published by Autism Asperger Publishing.

Steps to Self-Management based on Pivotal Response Training

Steps to Self-Management based on Pivotal Response Training
(Based on Koegel, Koegel, & Suratt, 1992)

1. Select a desired behavior. This can be either a behavior that needs to be taught (such as responding to peer’s greetings or attending to the teacher during class time) or one that needs to be reduced (such as speaking in class without raising your hand). It must be objective and measureable. In other words, it should be very clearly defined so that both teacher and student know exactly what behavior is expected of the student and can record its occurrence or non-occurrence objectively.

2. Identify potential reinforcers. Teacher and student choose rewards, such as computer time, for the student to work toward. It is also recommended that, in addition to these external rewards, students should be encouraged to be internally reinforced (rewarded) by their behavior (because it is the right thing to do, it helps them to do better in school, it helps the teacher do his/her job and helps the class learn, etc.).

3. Choose a self-monitoring system. The teacher selects a method of data collection and behavior tracking that is appropriate to the child's needs and abilities.

4. Teach the student to self-monitor. Teach the child to recognize the occurrence or absence of the target behavior and to record the behavior using the self-monitoring system.

5.Generalize. The teacher takes data to determine whether the student can generalize the self-management system to real-life situations (such as the school or community).

For more information about PRT for students with Autism, please the folloiwng book. We will also be reviewing this book in an upcoming series of blog posts on PRT.

Reference

Koegel, R. L., Koegel, L. K., & Surratt,A. (1992). Language intervention and disruptive behavior in children with autism. Journal of Autism and Developmental Disorders, 22, 141-152.

Components of Self-Management: Self-Reinforcement

Components of Self-Management
4: Self-Reinforcement

In general, self-reinforcement refers to an arrangement in which a student gives himself or herself a reinforcer (reward), contingent on a behavior (Adapted from Goldiamond, 1976). When using a token economy (or point system), the following steps may be used to increase student independence in self-reinforcement (based on Drabman, Spitalnik, & O’Leary, 1973 and Turkewitz, O’Leary, & Ironsmith, 1975 as cited in Alberto & Troutman, 2009).

1. Teachers (or other adults) initially award and record points and give reinforcers (rewards) to the students. Once the student is successful with this step, move to step 2.

2. Students record points on a chart as directed (awarded by) the teacher. In other words, the teacher tells the student when to mark a point on the chart or put a coin in the jar (whatever type of reward system you are using): “Good job working on your assignment, Jennifer! You can put one sticker on your chart.”

3. Students award points to themselves. Bonus points are earned for matching the teacher’s ratings. In other words, students determine whether they have met a certain criteria (such as a specified number of minutes on-task or a certain number of behaviors completed) and give themselves points accordingly. When enough points are earned, students give themselves a pre-established reward (such as taking a break to draw). Teachers are also keeping track of these points on their own charts, and the two are compared for accuracy.

4.Teacher matching is gradually faded out, and as they become more skilled in using the system, students independently rate and reward their own behavior.

References/Resources

Alberto, P. A., & Troutman, A. C. (2009). Applied behavior analysis for teachers (8th ed.). Columbus, OH: Merrill Prentice Hall.

Goldiamond, I. (1976). Self-reinforcement. Journal of Applied Behavior Analysis 9(4), 509-514.

Koegel, R. L., Koegel, L. K., & Surratt,A. (1992). Language intervention and disruptive behavior in children with autism. Journal of Autism and Developmental Disorders, 22, 141-152.

Components of Self-Management: Self-Evaluation

Components of Self-Management

3: Self-Evaluation

Self-evaluation occurs when students compare their self-recorded data to a set standard. This may include comparing answers to an answer key, self-correcting of spelling words, plotting test scores on a graph, etc. In other words, the student determines if he or she achieved the selected goals for the class period, school day, week, or other time period. For example, if a student’s goal is to remain on-task for 10 minute periods, he or she would, at the end of each 10 minute interval, reflect on whether this goal was achieved, and use self-recording to record either “Yes” or “No” on a chart.

Teaching students to use self-evaluation requires an instructor to teach students to discriminate between the inappropriate and appropriate behaviors.

Coming up next:

The big payoff! Self-Reinforcement

References / Resources

Alberto, P. A., & Troutman, A. C. (2009). Applied behavior analysis for teachers (8th ed.). Columbus, OH: Merrill Prentice Hall.

Goldiamond, I. (1976). Self-reinforcement. Journal of Applied Behavior Analysis 9(4), 509-514.

Koegel, R. L., Koegel, L. K., & Surratt,A. (1992). Language intervention and disruptive behavior in children with autism. Journal of Autism and Developmental Disorders, 22, 141-152.

Components of Self-Management: Self-Recording of Data

Components of Self-Management

2: Self-Recording of Data

Once goals are selected, students may be given the opportunity to make a record of their own behavior. Students may fill in a chart such as the one below to keep track of their behaviors. Self-recording may be used to track a behavior so that the student can be given a reinforcer (reward) based on the completion of certain behaviors.

For example, a student may write a checkmark on a chart for each 5 minutes he or she is on task working in class or place a plastic gold coin in a jar each time he or she responds to a peer’s question during lunch time. When a certain number of checkmarks or coins are earned, the student receives a reward, such as computer time. 

Even if rewards are not in place, sometimes the act of recoding alone can have a positive effect on behavior. Several research studies have suggested that student records of behavior are quite accurate when compared with teacher records of behavior. Some studies even indicate that inaccurate student records can have a positive effect on student behavior.

Before teaching students to record their own behavior, they must be aware of exactly what appropriate behavior they need to achieve. For example, identification of what on-task behavior looks like may be taught through observation and modeling of teacher and peer examples, role-play, and/or Social StoriesTM (http://www.thegraycenter.org/social-stories ).

Link to this data sheet: http://www.positivelyautism.com/downloads/selfrecordingsheet.doc

Teachers and parents using self-recording should utilize the following components:

•Selecting goals (a target behavior),

•Starting small. If a student has trouble staying on task, start with a small interval of time, such as getting a checkmark, sticker, or token every minute. As the student is successful with this, gradually increase the time to two minutes, then three, and so on. To determine which interval of time to start with, observe the student to see how long he or she is currently able to stay on task, and set your time interval either right at that time, or just slightly longer.

•Specifically define a target behavior to be monitored, The student needs to know exactly what the behavior “looks like” (what he or she is expected to do).

•Selecting a data collection/recording system (such as the above chart),

•Teaching the student to recognize the appropriate behavior in himself or herself, and

•Teaching the student to use the selected data collection system.



References / Resources

Alberto, P. A., & Troutman, A. C. (2009). Applied behavior analysis for teachers (8th ed.). Columbus, OH: Merrill Prentice Hall.

Goldiamond, I. (1976). Self-reinforcement. Journal of Applied Behavior Analysis 9(4), 509-514.

Koegel, R. L., Koegel, L. K., & Surratt,A. (1992). Language intervention and disruptive behavior in children with autism. Journal of Autism and Developmental Disorders, 22, 141-152.

Components of Self-Management: Goal Setting

Components of Self-Management
1: Goal Setting

In many educational settings, teachers, speech therapists, ABA therapists, and other educators choose and set goals for their students. Students may also be active participants in the goals setting process, which may increase student academic performance. In a 2006 research study conducted by Gureasko-Moore, DuPaul, and White, students were asked to record the problems that they were having with classroom preparation behaviors (such as coming to class on time with the necessary materials). The students made a checklist of solutions to these problems and decided how many they would complete the first week. Improvements were made over the 4 weeks of the study.

When teaching goal-setting to students, there are several points to keep in mind:

•Goals should be specific.
•Goals should be challenging, but achievable.
•The attainment of goals, at least in the early stages of learning, should be immediate, rather than far-off.
•Teachers should provide feedback about success of goal achievement.
•Students may need specific instruction on how to set goals that may include modeling of teacher and peer examples and/or Social StoriesTM (http://www.thegraycenter.org/social-stories ).

Bottom line: when students are active participants in setting goals for themselves, it may increase the likelihood that they achieve their goals. It also may increase their independence in setting goals for themselves, a skill that they can continue to use after they leave the classroom.

Introduction to Self-Management

Teaching students to manage and control their own behavior is a valuable life skill. According to Alberto and Troutman (2009), “the best person to manage a student’s behavior is the student” him or herself. Each student knows what type of reinforcement/reward he or she wants to earn (for completing school work or other appropriate behavior) better than anyone and is the only individual that will be part of his or her entire educational and life experience.

Mastery of self-management skills is essential for independent functioning. Therefore, it is important for individuals, whether they are on the autism spectrum or not, to learn to monitor, reinforce (reward), and maintain their own positive behavior. This type of behavioral intervention is known as self-management. Self-management may also be thought of as self-discipline or self-control, but it is more than simply a matter of keeping behavior “under control.”

In this issue of Positively Autism, we will describe how you can teach your children or students to use various elements of self-management including:
• Goal Setting
• Self-Recording of Data
• Self-Evaluation
• Self-Reinforcement

Additionally, in this issue you’ll learn about self-management as a part of pivotal response treatment (PRT). PRT is a “naturalistic child- and family-centered intervention that has been used to promote” social and communication skills in children with autism (Texas Autism Resource Guide for Effective Teaching, n.d.).

References

Alberto, P. A., & Troutman, A. C. (2009). Applied behavior analysis for teachers (8th ed.). Columbus, OH: Merrill Prentice Hall.


Texas Autism Resource Guide for Effective Teaching (n.d.). Retrieved August 22, 2010 from http://www.txautism.net/docs/Guide/Interventions/PRT.pdf

Video: Should you tell your child about his/her autism diagnosis?

A video interview with Stephen Shore, an adult with autism and well-known professional in the field of autism. The video addresses topics such as when a child is ready to learn about his or her diagnosis,  how to present and discuss the diagnosis, explaining a diagnosis to siblings, and children using their diagnosis as an "excuse."


From Natural Learning Concepts: http://www.nlconcepts.com/

Telling Your Child about Asperger's

Perspectives and tips from parents on telling your child about his or her diagnosis, in the context of a recent episode of NBC's Parenthood. From Thinking Person's Guide to Autism.

http://thinkingautismguide.blogspot.com/2011/03/parenthood-telling-your-child-about.html

How to Tell Your Child About Their Autism

Another parent perspective on this topic with a sample script for telling your child about his or her diagnosis in a very positive way. From Autisable.com.

http://www.autisable.com/742787896/how-to-tell-your-child-about-their-autism-/

Telling Children They Have Autism or Asperger's Syndrome Video

An informative and positive video from http://www.aspergerssociety.org/

Positive Role Models on the Autism Spectrum

If you’ve recently told your child about his or her diagnosis of Asperger’s Syndrome, it is often beneficial to discuss other individuals with Asperger’s that are making positive achievements. One of the competitors on this season of the Amazing Race has Asperger’s, and was recently interviewed along with his race partner on the Autism Speaks blog: http://blog.autismspeaks.org/2011/02/20/zev-justin-interview/

Other famous persons with Autism (these lists do not necessarily reflect “official” diagnoses):

http://en.wikipedia.org/wiki/List_of_people_on_the_autism_spectrum

http://www.youtube.com/watch?v=axdTT0S3VGI (This is a great video with a very positive outlook for someone coming to terms with his or her diagnosis)

When and How to Tell Your Child They Are on the Autism Spectrum

One parent's perspective, tips, resources for telling your child about his or her diagnosis and supporting self-esteem.

http://www.autism-help.org/family-telling-your-child.htm

Telling Your Child With Autism That They Have Autism

An interesting spin on this topic from 5 Minutes for Special Needs.

Telling Your Child With Autism That They Have Autism

"You might have a kid like mine who explains his autism to people in terms of 'autism super powers.' His super power is super-reading and math and super-sonic hearing and touch (clothing tags are bad, yo). His brother’s super power is lightning fast speed, super strength and flexibility."

Read the complete article here: http://www.5minutesforspecialneeds.com/8434/telling-your-child-autism-that-they-have-autism/

Advice for Parents of Newly-diagnosed Children

From an Interview with Association for Science in Autism Treatment Board Member, Cyndy Hayes

Interview by David Celiberti, Ph.D., BCBA-D

http://www.asatonline.org/pdf/winter2011.pdf

"Any advice for parents of newly-diagnosed children?

Yes, I do have a few suggestions:

Become an autism expert. Learn as much as you can.

Be a discriminating consumer of products, programs and services. Examine outcomes – require and make sure you understand the data.

Understand and challenge any assumptions about your child that limits him or her. You are the expert on and voice of your child. Build an effective team of professionals for your child, but you drive the process.

Work with other families; they have similar needs and can be a great source of information and support. Together you can do more.

And even though this is a huge challenge and it often feels like you have to take it one day at a time, find those moments when you have just a little bit of reserve energy. Use this time to take the long view.

Autism is a lifelong disability. Lifelong planning is critical to providing quality lifelong support. This means seeking legal and financial advice. It also means creating a vision for what your child’s life can look like at its best and creating a plan to make that a reality.

And finally take a deep breath; take lots of deep breaths. Take care of yourself and if you have a partner in this journey, take care of each other. You can do this!" 

Copyright © 2010. The Association for Science in Autism Treatment (ASAT). All Rights Reserved.

Terrific Traits of People with Autism

I wanted to include these articles this month, as our focus is on parents receiving a new diagnosis. I wanted as much positive information to be included as possible. However, I think these articles share a unique perspective and are good reads, not just for new parents, but for anyone touched by autism.

Top 10 Terrific Traits of Autistic People: http://autism.about.com/od/inspirationideas/tp/besttraits.htm?nl=1

Autistic Traits: A Plus for Many Careers: http://autism.about.com/od/transitioncollegejobs/p/autismskills.htm