What are visual supports?
Visual supports are non-verbal ways for children with autism spectrum disorders (ASD) to communicate their needs and make sense of the world around them. Children with autism benefit from using visual supports for a variety of reasons. A nonverbal child can use a Picture Exchange Communication System (PECS) to communicate his/her needs.
A child who benefits from routine and knowing the order of the day might use a visual calendar or schedule to familiarize himself/herself with upcoming events. A child who struggles with transitions such as leaving his/her home and getting on the school bus or tidying up toys might find pictures illustrating the appropriate steps helpful.
How can visual supports help your child with autism?
Visual supports can help children with autism find effective ways to communicate using visuals rather than auditory information. Most children with ASD are visual learners. The University of New Mexico’s Center for Development and Disability says “Using visual information to communicate with your child is taking advantage of how children with ASD naturally prefer to communicate and can reduce their frustration.”
The Center also notes that processing language quickly can be difficult for children with ASD and is why many parents find themselves repeating the same information over and over, “However, when you present information visually it can be there for as long as the child needs it.” (Visual Supports for Children with ASD).
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The Benefits of Visual Supports for Autism
The importance of visual aids for autism
Visual aids expand a child with autism’s ability to interact with his/her surroundings. They can give children a sense of autonomy and allow them to make choices and express needs. Visual aids also help children comprehend daily rhythms and have input in their activities. Perhaps most importantly, visual aids can open lines of communication between children with ASD and their caretakers.
Families who previously struggled to understand their child’s needs, endured meltdowns, and tried to reassure anxious children, can find some respite in opening lines of communication. Most importantly, children can learn how to express their desires, ideas, personalities, and wishes in a way they could not before.
Communication aids for autism
Communication aids offer children with autism a way to be active participants in their daily lives. Each child’s preferred method of communication will be unique, and it is likely to evolve as he/she transitions into new developmental phases. Some children might respond well to illustrated picture cards while others may find videos or digital photographs more helpful. Communication aids can change along with your child’s needs.
A child who starts with simple illustrated cards showing a thumbs up or thumbs down might learn to use cards with more variation including phrases like “I don’t like that,” “That’s not what I wanted,” “I would like more,” or “I am happy today.” It is important to note that using visual communication aids has not been shown to prevent children from developing speech; rather it more frequently helps children to form the foundations of verbal communication.
The role of visuals and augmentative and alternative communication
When you are deciding which role visual aids and augmentative and alternative communication (AAC) strategies should play in your child’s life, it is important to consult a speech-language pathologist (SLP). An SLP can help you gauge your child’s current understanding of speech as well as the best ways to help him/her develop speech. There are many AAC strategies available and trying to find the best one for your child can be a daunting task.
Sign language, picture cards or other visual aids, and electronic devices that produce speech are all options. An SLP can help you identify which will best help your child communicate with you while encouraging him/her to continue to progress towards speech or more developed nonverbal communication.
Different types of visual supports for autism
Picture exchange communication system (PECS cards)
The Indiana Resource Center for Autism (IRCA) described PECS as a “modified applied behavior analysis program designed for early nonverbal symbolic communication training.” (Vicker) According to the guide Autism Therapies and Solutions – The Ultimate Guide, “PECS was developed in 1985 by Dr. Andrew S. Bondy and Lori Frost as a unique augmentative communication intervention package for individuals with autism.” (Autism Therapies and Solutions, 2018) PECS is well-suited for children who are nonverbal or preverbal who attempt to communicate and express preferences but are not able to do so verbally.
These attempts might look like a child pushing a cup of water away because he/she wants juice, grabbing a toy with which he/she wants to play, pointing to the desired object, or even having a meltdown due to an inability to express needs and wants. Children do not need to be able to discriminate pictures before starting PECS, and it can be an appropriate option for children who have a dual diagnosis such as a mobility impairment.
The IRCA also notes that “although the PECS strategy is primarily used with individuals who are nonverbal, it could be used with individuals who are primarily echolalic, those who have unintelligible speech, and those who have only a small set of meaningful words or signs in their repertoire.” (Vicker) A teacher, therapist, or doctor who is certified can teach the PECS method to you and your child.
It is usually taught in six phases with the end goal of a child using the cards to respond to and comment on questions asked of him/her. PECS cards are usually displayed on a board or table so the child can see all of the available cards and choose which ones represent his/her needs or wants. Children might have different decks for food, play, locations, emotions, or any other relevant category.
Starting out with two cards and growing the deck(s) as your child begins to master PECS can avoid overwhelming your child with too much information. The decks can also grow in visual complexity and be accompanied by text as your child progresses. You can read more about implementing PECS and why mother and writer Emily Davidson called PECS her family’s saving grace here.
Feelings and Emotions Charts
Feelings and emotions charts can help children who struggle to communicate their emotions by providing them with clear visuals to which he/she can point. Charts can show a few emotions such as happy, sad, angry, and scared or display a diverse range of emotions to include mischievous, skeptical, confident, enraged, or any other emotion you chose to include. These charts can be useful in a therapy setting as well to provide a visual aid for children practicing appropriate facial expressions. They can also act as a field guide of sorts to help children identify the emotions of people with whom he/she interacts.
Emotional communication is key for children with autism and the families who support them. You can make your own feelings and emotions chart of you can purchase pre-made ones. Amy KD Tobik, editor-in-chief of Autism Parenting Magazine suggests LEGO® mood prints. “The lego Moods print entitled, How Do You Feel Today is an example of a tool children of all ages and genders can relate to.” Using LEGO® and Other Visual Supports to Help Autistic Children Understand Emotions, 2015)
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Visual schedules and visual timetable cards
Visual schedules and timetable cards let children know what the rhythm of their day is. schools often use a visual schedule to give students an idea of what subjects they will be covering and in what order, but many children with ASD benefit from visual schedules at home as well.
Schedules not only let children know what to expect in a day but allow them to prepare for upcoming transitions and changes to routine. For example, a holiday might mean that family is coming to your house midday. This disruption of a schedule can be hard but seeing that the morning routine and evening routine is the same can offer your child some stability.
Some children benefit from several schedules identifying which days are school days and which days are home days, a timetable breaking down the flow of the day (i.e., morning routine, LEGO bricks, snack, outside time, lunch, etc.), or the steps to a particular task such as hand washing or getting dressed. Allowing your child to have as much input as possible into his/her daily schedule provides ownership of his/her day and how time is spent. A child who uses PECS might choose from his/her “play” board whether he/she wants to jump on the trampoline or do a puzzle during play time.
The University of Florida Center for Autism and Related Disabilities notes that visual schedules are especially important to reference during transition times. “In order for the schedule to be useful, it is important to have some way of indicating that the activity has ended. This can be done by either turning the picture over or placing it in a stop or finished pocket. If your child wanders away from an activity, you can also use the schedule to guide the child back.”
(Schedules) If a schedule seems too overwhelming for your child, a “First, Then” chart can guide children, “to do an essential task before doing a task that they prefer to do. First, eat your lunch. Then, you can play.” (The Effectiveness of Visual Schedules for Kids with Autism, 2014) Whether you choose to use a “first, then chart,” a visual schedule, a visual timetable, or a combination of schedules, modeling behavior for your child can be helpful in the beginning to show your child what you expect of him/her.
Can I make my own visual aids?
Making your own visual aids is a great way to customize them to your child’s needs. After you have decided which visual supports will best serve your child, The University of Florida center suggests identifying images that will be easy for your child to understand and appropriate for his/her developmental level. You might begin with a simple illustration, then introduce a digital photo, and eventually incorporate text into the aids.
The university then suggests making the aids durable by laminating them, adding Velcro or magnets, and deciding how to display them. Finally, it is suggested that you create a “STOP” folder where children can place cards after he/she has finished an activity or to show that an activity is not a current choice. (How to Start)
You can visit Do2Learn for picture cards in categories including health, self-help, activities, home, and school, social, safety, calendar, and technology.
Autism Therapies and Solutions – The Ultimate Guide. (2018, December 6). Retrieved from https://www.autismparentingmagazine.com/autism-therapies/
How To Start. (n.d.). Retrieved from http://card.ufl.edu/resources/visual-supports/howtostart/
Schedules. (n.d.). Retrieved from http://card.ufl.edu/resources/visual-supports/schedules/
The Effectiveness of Visual Schedules for Kids With Autism. (2014, February 6). Retrieved from https://www.autismparentingmagazine.com/effectiveness-visual-schedules/
Using Lego and Other Visual Supports to Help Autistic Children Understand Emotions. (2015, June 11). Retrieved from https://www.autismparentingmagazine.com/lego-and-emotions/
What is the Picture Exchange Communication System or PECS? (2002). Retrieved from https://www.iidc.indiana.edu/pages/What-is-the-Picture-Exchange-Communication-System-or-PECS
Visual Supports for Children With ASD. (n.d.). Retrieved from https://www.cdd.unm.edu/autism/pdfs/Visual Supports PHT Parent Handout.pdf