Thursday, February 10, 2011

Why Autistic kids need visual aids?

We all require visual aids, not just Autistic children, or even Neuro-typical children. There aren't many of us that cannot survive without a calender, diary, address book or notebook. These are all visual aids that help us in our day-to-day lives. People with Autism however, are less able to function without visual aids and there are many reasons for this.

Firstly, Autistic children have poor informational processing. This leads to poor memory. When there is also poor information processing there is also increased anxiety, because you are less able to remember/predict/understand what will be happening next. (This is why Autistic children have a preference for "sameness", it makes life a little easier for their information processing system). Having a visual schedule or scripted routine elliminates the need to rely on a faulty information processing system.

Second, as mentioned in the communication blog, verbal communication is transitory. Once something has been said it is gone and the information will only be available again IF the person decides to repeat the sentence. As many children with ASD also suffer from a processing delay, then this can mean the request is misunderstood or not acted upon. This again can create anxiety, because the child cannot be confident that they have the correct information. Visual information is NOT transient and can be access when the child needs to.

Visual aids reduce the need for Verbal prompts by the caregiver. Visual prompts (maybe a "handwashing routine") means that a child can perform the task without having to be prompted verbally every stage. Visual aids increase independence and reduce "learned helplessness" (as with verbal prompting - "learned helplessness" is when a child will wait for a prompt before continuing the task and will be reluctant to do any stage of the task without a "usually" verbal prompt).

There are many types of visual aids:
  • Visual Calenders showing what will happen over week/month
  • Visual schedules (showing activities that will be done through-out the day)
  • "Now" and "Then" strips; cut-down versions of a visual schedule
  • Visual scripts/routines: A visual way of showing the various parts of a task; i.e. hand-washing
  • Cue cards: cards that can be used to show what should be said or done next in a script, or showing single actions (like STOP)
  • Visual Rules: a visual list showing what should/shouldn't be done
  • Countdown strips: a way of visually showing the time till a task is to be completed; helps with transitional situations. "You have 5,(4,3,2,1,) minutes till you are all done"
  • Visual bridges to convey information between home and school
  • Choice boards; allowing a child to indicate what he/she would like (to do)
  • Social stories; a visual way to show a child what he/she should do in a social situation - a way of learning the social rules.
  • Problem solving cards; a visual way to show have a "social problem" can be solved
  • Consequence mapping sheets: a visual way to show a consequence of an action
  • Relaxation and calming down routines
  • Zone meters: showing how loud/quiet you should be in an activity/area/time
  • PIC communication: picture cards used for non/reduced-verbal situations allowing reciprocal communication. (asking for something). This is part of the PECS system (Picture exchange)
Examples of visual supports can be found here:

The Benefits of a visual scripted routine is as follows:
  • Breaks larger tasks into smaller steps
  • Allows more independence from verbal cueing
  • gives all staff the format to teach in the same way
  • reduces anxiety by providing predictability
  • Allows the accomplishment of large goals.
Please see "30 reasons to use and keep using a Visual schedule" which can be found here:

We have to remember that the fading out of the visual aids should be dictated by the CHILD and not the adult. Just because the adult believes the visual aid shouldn't be used anymore, doesn't mean the child still isn't using it.

Apart from visual schedules, on of the main visual aid is the "Picture Exchange Communication System (PECS). This is a way for a non-verbal child, (or a verbal child who has decreased language because of an overwhelming environment) to be able to communicate their needs. It has been shown that instead of hindering language, the PECS system actually facilitates the growth of language.

The PECS system teaches the child to:
  • Locate a communication partner
  • Present a picture for a desired item
  • Get the item in exchange for the picture
  • The exchange is intentional
  • Initiative is taught
  • Is a child centred approach
The PECS system should follow the child's level of comprehension of reality regarding the item. A line drawing of an object maybe beyond a child's level of understanding, if this is the case, then the PEC symbol should then be downgraded to an actual photograph. Likewise, if an actual photograph is beyond a child's comprehension then you shouldn't use a "picture" but the actual object. The development of comprehension of symbols is as follows (1-8):
  1. Actual Object (then miniature)
  2. Similar object
  3. Photograph of actual object
  4. Photograph of similar object
  5. Colour line drawings
  6. Black line drawings
  7. Pictorial Symbols (PCS)
  8. Written words

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