Receptive Visual Supports for Children with Autism

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As I mentioned previously, visual skills are often a strength for children with autism. In my ten years of experience working with children with autism, I have seen first hand the benefit that adding picture representation to explanations, descriptions, or instructions can have on a child’s understanding of the material– and by extension, their cooperation and participation in the activity.

Receptive visual supports help a child understand something going on in their world. That ‘something’ might be what to expect throughout their day, how to behave at the dinner table, what their options will be at the fair, or the steps to take to brush their teeth.  When people hear the term visual support, they often think of Social Stories, created by Carol Gray. Social stories are by far the most sought-after visual support type on the web, and the most popular and well-known type of support among families and professionals. Social Stories are a great tool to have in your toolbox when working with children with autism, but they should not be the only tool.

There are a variety of other types of receptive visual supports that can be used individually or together to help a child understand what is going to happen, and what expectations are present in a situation.  Examples of receptive visual supports (with basic definitions) include:

  • Visual Schedule – An organized schedule that might include pictures or text (or both) that sequentially lets the student know what is coming next throughout their day.
  • Work  System – A support which breaks down a large task into smaller, more manageable steps to help the child be successful and independent.
  • Transition Board – Gives a quick reference to the student of what they are doing and what they are will be doing next. Often used when the student is doing a non-preferred task and will be transitioning to a preferred task or activity.
  • Social Story – This story uses describing words and flexible language. It typically answers the “Wh” questions of the activity, such as “who,” “what,” “when,” “where,” and “why.” The story should be more descriptive than directive.
  • Planned Activity Training – Lets the child know what the behavior expectation is for a given activity and what they will earn when those expectations are met.
  • Comic Strip Conversation – Can be used when there is a dialogue between two or more people. It allows for simple drawings to be used in conjunction with the text to allow the child to follow along in a conversation they would typically have trouble following and understanding.
  • Power Card – Utilizes a child’s special interest as a main character in the character sketch to help motivate the child to work on the targeted skill. The instructions from the character sketch are then summarized on a smaller card with the main character reminding the child what to do in a very positive manner.
  • Cue Card – A short, to the point list or quick reminder of what the child needs to do in a targeted situation.
  • Routine Book – Uses a book format, often with actual pictures of each step of the activity to help the child know what to expect, or the desired behavior/skill of a targeted activity.

What all of these supports have in common is that they should be used proactively in the student’s programming. For example, if a child struggles with going to Walmart to shop, a planned activity training might be used prior to going to Walmart to let the student know what the expectation is for their behavior, and what they will earn when those expectations are met. A social story might also be used in this example to let the child know what they might see, hear, and do at Walmart. Both of these supports entirely lose their purpose and effectiveness if shared with the student when they are already at Walmart and showing signs of agitation.  Like all of us, once a child starts getting agitated, he has a hard time focusing, paying attention, and learning. In addition, going over the supports when a child is agitated or on the verge of having a meltdown makes the visual supports a part of that behavior chain. This can decrease the likelihood that the child will want to participate in the review of the visual supports at a later time because they have been a part of a tense and negative experience.

Using receptive visual supports can take a lot of forward planning and work, but they increase the odds that a child will go into an activity armed with knowledge about what they can expect from that environment, the expectations for their behavior, and the reinforcement they will earn when that activity is successfully complete. In my experience, the more concrete a situation is for a child with autism , the more successful they will be.

Image credit: Happy kid 4 by arsel


About Lindsay Dutton, MA CCC-SLP
Lindsay is the co-founder of Symbly, and has more than 10 years experience working with children with Autism and multiple disabilities. She is passionate about assistive technology and augmentative and alternative communication, and an expert on all things visual support and communication. Contact her at lindsay@symbly.us.

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