Category Archives: Visual Supports

Autism, Visual Schedules and Prompting

Many autistic students, who have difficulty transitioning from one activity to another, benefit from using a visual schedule in the same interactive way for each transition. Visual schedules provide the means to implement the same transition routine each time the activity changes. Many teachers simply say, “Check your schedule” to signal when it is time for one activity to end and another to begin. Those words serve to initiate the transition routine which the student has learned to complete once initiated without further prompting.

When getting your student to use a schedule, whether it is a schedule with activities rep­resented by real objects or one where activities are represented by pictures or by words, it is impor­tant to be mindful of the prompts you put in for the student. Before introducing anything new, think through how you want the student to ultimately engage in the activity.

  • Do you want the student to start only after you verbally prompt him? For exam­ple, when a student puts a picture from his schedule into the “all-done” pocket, if you want him to be in the habit of waiting to start the next subject, you would teach him to only start after you prompt him saying something like, “Look what’s next.” Some teachers do this because they need to check over work the student just completed before wanting him to move on to the next subject or task on the schedule, or they may need to get materials for the student to use in the next subject or task.
  • Do you want one prompt to initiate a whole sequence? It is most expedient to use one prompt such as “Get ready for the bus” to initiate the chain of events that is to occur when getting ready for the bus. Initially, the student may not know what getting ready for the bus entails. What often happens is that someone prompts the student each step of the way so as to offer support and to keep the student on track to en­sure he is out the door to the bus on time. As a result, some students inadvertently learn to wait for the prompt each step of the way. To avoid this, it is helpful to provide a mini-schedule of pictures to show each step in getting ready for the bus. Then you can use one verbal prompt “Get ready for the bus” and use visuals for the student to track the process. Remember NOT to insert verbal prompts as you teach the student to follow the mini-schedule.

At the same time, when students are learning to follow the sequence of steps, you may need to repeatedly draw their attention to the visual. One way of doing this without speaking – and inadvertently creating a prompt – is to take the student’s finger, put it on the beginning of the picture sequence, and then when he is looking, move his finger through the pictures that represent steps he has already completed, stopping at the pic­ture showing where he is in the sequence. This designates what he is to do next.

It may take several days or weeks for the student to learn this, but once learned, it will be a lifelong skill as we need to “get ready” for countless things and situations. Visuals can be used for the process of getting ready for several different things, such as getting ready for the day (self-care, getting dressed), getting ready for school (school clothes, lunch, backpack, jacket), and getting ready for bed (pajamas, brush teeth, story book). Adults get ready for work, for taking the car in for an oil change, for gro­cery shopping, etc. The fact is, we all “get ready” for many reoccurring events. All we are doing for our students is making that process visual, teaching it to them, and setting them up from the outset to be able to accomplish the entire process indepen­dently when we tell them, in this case, “Get ready for the bus.”

  • Do you want the student to need a prompt each step of the way? Occasionally you may want the student to wait for a prompt for each step of the way, such as on a field trip to a new place where you may not know exactly what will happen when. It then becomes helpful to the student to know that he can count on your prompt each step of the way. At the same time, it is helpful for you to know that the student will not do anything new until you prompt him to do so.

However, in most everyday situations it is not helpful for our students to need to be prompted each step of the way. Most everyday situations are repeated over and over, time after time. Typical students learn from repeated routine that when the teacher says, “Time for math,” she expects students to have their math book, math notebook, and pencil on their desk with everything else put away. However, our stu­dents with autism often need to be taught the routine directly as they do not pick up on routines in the same way typical students learn them.

It is natural for us to verbally prompt each step of the process and that is what is helpful and what works for most students. In fact, it works so well that we don’t even realize when we are doing it. Only when we prompt each step over and over more times than typically necessary for most students do we become frustrated. Verbally prompting each step of a sequence isn’t an expedient way for many students with autism to learn routines. In fact, this often results in the teacher exasperatedly exclaiming, “He is sooooo prompt dependent!” Just remember that for every prompt-dependent student, there has been a prompt-dependent teacher – rarely someone who set out to intentionally teach prompt dependency, but who never­-the-less has taught his student well!

Often, educational assistants work with students with ASD. Since they often work with only one student, they end up talking to that student a lot, often using continuous verbal prompting in their well-intentioned attempt to be helpful to the student. Unfortu­nately, many students learn that the way to do any activity is to wait for the prompt each step of the way. In the end, they may not be able to use their visual schedule unless the teacher or assistant talks them through each and every step at every transition from one activity to the next. Before you start using any new visual with a student it is most important to know that visuals do not need to be narrated! In fact, narrating visuals often insures they are not nearly as helpful as they would have been had your verbiage not been inserted.

To avoid such counterproductive outcomes, it is important to think carefully of the prompts up-front, only putting in what is necessary rather than all of a sudden realizing that your student is not able to use his picture schedule unless you are prompting him each step of the way. It can be difficult to fade prompts, so it is best not to incorporate them in the first place. So, plan ahead. What do you want to ultimately happen when you say, “Check your schedule?”

– From Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go.

2015-10-25 13.23.23

BOOKS AND DVD BY JUDY ENDOW

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic Adult. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2006). Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013). Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009). Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009). The Power of Words: How we think about people with autism spectrum disorders matters! Shawnee Mission, KS: AAPC Publishing.

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

Endow, J. (2010). Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013). The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS

Originally written for and published by Ollibean on November 19, 2015
To leave a comment at the end of this blog on the Ollibean site click here.

Autism, Perseveration and Holding onto Thoughts

Like many autistics, all my life I have thought visually. My thinking is comprised of pictures, colors, shapes along with their sound and movement. Given that experience, I have had to learn how to hold onto new thoughts because it doesn’t just happen automatically. This is especially true if I see a novel thought while in a slightly (or more than slightly) elevated emotional state. It doesn’t matter if the emotion is negative or positive. Here is an example:

When I am looking forward to an event such as going on a trolley for the narrated Fall Color Tour, it generates a slightly elevated positive emotional state. I want to remember to stop at the grocery store on the way home to purchase an ingredient for a dish I am planning to make for dinner. If I have no way of storing or retrieving that information I will need to hold onto that picture until it happens.

As a child, the way I would hold onto a picture – a thought that was important that I didn’t want to forget – would be to talk about it over and over until the event happened. In the above example I might repeatedly ask, “Will we stop at the grocery store on the way home?” Even though the question would be answered very patiently several times I would persist in asking it. The function of the question in this case was not to get the answer, but instead to hold the picture in place – front and center in my head – so that I would not forget it. This is because a visual thought, if not stored and therefore retrievable, is literally, out of sight, out of mind never again to be found.

Today in my practice I work with many autistics that repeat things over and over. It is often referred to as perseveration. Sometimes the perseveration is happening because the individual is thinking about something he does not want to forget and hasn’t yet figured out another way to hold onto his visual thought.

Here are some ideas that have been helpful to me to me and to others I have worked with over the years:

  • Visually construct a garage or a parking lot in your head. Consciously think of putting the picture thought in the garage or parking lot. Once the thought has been visually parked it will be there when you go looking for it at a later time.Many times when I first start working with someone to use this idea I will have them actually draw their garage or parking lot on a piece of paper and draw in the visual thought they want to park. Once the thought is parked they can go onto to do something other than perseverating on that particular thought picture, knowing they will be able to find that thought later even though they do not keep it front and center in their brain by repeatedly talking about it. Typically, after a few times of using the drawing and with encouragement to put the drawing in their head, individuals drop the paper and pencil garage or parking lot once they indeed have the visual in their head.
  • Often, a visual thought can be jotted down or drawn so as not to lose it. We all do this when we make our grocery list or jot a note to pick up milk on the way home. I needed direct instruction, many reminders and lots of practice doing this before it became automatic for me to even think of using this strategy. I find autistic individuals I work with often need direct instruction and repetitious practice before the seemingly simple idea of writing it down becomes a viable everyday strategy.
  • Another strategy that works well is to visually pull up a future scene of when you need to remember your current thought. Directly create that picture thought of the future scene when you will need to have the picture reminder pop up.Using the above example I would think of driving home from the Fall Color Tour around 2:30 along with onions at the grocery store. My picture would be of me in the car with my watch at 2:30. On my watch I put the words “on my way home” because I know my brain may not co-operate if the time is different than exactly 2:30 when I am driving home.Often, when there is not the exact visual brain match to reality, my brain will boot the picture out which causes me to lose the reminder. Thus, I have learned to outsmart this.

    When the picture of me in the car with my watch is in place I add the picture of a building with the words “Grocery Store” and an open door where I put a picture of onions just inside the door.

    Again, I outsmart my exacting visual brain by using a generic box building with the words “Grocery Store” rather than a specific grocery store. I know that I have a few possibilities of grocery stores to stop at on the way home and want to make sure I get to decide in the moment based on other needs. For example, I only want to make one stop so will stop when I need to use the bathroom and pick up the onions at this same stop regardless of which grocery store is at the stop.

Hopefully, if you are autistic and have difficulty holding onto thoughts these ideas, might be useful for you like they have been for many others. If you know an autistic person who is prone to get stuck and perseverate please know that if the reason for the behavior labeled perseveration is for them to hold onto a visual thought, these ideas may be helpful alternatives.

It has been life changing for me to learn to work with my autistic brain rather than trying so hard to copy and display the behaviors of typical people. The copy mode is draining and even when I do copy it often doesn’t fit in well, sometimes appearing a bit robotic. It is unfortunate that most of the folks who are teachers and helpers of autistics are at a disadvantage when it comes to supporting and working with autistic thinking only because they do not understand how the autistic brain functions. I have learned that it is so much easier to respect my neurology and work with it than it is to learn to copy the behaviors of neuromajority folks. I hope more information for autistics on how to work with their neurology becomes available.

IMG_2953

BOOKS AND DVD BY JUDY ENDOW

Endow, J. (2012). Learning the Hidden Curriculum: The Odyssey of One Autistic Adult. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2006). Making Lemonade: Hints for Autism’s Helpers. Cambridge, WI: CBR Press.

Endow, J. (2013). Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009). Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2009). The Power of Words: How we think about people with autism spectrum disorders matters! Shawnee Mission, KS: AAPC Publishing.

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

Endow, J. (2010). Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Myles, B. S., Endow, J., & Mayfield, M. (2013). The Hidden Curriculum of Getting and Keeping a Job: Navigating the Social Landscape of Employment. Shawnee Mission, KS: AAPC Publishing.

Originally written for and published by Ollibean on October 18, 2015
To leave a comment at the end of this blog on the Ollibean site click here.

Autism and the Importance of Stabilization

As an autism consultant I am often asked how I sort out what to do when I see an autistic client who is struggling in school or in life. As an autistic person I know first hand if stabilization needs are not met, regardless of the supports in place an autistic person will struggle. Stabilization consists of three areas that interplay – internal and external regulation in the context of a positive relationship.

Internal Regulation ~ Sensory Diet
Internal regulation has many components, but for stabilization I look at the sensory system. When a person has an autism neurology we can know that the sensory system very likely does not automatically regulate as it tends to do in a person without autism. Instead we must bring intentionality to sensory system regulation. So, the first order of business is to ensure sensory regulation. This can be accomplished through use of a sensory diet as prescribed by an Occupational Therapist well versed in sensory regulation and autism.

External Regulation ~ Visual Schedule
Most autistic people are quite visual. For many of us our native language is visual. It is how we make sense of the world around us. Words become understandable only when they are represented by something we can see either in our head or in the world outside our skin. Before anyone can learn in school or participate in life, besides being internally regulated, he needs to know that a structure exists. An autistic neurology doesn’t often automatically pick out and use salient information from day to day so as to be able to predict what will happen when from day to day. Therefore, use of an interactive visual schedule is quite powerful in establishing external regulation.

Positive Relationship ~ Person-First Attitude
Use of a sensory diet and a visual schedule are necessary for basic regulation. However, for individuals to truly reach their potential the daily working out of sensory supports and use of a visual schedule must happen within the context of a positive relationship.

People matter. People matter to autistics. Because of our differences in not automatically regulating, our style of thinking and cognitive processing differences we often appear to not be attending to others around us. Over the years, those looking at us have erroneously decided that because we do not interact the same way with people as others interact that we do not want or need other people in our lives.

As a result autistics are often not even thought of as fully human. Many times people talk about us in front of us as if we cannot hear or understand what they are saying. Did you ever wonder about that predominant theme among autistics of feeling as if one were an alien? I believe much of that comes from the interplay of not being regulated, not knowing what will happen next and, most importantly, not being regarded as a fully human person by others around us.

Conclusion
If you want the scoop on internal and external regulation and all the practical ways to put that in place the information is laid out in the book Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. When the context of service delivery, so to speak, becomes a positive relationship with person-first attitude the stage is set for an individual to reach his potential. Here is a section from the Foreword by Brenda Smith Myles to illustrate this concept:

“This book is replete with information that will help individuals meet their potential. One of the underlying constructs here and, indeed, in everything Judy does is “person-first attitude” (Endow, personal communication, June 27, 2010). We are all familiar with the concept of “person-first language” – talking about the person before referencing her exceptionality (i.e., a “child with autism” instead of the “autistic child”). “Person-first attitude,” according to Judy, is what some of us get after using “person-first language.” Unlike “person-first language,” it cannot be mandated. “Person-first attitude” is not about how we use the power of our words to benefit people with disabilities. Instead, “person-first attitude” is a reflection of what we become while in relationship with each other. It is the elusive substance of how our hearts respond to our common humanity rather than the correctness of our language in response to their disability.” (Endow, 2011, pg.1)

IMG_3250

REFERENCE
Endow, J. (2011). Practical Solutions to Stabilize Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS. AAPC Publishing.

Originally written for and published by Ollibean on December 21, 2015

Autism and Holiday Schedules

As an autistic getting through the holiday time can be quite tricky. As an autistic parent with children who had different needs it was even trickier. Routine and structure can go a long way! They anchor the days that can otherwise be perceived by an autism neurology as totally chaotic, which in turn, often leads to being overwhelmed and experiencing meltdowns.

1.  Start by creating a visual schedule. You can simply use paper and pencil or use an iPad or computer to make your visual schedule. Words can be visuals for readers. I will use words here, but the words can also become pictures for nonreaders by simply taking a picture of the activity.

Directions to make the visual schedule I like to use:

Materials: two different colors of construction paper, sticky magnetic strips, scissors, marker, refrigerator or any surface to build a magnetic schedule such as a cookie sheet.

First, put a sticky magnetic strip on the backs of two different colored pieces of construction paper.

1

Then, cut the paper into strips, by cutting where you see the dotted lines in the diagram below.

2

Next, write the stable routine things that happen every day onto the fronts of one color of strips. Using the other color of strips write in the novel activities of the day.

3-e1417986595552

2.  Place the visual schedule strips onto a magnetic surface (such as a refrigerator or a cookie sheet). Line up the days activities in the order they will happen. Start by anchoring the day with the stable routines that happen everyday such as getting dressed, brushing teeth, mealtimes, bedtime routine and whatever else you do every day. Leave space for the chunks of time between the stable routines for the changing or novel activities. Lining up the schedule this way allows everyone to see the stabile routine – in this case the green strips – that reoccur each day. It also gives structure to allow for incorporating the novel activities that occur during the holiday season.

3.  Use this visual schedule by putting in the routine things you know will happen along with the novel activities you are planning on doing and leaving spaces for chunks of time during the day you do not know what activities may occur. For example, sometimes you will not know in the morning what activities will happen between lunch and dinner, but you have made a visual space – a placeholder – where the activity can be inserted when the time comes. Other times you may have put an activity on the schedule such as building a snowman, but when the time comes it cannot happen because a relative stopped by to visit. When this happens you can show how building the snowman can be moved to another spot or maybe another day and visiting relatives will happen just now.

4.  Typically, the schedule can be built in the morning, but some children benefit from building the schedule for the next day at bedtime so they know what is coming in the morning. Use this visual schedule in the way it benefits your child most. Think it through before you begin as many children will not want to change the way the visual works once they have started using it.

With a visual routine and structure in place novel activities are more likely to be accepted with meltdowns minimized. A happier holiday is likely to be had by all in the family!

REFERENCE

Endow, J. (2011). Practical Strategies for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go. Shawnee Mission, KS: AAPC Publishing.

Originally written for and published by Ollibean on December 10, 2014

How To Outsmart “Inflexible Thinking”

Because of my autism I have an autistic thinking style. One characteristic often attributed to me is “inflexible thinking.”

Flexibility in thinking has to do with being able to adapt when circumstances change by adjusting or shifting from one expectation to another. This has never been easy for me, but I have learned how to live more comfortably with my autistic thinking style in a world where flexibility is much more highly valued than my inborn trait.

First, I had to accept my own autism and the fact that I think differently (Endow, 2009). Self-acceptance doesn’t come easily for most autistics because we are brought up being molded into acting as an neurotypical (NT) acts (Endow, 2012).  While some of this is necessary to enable us to live in the world, the flip side of it is that we come to understand that in the eyes of the world we are less than and have little value in our natural state.

Nobody sets out to teach us this, but it is what we learn. It took me many years to figure out that the truth is my brain has a different operating system than the brain of a NT. It isn’t good or bad – just different. While this doesn’t make me a bad or wrong human being, it does make life difficult in that I have to constantly accommodate the ways of the majority.

Next, I had to learn to fit in. In reality this meant that I had to come to terms with the fact that the world would not change and run according to what would make sense to me and make me comfortable. I have to accommodate everyday for the NT world. Not an easy thing to do!

Essentially, I had to learn how to outsmart my own neurology. I think visually. When circumstances change the information is typically delivered verbally. I have spent many years figuring out how to efficiently translate this verbal/language-based information into a visual format that allows me to keep up with the fast pace of the ever-changing social interface I meet every time I step outside my door.

Most often, because helpers do not have an autistic style of thinking they are unaware that the brains of most autistic children do not automatically translate language-based information (especially spoken words) into their primary visual language. Here is a strategy I have used both with myself and with many autistics of all ages. It helps us to outsmart the phenomenon that others call our inflexible thinking (Endow, 2013).

How to Outsmart Inflexible Thinking

1.  Know You Do NOT Have to Tear Down Your Picture

Much trouble occurs because our thoughts are a picture in our heads. When one    little thing changes we have to tear down that picture and start from scratch. This is one reason we protest change!

2.  Instead, Make Your Picture in Layers

Demonstrate this by showing an actual picture thought in layers. I do this by using clear overhead projector sheets. I draw each element of a picture on a separate sheet, stacking the sheets up to create the one picture thought.

3.  Now You Can Switch Out One Layer

Using the stacked up sheets you can show how one overhead sheet can be removed and another inserted to accommodate a change. For ease in manipulating the stack of overhead sheets use a hole-punch on the sheets so you can then put them into a binder.

4.  Practice and Apply to Real Life Situations

Some autistics, once they see a picture made in layers, understand it and can apply it to the picture thoughts in their heads. Others need to watch the demonstration with overhead sheets. Most need to physically practice using the demonstration picture by actually changing out a layer and then go on to apply it to their own real life situations. This application process usually involves drawing out a picture thought onto layers of clear overhead sheets and then manually replacing one picture component with another. This is the basis for flexible thinking when your thinking is visual and your thoughts are in pictures. I have illustrated some concepts of flexible thinking through paintings that can be seen under the Art Store tab of my web site (www.judyendow.com).  In addition, the picture in this blog shows four separate paintings that I use to illustrate another way to bring understanding about and work with inflexible thinking (Endow, 2013).

And lastly, I need to give myself lots of down time (Endow, 2011). Now that I am able to be more flexible by thinking my picture thoughts in layers, I am often exhausted at the end of the day. Because it takes a lot of energy to do this I need much down time where I do not need to interact with others. In addition, I have a group of autistic friends I arrange to spend time with periodically. With these friends I am able to be myself, not having to worry about fitting in and acting appropriately. For me, each day involves a high personal cost to fitting in. I choose to pay that cost and balance it with down time because it has allowed me to do and to be all I want in life. 

original

REFERENCES

Endow, J. (2012) Learning the Hidden Curriculum: The Odyssey of One Autistic Adult. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2013). Painted Words: Aspects of Autism Translated. Cambridge, WI: CBR Press.

Endow, J. (2009). Paper Words: Discovering and Living With My Autism. Shawnee Mission, KS: AAPC Publishing.

Endow, J. (2011). Practical Solutions for Stabilizing Students With Classic Autism to Be Ready to Learn: Getting to Go! Shawnee Mission, KS: AAPC Publishing.

Planetary Sky is the tittle of the acrylic painting by Judy Endow. See art at www.judyendow.com

 

Originally written for and published by Ollibean on September 7, 2014