Monarch Center for Autism Cleveland Ohio
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Visual Supports

Monarch Center for Autism's visual language teaching Model leverages the strong visual processing abilities of children with autism. Each of our students receives individualized visual supports around three primary constructs: Visual Instruction (adapting instruction so it is presented visually); Visual Expression (using visuals to facilitate expressive communication); and Visual Organization (using visuals to organize activities and daily schedules).

The visuals we use at Monarch can easily be adapted for use in home, school and clinical settings. We hope you find the attached samples helpful. Please feel free to print them, customize them (if desired), keep them in a binder for future reference, and share them with others.

 

Using Visuals to Support Teens with Autism: Imagine being a teenager on the autism spectrum with impaired social and communication skills, sensory sensitivities, anxiety, inflexibility, and more. Trying to successfully navigate a high school environment can pose major challenges. Below are sample visual supports that are designed to help older students achieve success in three primary areas: Communication/Social Interaction; Organization; Instruction

Communication/Social Interaction:

Organization:

Instruction:

 

 

Back-to-School Tips for Young Children with Autism: Starting a new preschool or kindergarten experience (especially after a long summer break) can produce anxiety and fear in any child. These feelings of unease are often magnified by children on the autism spectrum, who may have trouble communicating and rationalizing them. It is especially critical for families to establish familiar and predictable routines so their children with autism feel confident, safe and happy while transitioning to school. Below are tips and sample visual supports that will help promote positive experiences for our youngest learners with autism, as they begin school.

Home Preparation:

1. Develop morning, after-school and bedtime routines

2. Practice taking out clothes and packing backpack

3. Create a schedule of the day

4. Practice using school supplies

5. Practice morning circle time

6. Practice eating lunch appropriately

7. Create a countdown calendar

School Preparation:

1. Create a social story about the new school

2. Create a packet of information about your child

3. Create communication forms to share between home and school

4. Develop a separation visual schedule and social story

5. Develop a simple, weekly school calendar

6. Develop an emotions chart

 

 

Using Visual Schedules to Assist with Transitions: We often take for granted our ability to successfully transition from one activity, task or location to another throughout the day. However, transitions can pose significant challenges for individuals with autism, who tend to rely on predictability and repetition. Transitions may provoke anxiety, decreased independence and challenging behaviors. While there are many effective strategies for assisting individuals with transitions, one in particular involves the use of visual schedules. A visual schedule is a tool used to organize a sequence of events. It is espcially important for individuals who have difficulty understanding, processing and remembering verbal language and directions.

How do I create a visual schedule?

  • Getting Started: Identify the routine
  • Step 1: Determine what type of schedule your child will respond to best
  • Step 2: Break down the difficult routine into smaller steps
  • Step 3: Represent each step visually

How do I implement a visual schedule?

Recommended technology for creating visual schedules:

Sample Visual Schedules:

Different Types of Schedules:

Schedules for Activities of Daily Living (ADLs):

 

Visual Supports are one of the 27 evidence-based practices (EBPs) identified by scientific researchers as being an effective intervention for individuals with autism. However, in order to successfully use a visual support, you must first assess what level of visual representation a child understands. By meeting a child at his/her level, you promote greater understanding, retention and generalization. Below are examples of 5 different levels of visual representation of a common object, which are part of a lengthy Visual Representation Assessment developed by Monarch Center for Autism and Boston Children's Hospital. Please clck on the links below to learn more about each of the 5 levels of representation. Once a child's level is determined, future visual supports should be created to reflect and build upon this level.

  1. Object to Object Matching
  2. 3-D Representation to Object Matching
  3. Photograph with No Background Detail to Object Matching
  4. Picture to Object Matching
  5. Line Drawing to Object Matching
  6. Labeling
  7. Greater Task Complexity

 

There are many unspoken rules of social engagement that pose significant challenges for individuals with autism. These Social Pragmatics (i.e., verbal and non-verbal language intended to engage communication partners in an exchange to initiate, maintain and terminate interactions) have to be taught to individuals with autism. Below are visual supports that help teach some social pragmatic skills.

Greetings & Partings: Visual supports provide a less intrusive means of supporting greetings (say hi) and partings (wave bye) than oral prompts.

Conversational Turn-Taking: Begin by teaching individuals to take turns during non-conversational, preferred activities (passing a ball). Gradually progress to the introduction of highly preferred conversational topics.

Topic Shifting: Many individuals with autism perseverate on topics that interest them, without regard to a communication partner's interest in the topic. Visual supports help them shift to alternate topics.

Waiting: Waiting in a social setting (e.g., waiting for a turn) can be enhanced by using visual supports.

  • Graphic symbol that stands for "wait"
  • Video models that demonstrate proper behaviors associated with waiting (e.g., wait in line)

Joint Attention: An interactive skill involving the use of gestures and eye gaze to share attention regarding objects or events. It teaches individuals the reciprocal nature of communication. Visual supports are often not used to teach joint attention. Instead instruction focuses on establishing shared enjoyment, gaze shift, and teaching individuals to follow a distal point.

 

 

Asking and answering questions can be tricky for individuals on the autism spectrum. Questions are often misinterpreted due to grammatical complexity, language confusion and/or comprehension limitations. Questions are also problematic because they invite/expect a reply, which may be difficult for those who are reluctant to interact socially. Below are numerous visual supports that are intended to help teach individuals how to ask and answer questions.

Wh-Questions (which, when, who, what, where):

Yes/No Qustions:

 

Being able to make objective and subjective comments may pose significant challenges for individuals with autism. Objective Commenting involves exchanging information that describes someone or something by including some or all of its relevant characteristics or qualities that are also perceivable by others (e.g., who, what, where, when, etc.). This requires one to understand nouns, verbs, prepositions, adjectives, and adverbs. A Subjective Comment is a remark intended to share one's internal state (e.g., thoughts, feelings, opinions, or reactions to an event, activity, object, or person). This requires a willingness to socially engage by sharing information and feelings with others. Below are numerous visual supports that are intended to help teach individuals how to make objective and subjective comments.

Objective Comments:

  • Scene Cue: A video or photo that captures a generic description of an event.
  • Element Cue: A combination of symbols that describe the details by creating a visually based message.
  • Labeling: An early form of commenting that uses a visual symbol to describe a noun.
  • Buildable Scene: A printed photo of a scene, plus a collection of object photos typically found in the scene, that can be manipulated on/off of it.
  • Guided Discovery: Assemble element cues that contain descriptors, and pair with a video that demonstrates the event described by the element strings.

Subjective Comments:

  • Topic Display Boards - Simple & Complex: Visual symbols representing different parts of speech that help with communication and social commenting.
  • Pain & Illness Display: Affix icons onto a representation of the human body to express pain, illness or discomfort.

 

 

School Bus Safety

  • Training for Transportation Staff:  This presentation will help your child's/students' transportation providers: a) Gain knowledge of the general characteristics specific to individuals with autism; b) Identify techniques to support students with autism during transport to and from school.
  • Rules, Routines & Rewards:  These visual supports can be used by transportation providers to teach their passengers rules, routines and incentives/rewards that promote bus safety.

 

 

Summer can be a challenging time for children with Autism Spectrum Disorder (ASD). Changes in daily schedules, environments, and personal contacts may result in feelings of confusion and insecurity. To alleviate these feelings and reduce challenging behaviors, it is important to establish predictable summer routines replete with instructional, organizational and expressive visual supports. Below are numerous visuals that can be customized to meet your child's needs.

Visual Instruction Mode:

  • Summertime Activities: Learn about a variety of summertime activities by viewing both static scene cues (i.e., images with captions) and dynamic scene cues (i.e., short videos).
  • Summer Sorting Game: Determine which activities are related to summer by playing a fun sorting game.
  • Summer Visuals: Print and cut out a variety of summer-related visuals.

Visual Organization Mode:

  • Daily Summer Schedules - Simple & Complex: These are sample schedules/checklists of summertime activities.
  • Morning Circle Time: This guide helps create a consistent morning routine at home.

Visual Expression Mode: 

  • Summer Commenting: This simple communication board helps individuals select preferred summertime activities.
  • Requesting Summer Activities: This topic display board encourages individuals to request/communicate about summertime activities.

 

Summer is a good time to Teach Directives. Initially children tend to use directives to direct the behavior of others - especially during preferred activities such as play. What better time to play than summer! Below are visual supports related to teaching directives.

  • "I Can" Book: See individuals demonstrate how to do numerous activities through static scene cues (i.e., images with captions) and dynamic scene cues (i.e., short videos)
  • Summer Safety Directives: Three sets of element cues help individuals communicate summer safety directives related to applying sunscreen, drinking water and wearing bike helmets.
  • Visiting the Grocery Store: This visual scene display would contain hotspots that users could click to learn more/communicate about the grocery store.
  • Sporting Event Directives: This topic display board encourages individuals to make requests/communicate at a sporting event.

 

Making requests is a key function of communication. Being able to communicate one's wants and needs and express a desire for preferred activities and objects (food, toys) are critical to one's happiness. At an early age, many individuals learn to communicate requests physically (by reaching for objects or leading communication partners toward desired objects) or gesturally (by pointing toward desired objects). Individuals often experience frustration when they cannot communicate their wants/needs. A primary goal for individuals with autism is to learn to communicate requests using symbolic means (i.e., visual supports). Implementation of a successful requesting program often results in a decrease in challenging behaviors. Below are numerous visual supports that can be customized to teach an individual to make requests.

Visual Instruction Mode:

  • I Want Something: This activity story teaches the reader how and with whom to effectively communicate when s/he wants something.
  • Asking for Help: This activity story provides numerous examples of how and when to ask for help.

Visual Organization Mode:

  • My Weekday Meals: These visual images and organizational chart help an individual request and organize breakfast, lunch, dinner and side/snack options throughout the week.
  • I am Working for: This token board helps an individual work for and earn a meaningful reward.

Visual Expression Mode:

 

While every individual with autism is unique, we frequently see common challenges associated with transitions, organization of daily events, and routines. Before individuals can learn, play or socialize, they need to be able to regulate their levels of anxiety, attention and motivation so they are open, receptive and ready to engage in the task at hand. Below are numerous visual supports that can be customized to promote successful Organization and Transitions.

  • First/Then Display and First/Next/Then Display: Indicates the order of scheduled activities to help one understand the expectation of participation.
  • Surprise: An alert that a change to an established routine is about to happen.
  • Y Juncture: Indicates that while the expected activity is not available, there are choices for the substitute activity.
  • Countdown Board: Provides a visual representation of the number of repetitions required to complete a task; upon successful completion, the motivating activity is earned.
  • Daily Visual Schedules - Simple and Detailed: Increases one's understanding of upcoming events and decreases anxiety related to these events.
  • Calendar Visual Schedule: Depicts an extended timeframe, usually in one-month intervals (includes previous and upcoming activities, teaches concepts of time).
  • Activity Visual Schedules/Checklists - Simple and Detailed: Makes clear the steps and sequence involved in completing a task (improves performance and leads to greater independence).

 

Protesting is defined as behavior that expresses objection or disapproval of an activity, event or person. Refusal is defined as behavior that expresses rejection of an object, activity or event suggested or initiated by another person. By teaching an individual with Autism Spectrum Disorder (ASD) how to effectively express Protesting and/or Refusal, you are affording that person a safe, socially acceptable, and universally understood means of expressing control over his environment. Below are sample visual supports, organized by instruction, organization and expression, that help teach this important function of communication.

Visual Instruction Mode:

Visual Organization Mode:

Visual Expression Mode:

 

With the holiday season upon us, sharing a meal with family and friends is a commonplace occurrence. Associated activities that we sometimes take for granted, can be challenging for individuals with autism. Below are numerous questions that represent potential challenges. Answers to these questions can be effectively taught by using Instructional Visual Supports. These enable you to adapt instruction so it is presented visually. Below are numerous instructional visuals that can be customized to teach your children how to prepare for holiday meals:

How do I set the table?

How do I place a napkin on my lap?

What are some rules I should follow while eating?

How do I know what my food choices are?

 

With proper preparation, trick-or-treating on Halloween can be a fun and rewarding experience for children with Autism. Critical to this preparation is ensuring your child has a "voice" on Halloween. This means preparing Expressive Communication Visual Supports that can accompany your child on Halloween. Thse will enhance your child's ability to convey wants, needs, fears, questions, requests, comments, and more. They will allow your child to more comfortably participate in Halloween and will afford him/her a wonderful learning experience in the natural environment. Below are several Halloween-specific expressive communication visual supports that can be customized to meet your child's needs:

 

As students resume their daily school routines, they will benefit tremendously from using Organizational visual supports. These effectively outline schedules, relay next steps, organize activities, set expectations and alleviate anxiety. They can be personalized to meet individual student's needs, and may include any of the following:

  • Visual Schedules (detailed)
  • Visual Schedules (simple)
  • First/Then
  • First/Next/Then
  • Surprise!
  • Checklist
  • Countdown Board
  • Ratings Scale
  • Visual Images
  • Video Model

 

As fun and relaxing as summer can be, its lack of structure and predictability can also pose challenges for individuals with autism. For many, the key to enjoying summer is creating structure when none exists. Below are visual supports that will help promote structure throughout the summer

Visual Instruction Mode (VIM):

  • Morning Circle Time: This guide helps create a daily morning routine that includes calendar, weather, storytime, and scheduling activities. It enables you to plan your own fun and educational "circle time," while establishing a consistent routine.

Visual Organization Mode (VOM):

  • Daily Summer Schedule: This is a sample schedule/checklist of activities that can be performed in the summertime.

Visual Expression Mode (VEM):

 

Exposing individuals with autism to varied work and life experiences helps promote future success. However, to maximize the effectiveness of this exposure, it is critical to incorporate the use of visual supports. Below are numerous visuals that can be customized for use in the community.

Visual Instruction Mode (VIM):

  • Professionals in Our Community: This interactive visual instruction guide (with an accompanying video) teaches about different types of professionals in the community.
  • Preparing for a New Job: This template can be customized for any job, and provides tips and vocabulary to help parents prepare their children for jobs in the community.

Visual Organization Mode (VOM):

  • Looking in the Mirror: This 3-step checklist helps an individual prepare himself to go to school, work or out in the community.
  • Crossing the Street: This 3-step checklist helps an individual determine if it's safe to cross the street.

Visual Expression Mode (VEM):

  • Workplace Manners: This matching game with images, text and audio, poses questions about how to behave appropriately in 5 different workplace scenarios.
  • Mealtime Conversation Prompts: This topic display board promotes the use of common greetings and conversations at mealtime.

 

Sporting events are replete with sensory experiences that can be overwhelming. However, with advanced preparation, they also contain sensory stimuli that can be enjoyable. Below are examples of visual supports that were designed to help children with autism attend an ice hockey game. These can be modified for a variety of sporting events.

Visual Instruction Mode (VIM):

  • Attending a Sporting Event: This activity story identifies how to prepare for, enjoy and cope with potential stressors during a hockey game.

Visual Organization Mode (VOM):

Visual Expression Mode (VEM):

 

Below are visuals that support coping strategies for children of various ages in numerous settings. Not only do they promote safety, but also socially acceptable interactions and academic and pre-vocational success.

Visual Instruction Mode (VIM):

  • Coping with Uncomfortable Feelings: This activity story identifies different types of uncomfortable feelings, defines unacceptable behaviors, and presents various methods for coping and relaxing.
  • Good Choices: This picture grid helps a child identify good choices to alleviate anger.

Visual Organization Mode (VOM):

  • My Emotions Management Scale: This ratings scale (1-5) helps a child understand, organize and select positive coping skills based on a range of situations and feelings.
  • Calming My Body: This color-coded scale helps children organize their feelings by color, and provides coping strategies for feeling "just right."

Visual Expression Mode (VEM):

  • Oops I Have a Problem: This communication form helps a child document and understand a problem, associated feelings and positive solutions.
  • Feelings Log: This log helps a child and/or teacher document the who, what, where, and how of feelings conjured by a specific event.

 

Communication is an esstential life skill that many of us take for granted. For individuals on the autism spectrum, engaging in conversations and social interactions can be very challenging. Below are visual supports that help to define, organize and prompt conversations.

Visual Instruction Mode (VIM):

Visual Organization Mode (VOM):

Visual Expression Mode (VEM):

 

Below are visual supports, with an elementary childhood focus, that we hope you find particularly useful over winter break and in the upcoming months.

Visual Instruction Mode (VIM):

Visual Organization Mode (VOM):

  • Getting Dressed in Winter Checklist: Follow these step-by-step instructions (with images and text) and learn which clothing to put on in the wintertime and in which order.
  • Washing Hands Checklist: Follow these step-by-step instructions (with images and text) and learn how to wash your hands.

Visual Expression Mode (VEM):

 

Below are visual supports that assist with brushing teeth, putting on clothing in the right direction, and requesting activities in one's bedroom.

Visual Instruction Mode (VIM):

  • How to Brush Your Teeth: This step-by-step activity story with accompanying photos, teaches an individual how to thoroughly and effectively brush his/her teeth.

Visual Organization Mode (VOM):

  • Putting on Clothing in the Right Direction: This step-by-step checklist contains instructions and tips, listed in order from start to finish, for ensuring clothes are put on in the right direction while getting dressed. 

Visual Expression Mode (VEM):

 

These visuals pertain to Personal Hygiene. Personal Hygiene encompasses a wide variety of self-care activities that promote cleanliness, good health, responsibility and independence. Mastering these can be challenging. Below are visual supports that assist with shaving (for men), using a urinal (for men), and establishing a morning routine in preparation for school.

Visual Instruction Mode (VIM): How to Use a Urinal Activity Story

Visual Organization Mode (VOM): Shaving Checklist for Men

Visual Expression Mode (VEM): Getting Ready for School Topic Display Board

 

These visuals pertain to Activities of Daily Living. Regardless of age, Activities of Daily Living (ADLs) significantly impact our lives. Whether it's bathing, dressing, eating, toothbrushing, or toileting, these lifelong skills are applied in numerous settings including home, school and the community. Not only do they comprise our daily self-care activities, but mastery of ADLs promotes greater independence. For some individuals with Autism, learning an ADL can be challenging. Below are visual supports that can be used in multiple settings to practice a variety of ADLs.

Visual Instruction Mode (VIM): My Shower Routine Activity Story

Visual Organization Mode (VOM): Washing Hands Checklist; Going to the Bathroom Checklist; Brushing Teeth Checklist; Cleaning Eye Glasses Checklist

Visual Expression Mode (VEM): Getting Dressed Topic Display Board

 

These visuals pertain to Promoting Independence. We are frequently reminded that autism is a lifelong condition, which requires lifelong supports. Childhood goals often vary from those of adolescents and adults. As individuals mature, it is important they learn activities that promote independence such as completing chores, trying new foods, shopping, and practicing good hygiene. The collective acquisition of skills is critical to promoting future success at home, in school and in the community. Below are visual supports for adolescents and adults that promote independence.

Visual Instruction Mode (VIM): Let's Go Shopping Matching Game

Visual Organization Mode (VOM): Loading the Dishwasher - Dishes Checklist & Silverware Checklist; Daily Chore Chart; Weekly Lunch Menu with Food Options; Visual Shopping List; Look in the Mirror Checklist

Visual Expression Mode (VEM): Mealtime Conversation Prompts; Fast Food Restaurant Topic Board

 

These visuals pertain to Spring Break and Visiting the Zoo. Spring Break is quickly approaching and that means plenty of quality time to spend with our children and families. While a break from school and work is welcomed, it is still important to exercise our brains and work on our children's communication skills. Luckily, communication skills practice can be incorporated into every day routines and activities. Attached are some ideas and visuals to help you get started:

A trip to the Zoo during Spring Break can be fun and worrisome. How will my child react? Will my child like the Zoo? How do I prepare my child for the Zoo? These are common questions many parents ask when venturing out to the Zoo. No need to worry. Below are some visual supports, organized by VIM, VOM & VEM, that may help alleviate your fears:

Visual Instruction Mode (VIM): Zoo Activity Story (relay what to expect during your trip to the zoo and curb fears)

Visual Organization Mode (VOM): Zoo Visual Schedule (provide your child with insights into the zoo routine for the day)

Visual Expression Mode (VEM): Zoo Topic Display Board (allow your child to see and express interests and dislikes)

 

These visuals pertain to Valentine's Day. For children with autism, this holiday presents potentially wonderful opportunities for social interaction. Younger children may exchange cards and greetings, and older children may purchase gifts and go to dances. Below are visual supports, organized by VIM, VOM & VEM, that may help children of varying ages prepare for Valentine's Day activities.

Visual Instruction Mode (VIM): Valentine's Day Activity Story; Valentine's Day Gifts - Which Buys It? Matching Game

Visual Organization Mode (VOM): Creating Valentine's Day Cards Checklist; Asking Someone to Dance Checklist

Visual Expression Mode (VEM): Valentine's Day Conversation Topic Display Board

 

These visuals pertain to Winter Fun (Dressing & Playing Outside). For those who live in cold climates, freezing temperatures and snow can be a part of daily life. Along with the outdoor fun this affords, individuals with autism may struggle with the abundance of winter clothing and gear. Here are visual supports, organized by VIM, VOM & VEM, which may help with dressing for winter and playing outside:

Visual Instruction Mode (VIM): "I Want to Play, But it is Cold Outside" Actviity Story; Non-Identical Winter Items Matching Board

Visual Organization Mode (VOM): Getting Dressed in Winter Checklist; Winter Clothing Visuals

Visual Expression Mode (VEM): Playing Outside Topic Display Board; Winter Fun Visuals

 

These visuals pertain to Holiday Travel. Traveling during the holidays can be stressful for everyone, and in particular for those on the autism spectrum. Long lines, unfamiliar people, deviations in routine, delays, overcrowding, sensory overload - any and all are cause for anxiety. Here are visual supports, organized by VIM, VOM & VEM, that may help set expectations and minimize the stress:

Visual Instruction Mode (VIM): Airplane Ride Activity Story

Visual Organization Mode (VOM): Family Vacation Visual Schedule; Family Vacation Schedule Template; Travel-Related Visuals; Airport Travel Visual Supports; Airport Schedule Template  

Visual Expression Mode (VEM): I Want... Topic Board; Holiday Commenting Board

 

These visuals pertain to Thanksgiving. Along with the joy and revelry of the Thanksgiving holiday, families of individuals with autism may also experience anxiety caused by deviations in routine and overstimulation. Advanced preparation and the following visual supports can help minimize stress and maximize enjoyment: Thanksgiving Visuals; Thanksgiving Dinner Topic Board"I am grateful for..." Visuals; Thanksgiving Visual Schedule; Interactive Thanksgiving Activity Story

 

These visuals pertain to Halloween. For children with autism, the fun and excitement of Halloween can be overshadowed by fear and anxiety. Halloween activities (e.g., costumes, parties, trick-or-treating) may disrupt routines and result in sensory overload. However, with advanced preparation and the use of the following visual supports (which can be customized), Halloween can be an enjoyable experience for the whole family: Halloween Visuals; Halloween Visual Schedule (detailed version); Halloween Trick-or-Treat Visual Schedule; Halloween Topic Board; Halloween Activity Story.

 

These visuals pertain to daily organization, task sequence and transitions. The First/Then Display promotes understanding of the expectation of participation by indicating the order of scheduled activities. The Countdown Board provides a visual representation of the number of repetitions required to complete a task. The Daily Visual Schedule helps increase an individual's understanding of upcoming events, thereby decreasing anxiety related to these events. The Calendar Visual Schedule depicts an extended timeframe and is useful for showing previous and upcoming activities and temporal concepts. The Activity Visual Schedule delineates the steps and sequence involved in completing a task.

 

These visuals pertain to summer time fun. The summer visuals can be printed, cut and assembled to create daily summer time schedules.

 

These visuals pertain to returning to school. The back-to-school visuals can be printed, cut and assembled to create visual schedules and social stories that illustrate school routines. 

 

These visuals pertain to meal time. The "Food Talk" Topic Board is helpful for those with minimal language who wish to communicate a single idea. The "Table Talk" Language Board is appropriate for individuals who are able to string together subjects, verbs and nouns to form sentences

 

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