using schedules all ages

Using Visual Cues Across All Ages Ranges and Skill Levels

Scot GreatheadSpeech and Language Therapist

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Consider the inclusive environment and the difficulties our students face accessing this.

Visual cues within the context of a larger ‘Prosthetic Environment’

Using visual cues to support transitions

Increasing the complexity of schedules

Text based cue systems and wider issues of developing independence in older students

Learning Objectives

The effect the environment has on developing independence and understanding

October 2005 Scot Greathead - Hatton School

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‘The Inclusive Environment’

“Inclusion is about much more than the type of school the children attend…(it’s)… about the quality of their experience, how they are helped to learn, achieve

and fully participate in the life of the school”

“The Government wants to see more children moving between sectors – dual placement and transitions”

“…promote the achievement of…pupil’s with social difficulties and interaction difficulties”

Removing the Barriers for Learning DoE 2004


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Difficulties with gaining independence

• Deficits with use and understanding spoken language

• Social deficits

• Adapting within an unstructured environment: rigid behaviours and problem solving difficulties

• Filtering internal/external distracters

• Seeing the whole picture: moving from one activity to do another

• Narrow focus: may not pick up on environmental cues as a reference to what they are meant to be doing


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Difficulties with gaining independence

Deficits with executive functions: Self Inhibition

Working Memory

Foresight (prediction and planning)

Sense of time

Shifting tasks

Starting / Completing tasks

Beginning a task

The Frontal Lobe -The Brain’s

‘Boardroom’


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How Do these Difficulties Manifest?

Raised Voices:

“Do this!”

Physical Prompting

Confusion

‘Opting Out’

Learned helplessness: “Everything gets done

for me”

Loss of control: “What’s happening

next?”

Self Harm?

Heightened state of anxiety

Failure

Confrontation, tantrums,

’behavioural difficulties’

Low self-esteem

Loss of independence – reliance on others


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The effect of the environment on developing independence

• Understanding your environment is fundamental to the way you interact and access it: – determines they way you behave– make sense of, put order to and create reasonable

expectations – how you adapt your social skills from setting to setting– increases security and reduces anxiety– the way you interpret your environment determines how

you interact with it and manipulate it for your own benefit– environmental cues exist within all levels of society


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A compatible environment?

Very often we put students in an environment which, by its very nature they can’t access

We can make environmental adaptations to ensure understanding across a range of settings


http://phillumeny.onego.ru/labels/russian/roadsft/page1/page1big1.html

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• An adapted environment aimed at increasing understanding, communication and independence.

• Recognises the differences in the way individuals think and learn - the environment, social demands and attitudes of others may be contributing to difficulties developing communication skills and independence.

• Applies to an environment that favours normalisation.

• Prevent disabilities from becoming handicaps - ‘help to do’ rather than ‘do for’.

• Includes accessible communication systems.

Rita Jordan 2002 - Autistic Spectrum Disorders

The Prosthetic Environment:


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Our ability to function independently

Relationship with your physical

environment

Relationship with your symbolic

environment

Relationship with your

social environment

The meaning we give to

objects within our

environment and how we respond to

them.

Ability to attach meaning to symbols and

markings

Awareness of how time is

represented

Ability to adapt your

role within a given setting


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Using visual cues to support the transition

process


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Using a transition schedule independently

What to do when you’re given a

visual cue

Assess students level of symbolic

understanding

Taught through backward chaining

How to use a series of visual cues i.e. a

schedule

Teach to respond to a visual command – backward chaining

2 key skills


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Hierarchy of Symbolic

Understanding

Real Objects

Miniature Objects

Photographs

Coloured Drawings

Line Drawings

Symbols: i.e. Bliss

Text/written word

Choosing an appropriate visual cue


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Following Visual Directions

• Student needs to be taught when they are given an object, photograph or symbol that this is a command meaning ‘Go Here’ or ‘Get this’

• ‘Go Here’ – Object, photograph or symbols to indicate where the student needs to go to. Requires appropriate labeling of the environment with base boards

• ‘Get this’ – Photograph or symbol indicating a required object/toy.

• Use backward chaining to teach this.


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Following Visual DirectionsBackward Chaining

• An action is a sequence or ‘chain’ of independent components• Accompany each component with comments NOT commands

Go to sink

Go to schedule

Dry hands

Turn on tap

Put soap on hands

Wash hands

Turn off tap

Take off top symbol

Look at symbol

Move to the indicated area

Teach the final component first by physically prompting the student to the end of the sequence then gradually allowing more independence


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Verbal PromptingA spoken command - tells a student to do something “pick it it”, “get the ball”, “put your shoes on”, “check your schedule”

Danger is that the student becomes reliant on the command rather than ‘thinking for themselves’

Impossible to ‘fade’ verbal prompts – easier to fade physical prompts.

Turn the command into a comment

“Turn the tap on” becomes ‘Hot Water!’

“Go to your schedule” becomes ‘Here’s your schedule’

“Get your shoes” becomes ‘They were under the chair!’


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Following Visual Directions

What’s in the box?

Here comes the hoop!

“Get this!” “Go here”Photograph which student takes from

his schedule as a cue to collect his PE kit

A photograph of an activity : Students collect the required Items for each song.

Take Register

Sensory Room

Photographs should clearly represent the area students are moving to.


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Following Visual DirectionsProviding a compatible environment

Consistent base boards for students to post pictures:

1. Naturally ‘ends’ the transition process

2. Clearly labels areas3. Keeps symbols together and tidy

Consistent labelling of boxes:

1. Acknowledges students visual strengths (menu system)

2. Allows students to visually organise their environment

3. Aids tidying up if shelves are labelled with corresponding symbols


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Visual SchedulesWhen students follow a visual command consistently without

verbal or full physical prompting they can then be mounted onto a vertical schedule.

• Acknowledges what you’re doing, when, where and for how long.

• Establishes routines, anticipates changes, reduces anxiety

• Contributes to an accessible prosthetic learning environment.

• Flexible to be tailored to students strengths and level of difficulty

• Systems are designed to be used independently to increase independence

• Can be evaluated with the transition profile to show level of progress


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Visual SchedulesConsiderations

• Build in ‘natural cues’ to indicate when the student is to return to their schedule.

• Ultimate aim is for student to use schedules as a tool for developing their independence. Use physical prompting to teach student when independence ‘breaks down’

• Monitor students understanding of new symbols

• Schedules can be made more sophisticated by mounting on clipboards, in activity books, text based lists etc.


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Visual Schedules6 steps to independence

1. Student responds to a natural cue to check their schedule

2. Student takes the top photograph/symbol

3. Student looks at the photograph/symbol

4. Student acts upon the photograph/symbol

5. Student posts photograph/symbol in base board

6. Student begins task

Student needs to carry out each stage independently for successful transition


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Student

1. Independent transitions

2. Ability to collect activity materials

I.E.P Targets

Consistent and regular

opportunities to develop skills

Assessment of student’s symbolic

understanding

Clearly Marked Areas

Consistent Meaningful

Symbols

Consistent Base Boards

Backward Chaining

Accessible Schedules

Prosthetic EnvironmentTeaching Strategies

Transition Profiling

Outcome Measures

Clear ‘ends’ and ‘beginnings’ to

activities


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Making schedules more complex


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Build In Surprises

Important skill for students are going to learn to tolerate and accept changes.

Teaching ‘Surprise!’ is a lesson in which the adult needs to have control over.

Regular surprises normalise ‘change’

Teaching Hierarchy:

1. A preferred change: ‘we’re having a party!’

2. An indifferent change: ‘We’re not doing maths, we’re doing reading!’

3. A non-preferred change: ‘We’re going to the dentist!’


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Build in time for choice

Support transitions with

reinforcers Develop sight vocabulary

Incorporate commands

Social Functional


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Collecting materialsItems for collection need

to be smaller than the ‘location’ symbol

Make your


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Incorporate Checklists/Gathering materials

• A separate box of checklists:

Different checklists within the same activity – assign different responsibilities to each group member.

The Art Checklist symbol is mounted on the schedule which signals the student to fetch the checklist from the box and collect the required materials


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Activity Schedules

• Can be portable

• Used to support understanding over a shorter period of time: sequencing a task, learning a skill, reinforcing a transition

• May need to be taught: backward chaining, timer for unstructured activities or commenting NOT PROMPTING: “You know what you’ve got to do.” “Well you’ve finished that task.”

• More complicated tasks may require a higher level of symbolic understanding


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Activity Schedules

To reinforce rewards and aid transitions: the following

activity is more motivating thanthe current activity

To help students organisetheir own unstructured time.Students choose activities, then follow their schedule.

choose


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Activity Schedules

To develop independence

To support the understanding of a sequence of events


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The success of supporting more complex instructions for non-reading students will be limited unless they are taught and can read a series of symbols

Can a series of symbols be replaced by 1 meaningful symbol

If you take the text away can you understand what the instruction is?

Using symbols to support complex instructions

V’sOctober 2005 Scot Greathead - Hatton School

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Schedule Books

Represents an event – going to a mainstream school, going shopping, using the library etcthrough, photographs/symbols/text

Used to familiarise student with a new event so they can visualise and prepare themselves

May want to incorporate roles, expectations,

social stories

Used before (familiarisation), during (reassurance),

after (consolidation/reflection) as necessary

Can’t see what happens next easily


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A weekly / monthly schedule

Requires ability to follow horizontal and vertical schedules

Less specific - indicates key event throughout the week

Could split into before and after school zones

Eliminates repetitive questioning

Teaches concepts of day names, today, tomorrow, yesterday, weekends

Able to recap on a weekly basis


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The development of the transition process

Understanding that a symbol represents a command or event

Following a vertical timetable

Following a horizontal schedule

Introduce the concept of a weekly schedule

Introduce the concept of a monthly schedule

Introduce the concept of a simple calendar, diary, to do lists, reminders etc

Acknowledging the past is equally as important as thinking about the future: diary/lifeline etc

Introduced as day planner and task planner

Concepts: months, seasons

Concepts: today, tomorrow, yesterday and days of week


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The next step to independence:

• Can students construct their own checklists/timetables? Within tray work? At the end of the day?

• Can students match to a template?

• Semantic Sorting activity: students are given 2 checklists and symbols (PE and art). Can they sort their own materials out

• Functional sequencing tasks: washing hands, snack time Concepts: days of the week, months


Text based systems to develop independence

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Adult Visual Cueing Strategies• Independence defined by how students are able to

generate, construct and execute their own visual support strategies.

• Greater onus on these skills within secondary and ‘life’ settings

• Strategies should reflect those used by the adult population and be incorporated into functional tasks.

Activity schedules

Daily Schedules

Weekly Diary

Monthly Diary

Calendar

To do lists

Recipes

Instruction manuals

Directions

Science experiments

Activities over longer

time periods:

Planning holidays

Planning trips

School projectsOctober 2005 Scot Greathead - Hatton School

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Difficulties achieving thisDeficits with executive functions:

Organisation of materials

Time management – predicting how long an activity will take

Multi tasking/switching between tasks

Beginning a task

Inhibition – staying focussed on a task

Breaking down a task into individual components

Sequencing a series of events / jobs

Poof self awareness - evaluating performance and making changes to increase success in the future.


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Wider issues with independence

Complementary work on language skills:

Taught about their own difficulties with compensatory strategies

Narrative Therapy: organising and sequencing spoken and written language

Visual Sequencing Activities

Note taking

Giving instructions / Giving directions

Decision making skills – personality, values, assertiveness, self awareness, life goals

Social Skills – using phone, asking directions, non verbal language, compromiseintonation training,


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Time

• Understanding clocks: analogue / digital / 24 hour

• Concept seconds, minutes, days, hours, weeks etc

• Predicting how long something will take – and then timing to see how long it actually took.

• Teach to allow more time than is needed for an activity

• Use of alarm clocks as cue

• Functional activities involving cinema listings, TV listings, bus/train timetables


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School Diary

• Concepts: days, periods, months, holidays etc

• Symbol supported text?

• Can students access diary: ‘What have you got week 1 period 2?’

• Do students make independent transitions ‘what have I got next?’ ‘respond to bell’ ‘collect materials etc’

• Are homework planners used functionally


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Calendar

• Concepts of months, seasons taught:

• Time markers generated with students: Birthdays, holidays, public holidays, when key events happen – Spiderman II released, non uniform day,

• ‘On this day’ news stories added to give past time markers

• Important that calendar `is integrated into students lives and becomes a functional instrument for planning work schedules, used for talking about future events etc

• Time lines: Puts the past in context, prompt thinking about the future

• Consider Palm Pilots, Microsoft outlook


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Coordinating many tasks

25 minutes: Sausages

20 minutes: 10 slices of toast

10 minutes: Fried Eggs

10 minutes: Lay the table

10 minutes: Beans

10 minutes: cups of tea

Completion

This strategy could also be used for projects which may takes weeks rather than minutes

Breakfast

Timer indicates when to start each task


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Specific programs integrated within curricular activities

Academic Skills

Preparing a presentation

Revision Skills

Breaking down tasks, writing instructions

Time management

.

Life Skills

Planning a dinner party

Taking a friend into London

Buying presents for Christmas

Ordering takeaway

At all levels students need to be involved with planning, execution and evaluation of their work.


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Planning for independence

• Behaviour Rating Inventory Executive Function Checklist (BRIEF) highlights deficits

• All activities / lessons to have some component of EF / language work related to students difficulties. Evaluation – planning – what I did well? – How long did it take me?

• Where does student need most adult support / prompting? Can this be replaced with a self maintained visual cue.

• Liaison with parents to coordinate life skills targets

• Student led IEP targets: ‘What do I want to change?’


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I am autistic. I've always been autistic, and I always will be autistic. Autism is part of who I

am, just as my sense of humor and my emotions are part of me. I like who I am, even

my autistic part.

http://www.geocities.com/growingjoel/


using schedules all ages

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