The Visual Thinker
I touched a little on anxiety and on the importance of using visual strips in our house in my previous post Routines and the Meltdown Monster. Today I thought I would break this down further and dive into the world of routine strips, visual stories and visual queues.
In the beginning we used visual strips for everything especially when the Monkey was non-verbal. When I say everything I literally mean everything from getting dressed, taking a bath, going to the store, getting ready to go, all the steps we do in the bathroom and the list goes on and on. These visual queues helped ease his anxiety, allowed us to transition to new activities with fewer meltdowns, made it possible for us to communicate and helped him to finally speak (along with some other things I did that I will post about in future). The Monkey has autism there is no doubt about that but autism aside the drive for a lot of his behaviors is the anxiety. Now that he has been able to talk for a little over a year now and he is doing so well in so many other areas our main focus is on the anxiety and how we can help him now before he starts school.
Lets start from the beginning. PECS (Picture Exchange Communication System) like these are basically where we started. These picture’s allow you to show the visual thinker what is happening and allows the visual thinker to use these pictures to tell you what they want. The images in most PECS are very generic and usually drawn or very basic pictures of none specific items. These images were too generic for the Monkey in the beginning and I ended up having to take pictures and print off my own PECS that would be more specific to our daily lives. Showing him an image of a drawn book did not relate to an actual book. He still tends to see the world in this sort of black and white separation of things but has gotten much better as time goes on. So if you have tried PECS in the past with little or no success I urge you to try taking actual pictures that relate to your daily life. We had pictures of our cars, his things like clothing, toys, tooth brush, books etc… We had pictures of our plates, our utensils, our favorite foods, all the stores we go to, the parks we actually went to, etc… Once I had literally hundreds of my own pictures taken I then laminated them all and used them as visual schedules and routine strips.
I usually broke the routine strip into three parts, morning, afternoon and evening. Now I can give him a very general schedule which shows where he will be and who we will see and then give him a detailed routine strip for the morning without him needing to see the one for the afternoon or evening right away. In the beginning however he needed to be able to see what he was doing from the time he woke up to the time he went to bed. This led to really long strips. We also had separate ones in the bathroom outlining all the steps for bath time or brushing ones teeth. A basic day back then would have looked like this:
Then if we were going some where in the morning for example I would instead show a picture of where we are going and give him a separate strip that would show us getting in the car, driving to where we are going, any stops on the way, who we would see etc… The more detailed the strips the less anxiety he had and we could transition from one activity to the next with less behaviors. As time went on I was able to simplify this system and now the only things on it are more or less simply to tell him where he is going from day to day:
When we first started to use this sort of system the Monkey had very few words and so communication between he and us was difficult. Once we realized how well he understood when things were visually laid out for him we saw a whole new more confident side of our little Monkey. To help with speech and to also allow him to communicate I mounted a board on the wall with pictures of a bunch of our everyday things. Food, toys, places were all on there and so I used them to communicate with him. I would use a strip that had velcro on one side and we would build a sequence together. The question, “What would the Monkey like for a snack?” The process: begin with a picture of the Monkey and a picture of an empty plate labeled snack. Next I would give him two options, apple or orange. Once he pointed to it I would place the item on the strip beside the empty plate. Next I might give him a picture of toast or crackers and again once he pointed to one I would add it to the strip. Then I would place a picture of an empty glass and the process would continue until we had what he wanted to drink and what he would need to eat the items with if utensils were needed. After we had the items on the strip then I would read it off pointing to each item. The Monkey wants an apple and toast for snack and juice to drink. I used this same method for going to the park or playing or doing my own ABA therapy with him. Once he was confident with this I started to emphasize the words a bit more and I moved on to having him try to say the words with me. This led to a few meltdowns at first but once he realized that if he tried the words he would get a little surprise on his plate for snack like a little chocolate then he started to say the words with me and this is how the Monkey learnt to speak. So this is a sample of what this would look like:
Rebecca also has used and uses visual strips and schedules for MJ with great results. They also found that generic images were not as successful as images they took themselves or drew with her present. MJ, although verbal, still benefited from these visual queues and schedules because like the Monkey and most children on the spectrum she is a visual thinker and she, like the Monkey, has high anxiety.
Routine strips were a life saver which we still use regularly and without them the Monkey’s anxiety which is still very high would be extreme.So if you are not using routine strips or visual schedules I really urge you to try it. If you have tried the PECS before and found they didn’t really work then you may need to do like us and be much more specific with the images you choose to use. Your child may need to relate to the picture to understand the picture especially when they are young and non-verbal. It’s really a trial and error of what might work for your child. Will you need the clocks? May be not. Will pictures need to be as detailed? Maybe yes in the beginning or maybe your child will do great even with very generic images.
For those of you already using visual strips what other tips would you have? For those of you not using them, if you have any questions please ask away. I know that it may seem time consuming and tedious at first but when you can ease some of the negative behaviors using them it truly is worth the time and energy.
Have a great day!