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Posts Tagged ‘picture schedules’

Hi! and welcome to What Works Wednesdays where we share a success story from our clinical files.Today’s success story is a follow up to a previous clinical case. Do you remember Little Cherub? She first came to us over a year ago. Little Cherub’s dad attended a presentation we did in Atlanta. He desperately wanted help because she had very restricted eating. After listening to dad talk about her symptoms, we suggested that Little Cherub be seen by a specialist to determine if she had celiac, an autoimmune condition that leaves the body unable to digest gluten, a type of protein found in bread, pasta, and cakes.

Sure enough, Little Cherub had celiac. After putting her on a gluten-free (GF) diet, she further restricted her eating. After 5 of the toughest days imaginable, we finally helped Little Cherub learn that new foods are not scary and that, in fact, new foods can actually taste good. Little Cherub’s parents were amazed to see her chasing them down to get more cantaloupe!

In addition to her eating behaviors, Little Cherub has a fear of many new things. Take toileting for example. Little Cherub wanted to continue using her pull up for toileting. Urinating on the toilet was not painful for her. But from the look on her face and the behaviors she exhibited, one would think she felt extreme pain on the toilet. In the same week we taught her to eat, we taught her to use the toilet for urinating and defecating. We made a simple visual schedule to show her that “pee” goes in the toilet.

Within 2 days, Little Cherub overcame her fears of using the toilet. We reserved her very favorite jalapeno corn chips as a treat and she learned to associate positive things with the toilet.

Less than 10 months after overcoming her fears of new foods and toilets, Little Cherub began showing fear-like behaviors in public places such as Target and grocery stores. Little Cherub’s dad reached out to us again for assistance.

Public places can be very scary for children on the spectrum. Public places are loud, they have strange lighting, and things are not always predictable. However, once you teach children the routine, and associate the public place with something positive, children learn that public places are not scary after all.

Little Cherub’s parents used the same intensive model we used with feeding. They began taking her to public places two times per day, every day, for a week. Little Cherub’s dad writes,

She went from cowering to smiling when we went twice a day for a week and explained to her what everything was she was seeing and hearing.

Congrats again to Little Cherub and her parents for working so hard on overcoming these fears. The work parents do is never easy but with success stories like this, it makes all the work worthwhile!

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Hi and welcome to Ask Missy Mondays where I respond to email questions from readers who have questions about behavior.

It’s the start of winter break for many families in New England. For those of you who are unfamiliar with the tradition, many families in the north-east plan trips to much warmer locations. This means that the stress level for many families is high right now due to packing, planning, and other cortisol-raising activities. All of this is exacerbated for families who have children with disabilities. Traveling with children is difficult but traveling with children with disabilities is even more so.

One question we receive often is “How can we travel with our child with disabilities? What can we do to make travel easier for him/her? What strategies do you recommend to help?”

One of our first recommendations is to help prepare your child for the trip using visual schedules. We have written about visual schedules previously (and we just recently learned it continues to be our most visited post).

So, we have created a sample schedule that may be used to support your child if you are traveling by plane.

Even if your child does not have a disability, preparing them for safe travel by reviewing the steps involved will help alleviate some of the stress associated with travel.

Safe travels to our New England Readers. To those of you in warmer locations, some of us are headed your way!

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Morning Schedule

We are often called out to consult in classrooms to help with “problem children”. Most of those visits confirm that the child, is in fact, having difficulties in the classroom. Sadly, many staff in those settings view the child as the problem rather than recognizing that the child is merely responding to his environment. As teachers, we often forget that children with disabilities, including autism, need ongoing support to be successful. We often try a strategy for a few days and then over time the strategy slowly slips off our instructional radar. This is especially true for a support strategy such as visual schedules.

Similarly, we are frequently called by families who need our help with tantrums and other difficulties in the home. Many times, families do not have any strategies to use in the home. Often, we meet families who have never seen a visual schedule, let alone know what to do with one.

A visual schedule (also known¬† as visual supports and picture schedules) is a task list with pictures. For example, this picture shows the “task list” for a child’s morning. First, he must put away his backpack. Then he participates in circle time. Then he has math followed by snack and toileting. Finally, it is time for reading.

Just as task lists help us remember all that we need to do in a day, visual schedules help children remember what they need to do each day. Visual schedules also help children predict their day. When children anticipate activities, they are less likely to engage in challenging behaviors around those activities.

Visual schedules may be used to show a morning routine such as the one just described. Visual schedules may also be used to show

Hand washing Steps

steps of a routine such as hand washing, toileting, or getting dressed. Visual schedules are a great support for individuals who are learning a new job such as putting together a packing list.

iPrompts Countdown Timer

Many resources exist to help you make visual schedules. One of our favorites is an application for the iPad called iPrompts. The photo library in iPrompts is not nearly as inclusive or as high quality as the one in Proloquo2go. However, you may add as many pictures from your personal library in to the iPrompts library.

Another excellent resource is Meyer-Johnson. We have used their product, Boardmaker, for many years. While it is somewhat cost prohibitive, you will find the software to be extremely useful. Using Boardmaker, we have made countless picture schedules, communication icons, choice boards. We work with a parent who uses the software to make many instructional materials for her child. You will need some training and practice to become proficient with this software. However, once you learn to use it, your options are unlimited.

Finally, Do2Learn is another excellent source of support for making visual schedules. You will find their website helpful with pictures, schedules and other tools.

Meyer-Johnson Afternoon Schedule

We recommend the use of visual schedules for children with and without disabilities. Children need to understand and predict the activities within their day. Visual supports will help them. Visual supports are another excellent way to support the beginning stages of reading as well.

Do you use visual schedules? Do you find them helpful for your child? What resources have you found helpful?

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