Autism Spectrum
Disorders
Dr. Avril V. Brereton
Helping young children to
communicate using visual supports
All children who receive a diagnosis of autism
have problems with communication. This fact
sheet discusses the use of visual support systems
and offers some ideas about their introduction
and use.
Children with autism have difficulty using speech
and language and also have difficulty
understanding the spoken language of others and
even the simplest sentences and instructions can
be difficult for young children with autism to
follow. Because of these problems in
understanding, young children may be confused
about:
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what is or isn’t happening in their day
why their routine has been changed
being expected to shift from one activity to
another
being allowed to do some things but not
others
not always being allowed to do what they
want to when they want to
Slow processing of verbal information also means
that an instruction may come and go too quickly
so that the child doesn’t have time to understand
the instruction and then respond to it. For young
children with autism, problems communicating
with others may lead to:
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difficulty getting their message across
frustration because their attempts to
communicate are not understood by others
giving up because it’s simply too hard
We do know that for most children with autism
the area of visual perception is a relative
strength. How many children with autism do you
know who can work the control for the TV and
VCR or know how to unlock the front door yet you
have never taught them to do these things? Little
Autism Friendly Learning: Visual supports
children with autism learn by looking and
watching. Because of this, visual supports can
help us to communicate with them and them to
communicate with us.
What are visual supports?
Some examples of visual supports or visual
communication tools are:
real objects
miniature objects
photographs
line drawings
picture symbols
choice boards
activity schedules
daily schedules
How and when to use visual supports
Planning for the introduction of visual supports
requires a thorough understanding of the child’s
abilities. Consultation with a Speech Pathologist
and members of a multi-disciplinary team of
professionals working with the child is highly
recommended.
Each child’s abilities and
communication needs must be carefully assessed
before a visual support system is introduced.
Importantly, communication needs will vary
according to the setting the child is in. For
example how and what a child needs to
communicate and with whom will be very
different at home, Early Intervention, childcare or
pre-school.
In order for the child to effectively use the visual
support system, it should be introduced across
different environments and with a range of
people. It is vital that everyone interacting with
the child consistently uses the same approach.
For successful introduction and effective use of
visual supports, the child needs to understand
what the object/picture/word represents, and
how to use it to communicate a need or
understand a request.
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The child also has to have the following pre
requisite skills:
1. the ability to attend to the visual stimuli
(object, picture etc)
2. the ability to interpret the meaning of the
stimulus
3. the desire to communicate with others!
There is a hierarchy of complexity in visual
supports. The most easy to understand and use
are real objects, followed by miniatures of real
objects, photographs of the real objects, line
drawings, symbols and finally the written word.
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requires very little interpretation,
is useful for a very young child,
can be used with a child with significant
development delay
Photo of the real object
The child selects the photo of the bubble jar if
they would like to play with the bubbles.
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requires a child to understand that 3D
objects can be represented in 2D form.
does not require the child to understand that
bubble jars can look different from each
other.
does not require skills of generalization
See below an example of the communication skill
– Choosing an activity.
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Bubble Play is the activity of choice and the visual
support hierarchy from easiest to most
difficult/abstract is described.
The child selects the generic line drawing if they
would like to play with the bubbles.
Making choices: using the visual
support hierarchy – Bubbles
Generic line drawing of the object
Generic line
understand:
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drawings
require
a
child
to
3D objects can be represented in 2D form,
an object can come in many different forms
(size, colour, shape),
one picture can be used to represent each of
these different forms of an object;
skills of generalization.
Line drawings are accompanied with the
written word, to encourage the child to
develop a bank of sight words that can be
read in order to introduce the next phase of
the hierarchy.
The written word
The child selects the written word “bubbles” to
play with the bubbles.
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This is a visual support in its most abstract
form.
There is no picture involved for the child to
refer to.
The child needs to be able to read
Real object:
The child selects the bubble wand as an indication
they would like to play with the bubbles.
Autism Friendly Learning: Visual supports
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Choosing activities using the visual support
hierarchy –
An activity choice board using
Photographs
Real objects to written word
Steps:
 Photos of the activities are placed on the
choice board
 The child chooses a photo from the choice
board
 The child is then directed to the activity the
photo matches
 Most effectively introduced when activity is
close to the choice board and is immediately
given to the child when they select a photo
from the board
An activity choice board using Real Objects
Steps:
 One piece of each activity is placed on the
choice board
 The child chooses an object from the board
 The child is then directed to the activity the
piece matches
 Most effectively introduced when activity is
close to the choice board and is immediately
given to the child when they select a piece
from the board
Available choices
Thomas cards, blocks, circle puzzle or play dough
Available Choices:
The choices are cards, blocks or circle puzzle
“I want to play with the circle puzzle”
Child removes a real object from the board to
make her choice.
1. Child gives you the block:
“I want to play with the blocks”
2.
Child plays with the blocks
Autism Friendly Learning: Visual supports
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An activity choice board using Generic
line drawings
Steps:
 Generic line drawings of activities are placed
on the choice board
 The child chooses a drawing from the choice
board
 The child is then directed to the activity the
drawing matches
First – then
Understanding the concept of first – then or to
get across the message to a young child with
autism that they can have something later rather
than immediately is difficult! The use of first –
then pictures can help.
Available Choices:
The choices are threading, dress-ups or painting
“I want to play with the dress-ups!”
Used to motivate the child
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Used to motivate a child to participate in an
activity they would otherwise avoid
o First: play lotto (undesired activity but
goal for the child),
o Then: play Mr. Potato Head (child’s
favourite activity)
Used as a 2-step schedule
 For a child learning to complete a sequence
of activities, a first-then card can be used as
a 2-step schedule
 The consistent presentation assist the child
to learn the skill
An activity choice board using written
words
Steps:
 Words of activities are placed on the choice
board
 The child chooses a word from the choice
board and is directed to the chosen activity
Used to assist a child to move on to the next
activity
 For a child who demonstrates difficulty
finishing a current activity and moving on to
the next activity
For a child who demonstrates anxiety when
unsure of the routine; finishing an activity can be
anxiety-provoking because the child does not
know what to expect next. A first-then visual can
ease the child’s anxiety by showing them the next
activity.
Autism Friendly Learning: Visual supports
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Try a play ideas mat!
Why use a play ideas mat?
 To provide the child with a range of different
options to choose from in open-ended
activities
 To use in open-ended activities with children
who lack play ideas and become stressed
and/or anxious as a result
 To increase the amount of time a child
spends in open-ended activities, as a range
of different ideas are presented to extend
the child’s play
 To reduce the child’s anxiety about not
knowing what to do
 To assist in the social inclusion of the child.
Useful websites and books
http://card.ufl.edu/visual.htm
http://www.scopevic.org.au/therapy_crc.html
http://www.do2learn.com
Teaching Children with Autism: Strategies to
Enhance Communication and Socialization by
Kathleen Quill, New York: Delmar Publishers
Inc., 1995.
How to use a play ideas mat
 Initially use each of the picture prompts
individually, showing the child step-by-step
how to create the image in the photo
 Once the child can copy several different
images, place them on to a mat (laminated
A4 or A3 sheet)
 Position the mat at the activity (on the wall
near the block corner or at the painting
easel, for example) for all children to see and
use if they wish.
Autism Friendly Learning: Visual supports
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