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Visual Supports for Students with Autism

Alyson Harris
Western Washington University

Ms. Graham is a primary, general education teacher.  She has been teaching for five years.  During her tenure, she has experienced the shift toward more inclusive settings and the least restrictive environment for students with disabilities.  This year a student with autism was placed in her classroom.  Ms. Graham was worried about her lack of experience teaching students with special needs and wanted to find out how to support her student with autism and best meet his needs. The purpose of this article is to inform educators, like Ms. Graham who are primary general education teachers, about different types of visual supports available such as those used in the TEACCH method so that teachers can implement these supports in the general education classroom with their students who have autism.

Autism spectrum disorder (ASD) impairs a person’s ability to communicate and relate to others (Roa, & Gagie, 2006).  Children with autism may also engage in repetitive behaviors.  Some examples include a child arranging objects repeatedly in a specific way, or following only very specific routines. Students with ASD need explicit instruction on what is expected of them and may require predictable routines.  Parents and educators must consider individual characteristics of children with autism to improve outcomes for the child.  General educators who teach students with ASD should consider effective methods for educating students who are diagnosed with ASD, such as: (a) early intervention, (b) referral for speech therapy, (c) teaching social skills, (d) visual supports, (e) consistent routines, and (f) intensive, evidence-based intervention.  Because the characteristics of students with autism vary, there is not one best way to teach or one learning method for all. It is important for teachers to collect data to determine that the student is benefiting from the interventions and supports selected. 

Visual Supports

Many students with disabilities are now included in general education classes for a majority of their school day.  Roa and Gagie (2006) describe how more students with ASD are taught in general education classes.  As a result of the increasing awareness of the incidence of ASD, researchers have gained interest to find evidence about how to effectively educate children with autism.  Although there is no one best support program or one best technique for helping children with autism, concrete visual teaching methods are recommended. Visual supports are tools that are used to increase the understanding of language, environmental expectations, and to provide structure and support for individuals with ASD. Visual supports can be provided in a variety of ways across multiple settings. For instance, you can incorporate supports in school, home, work, and within the community.  Roa and Gagie (2006) listed several reasons why these visual supports are useful to support learning and success within the inclusive classroom.

Roa and Gagie’s (2006) reasons to why you should use visual supports:

-          They are part of everyone’s communication system.

-          They can attract and hold a student’s attention.

-          They enable the student to focus on the message and reduce anxiety.

-          They make abstract concepts more concrete for the student.

-          They help the student express his or her thoughts.

-          They help all students.

According to Hodgdon (2000), visual supports, when implemented correctly, allow students with autism the freedom to engage in life, regardless of impairment.   Visual supports have been successfully used to teach children with autism a variety of skills to include literacy skills, cooking, encouraging positive behavior, and providing activity schedules.  Computer and video programs have also been used to visually signal when transitions are going to occur.  Roa and Gagie (2006) stated, that “Visual supports help bring in structure, routine, and sequence that many children with autism require in order to carry on their daily activities” (p.27).  In addition, Dalryaple (1989) declared that along with impaired communication, individuals with autism have trouble understanding social communication cues such as gestures, facial expression, body language, and voice intonation and therefore, “As a rule of thumb, the more people with autism can be provided with visual cues, the better they will understand what they are supposed to do”(Dalryaple, p.5). Consequently, visual schedules have the potential to tremendously help children with autism and facilitate successful transitions between each activity.

Individuals with ASD also require environmental and instructional support that will help them overcome various challenges.  The challenges can emerge from deficits in their skills to communicate, understand language, play, develop social skills, and relate to others.  Before any support is successfully provided, teachers and caregivers must understand the unique nature of the needs of individuals who require such supports.  Models have been designed to ensure that necessary information that is gathered by an interdisciplinary team that includes parents to plan and develop supports. Models also help to choose the instructional format, and to determine effective rewards based on individual interests, needs and skills.  Information about students can be gathered through standardized instruments, informal observations, teacher-designed checklists, interviews, and work samples.  Once the targeted behaviors are established, teachers should begin the visual support intervention.  Options for visual supports include icons, photographs, picture schedules, drawings, graphic organizers, and social stories.  Next, teachers must decide which instructional format will guide and teach the student with autism most effectively.  Once such structures are in place, teachers can then begin implementing the supports within the classroom and monitoring the effectiveness of the support and instructional format.  Roa and Gagie (2006) suggest the following for implementing an effective support within the classroom:

1.      Breaking down the desired task/behavior into discrete steps (task analysis)

2.      Deciding an appropriate visual support for each step. (pictures)

3.      Using individual, explicit, systematic instructions.

4.      Prompting and fading procedures as needed to guide and teach students with ASD to use the visual supports.

5.      Using effective reinforcers as rewards for successful use of the supports according to the criterion.

6.      Assessing to see if student is meeting the targeted objective. 

Examples of Visual Supports

Treatment and Education of Autistic and Related –Communication- Handicapped Children out of the University of North Carolina (TEACCH-UNC) is a comprehensive teaching method that has been demonstrated to work effectively for students with ASD using visual supports. TEACCH was developed in the 1970’s by Eric Schopler. His vision of the TEACCH approach was to focus on the child with autism and the development of a program around the child’s skills, interests, and needs. The TEACCH program has worked with thousands of individuals with autism spectrum disorders and their families and provides clinical services such as diagnostic evaluations, parent training and parent support groups, social play and recreation groups, individual counseling for higher-functioning clients, and supported employment (TEACH-UNC). class="apple-style-span"This program is a valuable support for students with ASD.

The Picture Exchange Communication System (PECS) is an augmentative communication system developed to help individuals quickly acquire a functional means of communication.  PECS is designed for individuals who do not use speech or who may speak with limited effectiveness.  TEACCH, PECS, and other visual support systems can be developed from simple and inexpensive everyday materials to affordable games.  These supports are used to enhance processing skills and teach several social skills children with ASD. 

Visual Schedules                                   

Difficulty with transitions can significantly limit a student’s skills to independently complete activities across environments throughout the school day. These types of problems can be especially evident when students with ASD are taught in the general education settings. Therefore, the use of visual schedules can be used to increase independence and reduce the need for continuous teacher intervention.  Visual schedules are particularly helpful to students with ASD because they clearly indicate what has been completed and what must be done next.  Having a visual schedule posted within the classroom tells all students when to expect transitions and certain activities.  All students can benefit from a posted schedule, not just students with ASD.  Rao and Gagie (2006) indicated that educators have noted that when visual schedules are posted, the amount of stress, anxiety, and behavioral outbursts is significantly reduced. These aids have also been found to be effective in reducing the latency time between activities and in increasing students’ skills to transition independently. A visual schedule can also be created for the purpose of helping student direct their own behavior throughout the work period. Providing small individual replicas of the information presented on the boards for the student to hold or place on his or her desk is helpful for increasing engagement and maintaining the student’s group focus.  Examples of two types of visual schedules are shown in Appendix A.

Goodman and Williams (2007) suggest providing visual models that elicit play for students with autism.  Playing does not occur naturally for many students with autism.  Play is often said to actually be work for students with autism.  Thus, a visual schedule will help the student explore and expand his or her knowledge and experience while playing with others.  For example, a visual schedule was in place for a student who needed support while at recess on the playground.  Initially the playground schedule was in place for the student to practice playing on different equipment and to increase the amount of time spent on each item. Currently, the student understands the concept of recess and fills their time out on their own preference and schedule.  Goodman and Goodman and Williams explained that, “By being shown pictures of premade structures of such items as interlocking cubes, blocks, and train tracks, student who have difficulty developing and executing original ideas are provided a model to copy”(p. 56-57).

The flexibility and creativity of visual schedules are quite vast.  It’s up to the teacher based on the student(s) how he or she would like to effectively implement a visual schedule into the classroom. Another example of a visual support is a visual organizer.  A visual organizer gives students with autism choices to participate in and placed that icon at the top.  When the student wants to change activities, they change the icon. Without the organizer, many students would simply engage in repetitive, self-stimulating behaviors, rather than participating in meaningful leisure activities.  An example of a visual organizer is shown in Appendix A.

Conclusion

The purpose of this article was to inform general education teachers about different types of visual supports available to support students with ASD in the general education setting. In summary, the intervention strategies suggested are intended to be unobtrusive methods to help students with ASD transition between activities and to maintain academic engagement during instructional activities.  These supports can reduce anxiety, make abstract concepts more concrete, prompt the student, and help the student express his or her thoughts. Think about the last time you used a road map, an organizer, or even a recipe.  These are natural visual supports that we use throughout our daily lives.  Student with autism require more visual supports that individuals without autism, however, not all students with autism require the same level of visual support.  Just as autism is a disability that varies in degree from student to student, the program that best meets the needs of students with autism should vary from student to student.


References

Banda, D. R., Grimmett, E., & Hart, S. L. (2009). Activity schedules: Helping students with autism spectrum disorders in general education classrooms manage transition issues. TEACHING Exceptional Children, 41(4), 16-21.

Dalryaple, N. (1989) Learning to be independent and responsible: Functional programming for people with autism. ERIC Document Reproduction Service NO. EC302 520

Goodman, G., & Williams, C. M. (2007). Interventions for increasing the academic engagement of students with autism spectrum disorders in inclusive classrooms. TEACHING Exceptional Children, 39(6), 53-61.

Hodgdon, L. (2000). Visual strategies for improving communication: Practical supports for school and home. Troy,MI: Quirk Roberts.

Rao, S. M., & Gagie, B. (2006). Learning through seeing and doing: Visual supports for children with autism. TEACHING Exceptional Children, 38(6), 26-33.

Washington Department of Health. (2010, April 12). Introduction to autism. In Autism guidebook for Washington State (chapter 2). Retrieved April 16, 2011, from Autism Task Force website:     http://www.doh.wa.gov/cfh/mch/autism/Documents/Guidebook/Chapter2.pdf

Washington Department of Health. (2010, April 12). Defining Autism. In Autism guidebook for Washington State (chapter 3). Retrieved April 16, 2011, from Autism Task Force website:     http://www.doh.wa.gov/cfh/mch/autism/Documents/Guidebook/Chapter3.pdf

Wilkinson, L. A. (2008). Self-management for children with high-functioning autism spectrum disorders. Intervention in School and Clinic, 43(3), 150-157.

Additional Bibliography

American Psychiatric Association- http://www.psych.org/

Alberto, P., &Troutman, A. (2003). Applied behavior analysis for teachers (6th ed.). Upper Saddle River, NJ: Prentice-Hall

Autism Speaks- http://www.autismspeaks.org/whatisit/index.php

http://www.autismspeaks.org/whatisit/facts.php

http://www.autismspeaks.org/treatment/teacch.php

Center of Disease Control-http://www.cdc.gov/ncbddd/autism/facts.html

Office of Superintendent of Public Instruction -http://www.k12.wa.us/SpecialEd/default.aspx

PECS- http://www.pecsusa.com/

Social Stories- http://www.polyxo.com/socialstories/

Snell, M. E., Brown, F. (2006). Instruction of Students with severe disabilities (6th ed.) Upper Saddle River, NJ: Merrill Prentice-Hall. 

TEACCH- http://www.teacch.com/

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