shaw, e., meredith, k., & hume, k. (2009). visual supports. chapel hill: national professional...

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Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter Graham Child Development Institute, The University of North Carolina. Visual Supports

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Page 1: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter Graham Child Development Institute, The University of North Carolina.

Visual Supports

Page 2: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Learning Objectives for Visual Supports

As a result of this presentation, practitioners will:1. describe the evidence that supports the use of visual

supports.2. identify skills that can be promoted through the use of

visual supports.3. explain the different types of visual supports and when

they might be used.4. implement the steps of visual supports as intended.5. discuss importance of fidelity of implementation and

progress monitoring when using visual supports.

Page 3: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Overview of Visual Supports

Definition: Any tool presented visually that supports an individual as he/she moves through the day

Includes: Pictures, written words, objects, arrangement of the environment (visual boundaries), schedules, maps, labels, organization systems, timelines, and scripts

Page 4: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Visual Supports in Our Everyday Lives

Page 5: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

What do we know about visual supports?• Meets our EBP criteria with 13 single-subject

studies

• Can be effectively implemented with learners from early childhood through middle school with autism and high functioning autism Early childhood settings: visual schedules to increase

task engagement, visual scripts to encourage social interaction, and picture cues to support play skill development

Elementary and middles school: visual schedules and pictures cues to reduce transition time, increase on-task behavior, and complete self-help in the home

Page 6: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

What do we know about visual supports?

• Skills and intervention goals that can be addressed by visual supports include: Targeting adaptive behavior (e.g., task engagement,

independent performance, transitions across activities, and increasing response chain length) Increasing skills across curriculum areas: play skills, social interaction skills, and social initiation

Reducing self-injurious behavior

• May be used in classroom and home settings as one component of comprehensive programming

Page 7: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Why are visual supports useful for learners with ASD?• Complete more tasks by themselves therefore

increasing their independence

• Learn more rapidly

• Demonstrate decreased levels of frustration, anxiety, and aggression related to task completion

• Adjust more readily to changes in their environments (Savner & Myles, 2000)

Page 8: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Types of Visual Supports

• Visual Schedules

• Visual Boundaries

Page 9: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 1. Developing Visual Supports for Individual Learners

• Determine what information should be presented visually. What activity, event, or concept causes frustration and or anxiety, requires a great deal of adult support for

success, or is difficult for the learner to understand when

information verbally presented?

Page 10: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 1. Developing Visual Supports for Individual Learners (cont.)

• Conduct an individual assessment of the learner’s comprehension skills in order to determine which form of visual representation will work. Objects, photographs, drawings or picture

symbols, words, phrases/sentences, or combination of the above

Page 11: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 2. Organizing Visual Supports for Individual Learners

• Ensure that the selected visual support is arranged, organized and in place prior to the activity or event.

Page 12: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 3. Implementing Visual Supports for Individual Learners

• Show learner the visual support

Page 13: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 3. Implementing Visual Supports for Individual Learners (cont.)

• Teach learner to use the visual support: stand behind the learner when prompting the

use of the support use only relevant language (as few words as

necessary) assist learner in participating in activity/event fade prompts as soon as possible

Page 14: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 3. Implementing Visual Supports for Individual Learners (cont.)

• Once student has learned how to use visual support, use minimal prompts

• Use visual supports throughout the day

• Prepare the learner for changes in activity or event that requires the use of the visual support

• Visual supports move with the learner across settings or are located across settings

• Collect data on how learner uses visual supports (i.e., level of prompts, independence, types of visual prompts used)

Page 15: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Overview of Visual Boundaries

Definition: A type of visual support that includes furniture arrangement, labeling, and color coding to make the use of a particular space more obvious

Page 16: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Visual Boundaries in Our Everyday Life

Page 17: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Why are visual boundaries useful for learners with ASD?

• Helps define for learner where things begin and end.

• Helps define for learner areas that are accessible without supervision.

• Provides meaning and context to an area or environment.

Page 18: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Steps for Implementation of Visual Boundaries

Page 19: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 1. Define/Prioritize the Need• Is there a safety concern?

• Does the learner have difficulty staying in one place?

• Does the learner know what she/he is to be working on in an area?

• Does she/he leave a location because of frustration?

• Does the learner have difficulty with entering others’ work spaces and/or making use of others’ work or personal materials?

Page 20: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Think about your student…

• Select a location your student visits throughout the day and describe some of elements of visual boundaries that are in place or that you would like to put in place. Consider what visual or physical boundaries

are needed

Page 21: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 2. Define the Boundary

• Establish where the visual boundary should be

• Use natural physical boundaries, objects, and furniture

Page 22: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 3. Teach the Boundary

• Introduce learner to the boundary

• Use modeling to teach the learner to stay within the boundary

• Model and use reinforcement when learner stays within the boundary

• Model and use corrective feedback when learners do not stay within the boundary

• Be consistent!

Page 23: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 4. Evaluate Success

• Collect data on learner’s use of boundaries

• Collect data on learners’ related target behaviors

• Make data-based decisions regarding the effectiveness of the intervention

• Monitor on-going effectiveness and impact of intervention on learner behaviors

Page 24: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Process for Determining the Best Evidence-

based Practice

Page 25: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Let’s suppose this is our goal…

Goal: John will improve his ability to independently transition from one activity to another throughout the school day.

Related Objective:John will increase his engagement in the task during an activity.

Page 26: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

How do we decide which EBP to use?

Let’s say we know this…

• John is in a self-contained preschool setting.• John is handed an object to transition

between all activities.• John has shown that he is able to match

objects to pictures.

Page 27: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

How do we decide which EBP to use?

Ask: What is our objective targeting?

• Transition, adaptive behavior (independence)

Ask: What are our options?

Page 28: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

How do we decide which EBP to use?

Next, make a decision based on:• your professional wisdom,• the learner’s learning style,• the learner’s temperament,• the learner’s interests and motivators,• supports already in place, and• history of what has and hasn’t worked.

Page 29: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

How do we decide which EBP to use?

So, let’s say we decide to try…

Visual Schedules

What does this look like for John?

Page 30: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Steps for Implementation of Visual Schedules

Page 31: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 1. Overall Classroom/ Environment Schedules

• Display an overall classroom/environment schedule with staff and learner assignments Location of displayed schedule Format of the schedule (e.g. pictures, words,

combination) How/when will overall schedule be used

Page 32: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 2. Developing Individual

Schedules• Conduct an individualized assessment of

learner’s (1) comprehension level, (2) attention span, and (3) sequencing abilities in order to select the appropriate: form of representation, schedule length and presentation format, method of manipulating the schedule, location of the schedule, and method to initiate schedule use.

Page 33: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Forms

• Functional objects used in activities

• Object that is symbolic of activity

• Photograph

• Photograph with words

Page 34: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Forms

• Drawing or picture symbol with words

• Word

• Phrase or sentence

Page 35: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Schedule Length/Presentation

• One item – signifies upcoming transition

• Two items (left to right or top to bottom)

• Three to four items (left to right or top to bottom)

Page 36: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Schedule Length/Presentation

• Half day (left to right or top to bottom)

• Full day (left to right or top-to-bottom)

Teacher

Art

Lunch

Computer

Library

Page 37: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Method of Manipulating Schedule

• Learner carries an object to be used in upcoming activity

• Learner caries an object/visual cue and it is matched in the corresponding location

• Learner turns over visual schedule cue/puts cue in a finished location when activity completed

• Learner marks off visual cue on schedule as completed

Page 38: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Location of Schedule

• Schedule information is brought to the learner.

• Schedule is stationary at a central location.

• Portable schedule.

Page 39: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Initiating Use of Visual Schedules

• Schedule information is brought to the learner

• Learner moves to the schedule using a visual transition cue

Page 40: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 2. Developing the Visual Schedule• Additional elements may be added to visual

schedules as necessary such as: Color coding Times Alignment with school bells Motivational components (e.g., pictures of

favorite characters) or Behavior cues (reminders about specific

expectations)

Page 41: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 3. Organize Visual Schedule for Learners• Arrange the learner’s daily schedule and related

elements for the learner either prior to the learner’s arrival or with the learner

• Ensure that visual transition cues are in place, if appropriate

• Ensure that the classroom/school areas are visually labeled with matching schedule components

Page 42: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 4. Implement Visual Schedules

• Give learner a visual cue to transition to the schedule or bring schedule information to learner

• Teach the learner how to transition to the schedule with a visual cue and/or how to transition to location with schedule information

• Minimize prompts once learner has learned how to use the schedule

• Have learner use schedule consistently throughout the day

Page 43: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Step 4. Implement Visual Schedules

• Visual transition cue use is consistent throughout the day

• Prepare the learner for changes in scheduled activities

• Individual schedules move with learner across settings or elements of visual schedules are located across settings

• Use a data collection system to record learners use of visual schedules

Page 44: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Visual Schedules: Examples

Page 45: Shaw, E., Meredith, K., & Hume, K. (2009). Visual Supports. Chapel Hill: National Professional Development Center on Autism Spectrum Disorders, Frank Porter

Visual Supports: Take Home Points

• Visual supports must be age appropriate and individualized.

• Visual supports will have different forms, lengths, presentations, locations, and methods of manipulation based on individual needs.

• Visual supports may be used in all settings and across environments.

• Visual supports should be used consistently, implemented with fidelity, and monitored through data collection to determine effectiveness.