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Using Visuals to Help Neuro-Diverse Youth

Updated: Feb 9, 2022

Jennifer Keluskar, Ph.D.

Figure 1. A Picture Schedule with "To Do" and "Done" columns.

Four-year-old Colby is having trouble with his preschool homework assignment: Finding all of the "B's" on a page featuring mixed letters and numbers. When I use scrap paper to cover up all but a small portion of the page, he completes the task with ease.

Seven-year-old Skylar is learning to be independent with her morning routine. We write a to-do list on a large dry-erase board, and she uses a marker to cross out each activity as she completes it.

I am asked to read through paperwork at a physician's office. An assistant highlights areas for me to sign to ensure I do not miss anything.

These are just a few examples portraying the importance of visuals -- tools or strategies that use pictures, words, and symbols in a way that help us process information -- in our everyday lives.

Many of these tools have become so commonplace, we likely do not appreciate their value. Take the person who has driven the same commute for years and knows when to shift lanes without having to think much about it.

In contrast to the underwhelm sparked by common symbols, I find that parents sometimes feel overwhelmed when the use of a "visual strategy" is suggested for their children. They might say that such strategies are too juvenile, or that using pictures and symbols to improve their child's functioning has not been effective. Alternatively, they might agree with the suggestion, but then over-focus on making a visual look "perfect," as opposed to what is appealing to the child. They might give up quickly if the child does not take to it immediately.

Visuals are among the simplest and most effective strategies for helping individuals with various tasks and activities. They are especially important for helping people who have learning differences. However, understanding the mechanisms by which a particular visual improves one’s understanding of the world is essential for enhancing it's effectiveness.

I have learned that small details, including whether a visual strategy addresses a particular or potential difficulty, how easy it is to use, and your child’s motivation for using it, can make a big difference.

I came to appreciate the importance of such details through my own difficulties with organizing visual information. For example, there are times when I ask my young daughter to help me find items at the store, as I am bound to miss them, not because I have any trouble with my vision, but because my difficulty with visual processing gets in the way of efficiently comprehending what I am looking at.

There have been times when this obstacle has been more troubling than missing a grocery item. After one instance in graduate school in which I misread a table of scores during a practice psychological assessment (and subsequently scored poorly on the assignment), I made sure to use a ruler as a guidepost for scanning score tables from that point forward.

In this situation, I understood that my difficulty lied in being able to accurately scan the numbers across a table. Therefore, my intervention (using a ruler or straight edge along the row I needed to scan) appropriately addressed the problem.

To illustrate the importance of fitting the intervention to the difficulty it is targeting, I created a made-up table of numbers in random categories (Categories A through E), a table that resembles score tables I have used in my profession. The random numbers in the body of this table correspond with made-up “T-scores,” a type of standardized score into which we often convert an examinee’s original score.

Figure 2 depicts a table without any kind of visual support, other than the information being organized within rows and columns.

Figure 3 depicts color-coded ranges of scores, which would help me quickly determine whether a person’s score fell within the Low, Moderate, or High Range.

In Figure 4, scores are boxed in, which would help with scanning numbers across a table. Placing a ruler or straight edge underneath the row I want to scan would further facilitate this process.

Ideally, both supports (color coding and borders) would be useful for processing the information efficiently, as depicted in Figure 5.

In addition to demonstrating the importance of understanding the difficulty that is being targeted (e.g. scanning a table), this example also illustrates other important factors to consider in visual interventions. One of these factors is the idea that how we use a visual strategy (e.g. my effort to use a straightedge to scan the table) is as important as its presentation (bordered number boxes and color-coded score ranges).

We also need to consider motivation. In my case, I was motivated to improve my scanning skills to avoid the uncomfortable feeling of possibly receiving more poor grades. When creating a visual strategy for someone else, we need to consider what is motivating for that person.

As I have immersed myself in the world of treating neuro-diverse children over the past decade or so, I have learned that their struggles in navigating the world are similar to my difficulties with mentally organizing tables of scores and categories. It is like driving on a parkway without having any lanes or road signs to direct us. I have also learned that helping children utilize any tools to improve functioning requires an understanding of their individual needs, strengths, and interests.

Here are some factors to consider when honing your craft of creating and implementing visuals.

1. Consider the Child's Developmental Level:

The purpose of a visual strategy is to make a task easier and more approachable for a child. If your child's developmental level is not taken into consideration, and consequently the strategy itself is beyond your child's ability to understand and navigate, then you are defeating the purpose of the visual.

Take, for instance, the use of a visual schedule (featured in Figure 1), a type of tool that helps individuals (children and adults alike) know what to expect and helps them keep track of required tasks.

My visual schedule takes the form of populating digital calendars and typing to-do lists in the Notes app of my smart phone. For my 7-year-old daughter, it is making a list of activities involved in her morning routine (e.g. 1. Eat Breakfast; 2. Brush teeth; 3. Get dressed). My 4-year-old son uses a similar list of routine activities except he uses pictures instead of words. Sometimes, we modify the schedule even further by using a “First -->Then” Board (see Figure 6), which requires processing only 2 activities at a time.

Figure 6. An example of a “First-->Then” Board

For a deeper dive into visual schedules specifically, I recommend the following episode of the Autism Helper Podcast with Sasha Long BCBA:

2. Incorporate Your Child's Interests:

Putting a lot of time and effort into making a visual fancy is not only unnecessary, but also may not be useful for your child. However, incorporating your child's interests into a visual strategy might improve your child’s engagement with it. For example, I have had more luck getting my son to complete learning activities, such as matching, understanding patterns, and counting, when these tasks incorporate pictures of dinosaurs and superheroes.

For worksheets featuring common child interests, check out the following activities for young children created by Beth Gordon:

Another way to increase motivation is to give your child a sense of agency over the visual, such as allowing them to choose pictures for it. You can also have them choose where to place the visual, although leaving it within their reach might not be the wisest course of action. Rather, a forced choice, or telling your child they can place it in "Spot A" or "Spot B," might be the way to go.

With schedules such as the one depicted in Figure 1, it is also important to have your child place the check marks on the schedule (or cross items off) themselves, which allows them to keep track of their own progress. If possible, have them choose the order in which they wish to complete certain tasks. Giving your child control over structuring the visual will enhance their buy-in.

3. Teach Your Child How to Use the Visual, Using Incentives if Needed:

None of us were born knowing the meaning of a red traffic light, a peace sign, or a check mark. Just like we learned to associate these symbols with their given meanings, your child will need to be taught how to interpret and follow the visuals you present to them.

Take, for instance, the visuals presented in Figures 7 and 8. We created these for our son, Colby, when he got frustrated at the sight of my husband and I retreating to our home offices while he stayed behind with his babysitter. The visual shows pictures of a house and an office on one page, accompanied by family photos (here shown on a second page). Using Velcro, we placed each family member in the location they were supposed to be in at that moment (e.g. I might be in the office area while the kids were in the home area). Although we do not own jungle animals as pets, pictures of them were incorporated because Colby loves animals.

Colby had to be taught what the above components meant, the purpose of the visual, and what behaviors were expected of him when his attention was drawn to it. As with any set of expectations being placed on a child, you can also use incentives, such as verbal praise or small rewards, for following the visual as directed.

Figure 7. A visual board depicting our home and home office. We added jungle animals to make it more appealing to our son. The family photos in Figure 8 were placed on the board to show where we were located at a given time.

Figure 8. Family photos used for the visual shown in Figure 7.

4. Give Your Child Time to Acclimate to the Visual: Most of the visual strategies I have implemented with my children have been effective. At the same time, many of them have not been immediately well-received. For example, my son's initial response to the visual schedule in Figure 1 was to run away from me. He tore down the visual in Figures 7 and 8 the first time I hung it on the door leading to our home offices.

Experience has taught me that when such adversities arise, the most effective response is to hang in there and ride the wave, while at the same time trying to understand your child's behavior. For example, your child's response might be due to the novelty of the visual, which might trigger a fear of the unknown. They might be anxious about not understanding the expectations that are associated with it, or they might interpret it as representing a demand or criticism.

Other times, the visual needs to be simplified (See Recommendation #1); or made more interesting (See Recommendation #2). Your child might need to be provided additional instruction for how to use it (See Recommendation #3). In such instances, take your child's resistance as feedback rather than as a verdict that the visual "did not work."

5. Little Tweaks Can Go a Long Way: I noticed that when Colby was presented with the visual schedule in Figure 1, he had trouble accurately placing the check mark next to the chore he had completed. Instead, he placed the check mark several tasks below the one he was supposed to “check off.” The process of placing a check mark became a chore in and of itself.

I helped Colby by using my hands to cover all but the spot I wanted him to “check off.” Later, I realized that rotating the board so that he could view the items horizontally instead of vertically might be a more sustainable strategy (as it might allow him to use it more independently).

There are many, wonderful online resources for free visual strategies (In addition to the ones I have listed above, I reference more below). While you might be successful in using some of them “as is,” individualizing these tools to fit your child's needs and interests will likely be your best bet.

Finding a professional to consult with about implementing them can also be valuable. I continue to seek others' input despite having years of practice in utilizing visuals.

No matter what, approaching visuals with a mind towards creativity, flexibility, and simplicity will pay off in meaningful ways.

Resources for Visuals

And Next Comes L: Printable Social Stories for Kids:

Easter Seals, School Closure Toolkit:

Long, S. (Host). (2020, August 10). Why I won't stop talking about schedules (No.82)

[Audio podcast episode]. In The Autism Helper. Apple Podcasts.

Preschool Play and Learn (worksheets by Beth Gorden):

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