Monday, 30 September 2013

Picture this: now and next

Hands up who owns a diary? 

How about a to do list? 

As a mum, a therapist and everything in between, I often feel like my whole life is made up of lists upon lists. Also, if I don't have my diary to hand, or up to date with everything planned In half hour slots, my world would seem to crumble around me! Ok, I'm not quite that bad, but I do need to know what has to get done that day.  

Children are similar.  They need structure and routine (anyone who's heard of Gina Ford will know about that!).  Littlies also need to be able to make their own choices within their routine and to gradually become more independent.  The same applies to children who are non-verbal, or who have significant language delay or communication difficulties, and that's where pictures or symbols (or objects) can come in handy. 

Not all children will need pictures to understand their routine, but they might need things simplifying. Instead of suggesting "lets get our shoes on, then we can visit granny once we've done the shopping and got your tea sorted" you could say "shoes first, then shops". Once at the shops you can move on to the next part of the day "shops first, then granny's". The same can be done with pictures in a 'now and next' board. 

For those who have more understanding but struggle with changes in routine or find it hard to switch from one activity to the next, a visual timetable can be very helpful. It helps reduce anxiety, and provides reassurance to children who can take themselves back to check what is happening next. 

Other children need to use pictures to help them make a choice. They are unable to retain the information to be able to choose the activity from several that might be on offer. A lot of the children I work with do not have the verbal skills to say what they want and so they need a system that others can easily understand. That's when a choice board with several pictures of activities can be useful. 

What if the child doesn't recognise pictures? 

Last term, I spent a lot of time introducing pictures to different children (about 3 on my caseload) who did not seem to recognise what they represented. The aim of introducing pictures was to provide a choice board for the activities at nursery. I worked with nursery settings and between us, we followed the child round, and 'slid in' the photos or symbols that matched with what the child was playing with to their eye-line and named it e.g. "sand, Tommy's playing with sand". That way, even if i didnt get eye-contact, they saw the photo and would start to relate it to what they were doing. All of the children ignored the pictures at first, but now are happy to handle the laminated pictures and some can now be led to the next activity, once given the relevant picture, from their timeline. 

So how do I do it?

Just remember when introducing pictures and symbols that one set, the visual timetable is for us as adults to tell the child something, but a choice board (or communication book) is for the child to tell us their news, and not to be quizzed! Also, don't worry about what it looks like, I've used hand drawn pictures on sticky notes many times, particularly when I don't know what the child is going to be interested in during my therapy session. 

For real detail on how to set up now and next boards, choice boards and visual timetables, visit A Version of Perfection  which is written by 'JC's mum'. JC has sensory processing disorder and ASD. In her blog, JC's mum has explained very clearly the methods to put visuals together. Just don't forget to pop back here to tell me how you got on!

Hope to see you again soon! 



  1. Such great points, Katie, and terrific examples! Thanks for sharing this.

  2. Thank you for your comments Carole. Hope to see you here again soon! Katie