1. Visual Supports Are For All Learners Dwain Stone Speech Language Pathologist February 2010 Visual Supports Are For All Learners Dwain Stone Speech Language Pathologist February 2010

2. "We can't teach the students we used to have, or those we wish we had. We must teach the students we do have." ~ Linda Albert ~

3. Outline Definition What are visual supports? Why do we use them? When do we use them? Where will they be of use? How do we use them? ASD PECS Social Stories Behavior Management Case Studies Definition What are visual supports? Why do we use them? When do we use them? Where will they be of use? How do we use them? ASD PECS Social Stories Behavior Management Case Studies

4. Definition Visuals Visual tools, strategies, and supports are things we see that enhance our organization, comprehension, and communication. Visual tools are signs, objects, printed words, post-it notes, symbols, drawings, or colors. Anything that gives a message and often simplifies it for easier access is a visual tool. Visuals Visual tools, strategies, and supports are things we see that enhance our organization, comprehension, and communication. Visual tools are signs, objects, printed words, post-it notes, symbols, drawings, or colors. Anything that gives a message and often simplifies it for easier access is a visual tool.

5. What visual supports have you seen or used with children?

6. Common Materials PECS book Big Mac Sentence Strip GOTALK Social Stories Visual Schedules PECS book Big Mac Sentence Strip GOTALK Social Stories Visual Schedules

7. What type of learner are you? Auditory Visual Kinesthetic/Tactile Auditory Visual Kinesthetic/Tactile

8. Learning Styles Five styles: Rote Gestalt Visual Hands On Auditory **Keep these styles in mind during programming or classroom activities Five styles: Rote Gestalt Visual Hands On Auditory **Keep these styles in mind during programming or classroom activities

9. What is the problem? Language disorders/delays are often the root problem in social interaction, educational performance, and behavior

10. Communication What is communication? Typical communication Ability to receive information, attach meaning to what is heard and express an appropriate response. Communication is comprised of speech, language and pragmatics e.g. ASL What is communication? Typical communication Ability to receive information, attach meaning to what is heard and express an appropriate response. Communication is comprised of speech, language and pragmatics e.g. ASL

11. Common Communication Breakdowns

12. Facts Research about communication shows communication is: 55% visual (gestures, body movement and posture, handouts, calendars, or environmental cues). 37% vocal (intensity and tone of your voice, or rate and volume of your speech). 7% the actual message. Research about communication shows communication is: 55% visual (gestures, body movement and posture, handouts, calendars, or environmental cues). 37% vocal (intensity and tone of your voice, or rate and volume of your speech). 7% the actual message.

14. Chinese Proverb I hear and I forget. I see and I remember. I do and I understand. I hear and I forget. I see and I remember. I do and I understand.

15. Why use visual supports? Quiz: Because they work!! Demonstration Quiz: Because they work!! Demonstration

16. Why we use visuals….. Visual strategies help individuals in many ways. We use visual strategies to help us communicate information TO individuals. Visual tools help students organize their thinking. Visual supports are used to give choices or communicate rules. One of the most important uses for visual strategies is to give information such as what is happening, what is not happening, what is changing, etc.

17. A day without visual supports… Somehow, somewhere, your day spun out of control. You missed a dentist appointment, got lost going to a new area of town, and could not remember the name and phone number of the person you were supposed to meet after school. At the grocery store, you forgot what you had to buy for dinner and took 10 minutes looking for the car in the parking garage because you forgot to look and see what level you were parked on. It was an awful day. It all started when you left your day planner at home!! Somehow, somewhere, your day spun out of control. You missed a dentist appointment, got lost going to a new area of town, and could not remember the name and phone number of the person you were supposed to meet after school. At the grocery store, you forgot what you had to buy for dinner and took 10 minutes looking for the car in the parking garage because you forgot to look and see what level you were parked on. It was an awful day. It all started when you left your day planner at home!!

18. Children who may benefit…. Autism Asperger's Syndrome PDD Fragile X syndrome Attention Deficit Disorders Nonverbal Learning Disabilities Learning Disability Down Syndrome Hearing Impairment EAL FASD Autism Asperger's Syndrome PDD Fragile X syndrome Attention Deficit Disorders Nonverbal Learning Disabilities Learning Disability Down Syndrome Hearing Impairment EAL FASD Emotional Impairment Communication Disorder Behavior Disorder Language Delay or Disorder Comprehension Problems Auditory Processing Disorder Aphasia Speech Disorder Cognitive Impairment Developmental Delay Multi-handicapped And many more...

19. What if the students already talk? Sometimes people question using visual strategies for students who already talk. Traditionally, communication boards and other AAC supports have been used to help non-verbal students or those with limited verbal ability to express themselves better. The current use of visual strategies for supporting understanding has shifted that focus. The important thing is to remember why we are using visual tools. Sometimes people question using visual strategies for students who already talk. Traditionally, communication boards and other AAC supports have been used to help non-verbal students or those with limited verbal ability to express themselves better. The current use of visual strategies for supporting understanding has shifted that focus. The important thing is to remember why we are using visual tools.

21. Multi-modality Presentation Visual and tactile stimuli Capitalize on routines Demonstrate rather than explain Visual and tactile stimuli Capitalize on routines Demonstrate rather than explain

22. "A picture is worth a thousand words" The adage "A picture is worth a thousand words" refers to the idea that complex stories can be described with just a single still image, or that an image may be more influential than a substantial amount of text. It also aptly characterizes the goals of visualization where large amounts of data must be absorbed quickly.adagevisualization The adage "A picture is worth a thousand words" refers to the idea that complex stories can be described with just a single still image, or that an image may be more influential than a substantial amount of text. It also aptly characterizes the goals of visualization where large amounts of data must be absorbed quickly.adagevisualization

24. WHY?

25. Count the ways your students receive visual support… Establish attention Give information Explain social situations Give choices Give structure to the day Teach routines Organize materials in the environment Establish attention Give information Explain social situations Give choices Give structure to the day Teach routines Organize materials in the environment

26. Assist students in handling change Guide self-management Aid memory Speed up slow thinking Support language retrieval Assist students in handling change Guide self-management Aid memory Speed up slow thinking Support language retrieval

27. Organize the space in the environment Teach new skills Support transitions Stay on task Ignore distractions Manage time Communicate rules Organize the space in the environment Teach new skills Support transitions Stay on task Ignore distractions Manage time Communicate rules

28. Provide structure Learn vocabulary Communicate emotions Clarify verbal information Organize life information Review & remember Provide structure Learn vocabulary Communicate emotions Clarify verbal information Organize life information Review & remember

29. Top Ten Reasons To Use A Visual Schedule!!

30. Top ten reasons… 1. Visual schedules increase on-task behaviour and therefore increase Academic Learning Time. 2. Teaches Delayed Gratification 3. Visual schedules teach the importance of organization in a day. In other words, the schedule becomes a way for the child to learn to be proactive in managing his own behaviour. 4. Visual schedules teach patience and persistence 5. Once the student knows how the visual schedule works, he or she will be less dependent upon consistency of staffing in order to function. 6. As the child gains independence in using his visual schedule, his instructional assistant also gains independence. This “found time” can be used to prepare instructional and support materials and to make careful observations and notes regarding student successes and difficulties (particularly in the important area of social functioning) which will later assist in determining new instructional goals and learning outcomes. 1. Visual schedules increase on-task behaviour and therefore increase Academic Learning Time. 2. Teaches Delayed Gratification 3. Visual schedules teach the importance of organization in a day. In other words, the schedule becomes a way for the child to learn to be proactive in managing his own behaviour. 4. Visual schedules teach patience and persistence 5. Once the student knows how the visual schedule works, he or she will be less dependent upon consistency of staffing in order to function. 6. As the child gains independence in using his visual schedule, his instructional assistant also gains independence. This “found time” can be used to prepare instructional and support materials and to make careful observations and notes regarding student successes and difficulties (particularly in the important area of social functioning) which will later assist in determining new instructional goals and learning outcomes.

31. Top ten reasons… 7. Visual schedules minimize the need to write as the daily agenda is being established 8. Once the child has a visual schedule, his or her behaviour will settle. Thus, a schedule does not make the child appear to be different; it helps him appear to be more the same. 9. Visual schedules provide independence by removing the need for the student to ask others (particularly adults) about what schoolwork has to be done. The fact that the student functions more independently (“normally”) can increase his or her acceptance by other students. 10. Because they provide a means for the child to anticipate upcoming events, visual schedules help to ease the student through transitions. Thus, they are a means of reducing rigid behaviour. In fact, they promote flexible behaviour. 7. Visual schedules minimize the need to write as the daily agenda is being established 8. Once the child has a visual schedule, his or her behaviour will settle. Thus, a schedule does not make the child appear to be different; it helps him appear to be more the same. 9. Visual schedules provide independence by removing the need for the student to ask others (particularly adults) about what schoolwork has to be done. The fact that the student functions more independently (“normally”) can increase his or her acceptance by other students. 10. Because they provide a means for the child to anticipate upcoming events, visual schedules help to ease the student through transitions. Thus, they are a means of reducing rigid behaviour. In fact, they promote flexible behaviour.

33. Purpose Think of the purpose of a visual tool. What does the student need to understand? What would help him participate better? Defining the need guides the decision about what kind of tool to use. Identifying the purpose of a visual tool helps us know how to use it.

34. Keys for Successful Implementation of Visual Tools Student participation. Involve the student in the design of the tool. Have him choose colors, pictures (especially to describe emotions), the style, size, and so on. The more involved he is in the design, the more apt he is to enjoy using it. Format selection. There is no standard template for visual tools. Some students want only words or pictures that don’t look too young and some students need photos or concrete items instead of drawings. It’s important to consider the size and how easy it is to use in all settings (ie. recess, PE, lunch room, chemistry lab). Student participation. Involve the student in the design of the tool. Have him choose colors, pictures (especially to describe emotions), the style, size, and so on. The more involved he is in the design, the more apt he is to enjoy using it. Format selection. There is no standard template for visual tools. Some students want only words or pictures that don’t look too young and some students need photos or concrete items instead of drawings. It’s important to consider the size and how easy it is to use in all settings (ie. recess, PE, lunch room, chemistry lab). Imbedding choices in the tool. Take into account the student’s interests and preferences such as what things he wants to do when he’s angry or what order he would like to get things ready for a class or activity. Ask yourself, “how am I empowering him to use the tool?” The routine for using the tool. Consider where the tool will be kept, when the tool will be used (in the hallway or at a desk), and what other activities the student will be doing at the time.

35. Do’s and Don’ts Start Small: Start with one or two rather than trying to use tools in every part of the day. Set the situation up to be successful with easy-to- reach first steps.! Make it easy to use, fun to look at, and meaningful to the student. Introducing it in a positive, fun way can also make a big difference. Start Small: Start with one or two rather than trying to use tools in every part of the day. Set the situation up to be successful with easy-to- reach first steps.! Make it easy to use, fun to look at, and meaningful to the student. Introducing it in a positive, fun way can also make a big difference. Make sure adults and peers are supportive and enthusiastic. Involve peers in developing, using and supporting the student in using the tool. Make sure it is easy to locate, and easy for the student to use. **Keeping visual tools in difficult to access places (in a pocket if he has trouble with fine motor skills) or difficult for the student to use (making check marks when using a pencil or pen is an emerging skill) is the quickest way for a visual tool to fail.

36. Positive Outcomes Increased independence. Empowerment. Increased self-esteem and self- confidence. Increased access to the rest of the world: friends, school activities, the general education curriculum. Increased knowledge and method of expressing what they know. Increased understanding of information and directions. Meaningful class participation and contribution. Decreased separation from peers and classroom activities. Meaningful class membership. When students have a way to participate meaningfully, their classmates see them as a member rather than a visitor. Increased success throughout the day. Increased understanding of peer expectations resulting in increased interactions. Assistance to adults to provide consistent, organized, non-intrusive support. Demonstrations of meaningful outcome in educational, social, and skill-related activities.

37. Why do visuals work with children with ASD? Difficulty shifting and reestablishing attention (modulate sensory info.) Difficulty attending to foreground sounds and blocking out background noises Gestalt learners Difficulty shifting and reestablishing attention (modulate sensory info.) Difficulty attending to foreground sounds and blocking out background noises Gestalt learners

38. Characteristics of ASD Hypersensitive (Over sensitive) Hyposensitive (Under sensitive) All six sensory systems may be affected Sight, sound, smell, movement, touch, taste **Emotional regulation is a core underlying process essential for “availability” for social interaction and engagement Hypersensitive (Over sensitive) Hyposensitive (Under sensitive) All six sensory systems may be affected Sight, sound, smell, movement, touch, taste **Emotional regulation is a core underlying process essential for “availability” for social interaction and engagement

39. ASD Challenges in Social Communication Monitoring social environment through social gaze precedes developmental milestone of intentional communication. Depending on ability levels of children they may have restricted range of communicative functions, difficulty with discourse skills, sharing feelings emotions, gaining attention, repairing communication breakdowns Monitoring social environment through social gaze precedes developmental milestone of intentional communication. Depending on ability levels of children they may have restricted range of communicative functions, difficulty with discourse skills, sharing feelings emotions, gaining attention, repairing communication breakdowns

40. Specific to ASD Some children with autism very obviously have difficulty with receptive and expressive language. Even the apparently capable child with autism can have difficulties understanding language for the following reasons: Some children with autism very obviously have difficulty with receptive and expressive language. Even the apparently capable child with autism can have difficulties understanding language for the following reasons:

41. Breakdowns In Receiving Often delays in processing Sensory interference High anxiety/Rigidity Auditory information is abstract Often delays in processing Sensory interference High anxiety/Rigidity Auditory information is abstract

42. Breakdowns In Sending Communication Characteristics of ASD Echolalia Intonation Jargon Speech-apraxia **40% of Individuals with Autism are nonverbal Communication Characteristics of ASD Echolalia Intonation Jargon Speech-apraxia **40% of Individuals with Autism are nonverbal

43. PECS Picture Exchange Communication System Developed as an augmentative or alternative communication system First priority is to provide a meaningful way of communicating for an individual Initiation is the principal to always keep in mind Does not replace speech unless necessary Requires 2 adults to implement initially Picture Exchange Communication System Developed as an augmentative or alternative communication system First priority is to provide a meaningful way of communicating for an individual Initiation is the principal to always keep in mind Does not replace speech unless necessary Requires 2 adults to implement initially

44. PECS Implementation Phase I: Exchange picture for item Phase II: Distance and Persistence Exchange picture for item when communication partner is in a remote location Exchange picture for item when picture is in a remote location Phase III: Discriminate between pictures Phase IV: Expand use of sentence structure Phase V: What do you want? Phase VI: Commenting Expand use of picture communication book Phase I: Exchange picture for item Phase II: Distance and Persistence Exchange picture for item when communication partner is in a remote location Exchange picture for item when picture is in a remote location Phase III: Discriminate between pictures Phase IV: Expand use of sentence structure Phase V: What do you want? Phase VI: Commenting Expand use of picture communication book

45. PECS Demonstration Volunteers?? Demonstration Questions Volunteers?? Demonstration Questions

46. Pragmatics Basic Level Eye contact, turn taking, social greetings, initiating interactions, reciprocal play Higher Level Topic maintenance, initiation and termination of interactions, figurative language, jokes, nonverbal cues (recognition) facial expression, tone of voice, proximity (videos and role playing) Basic Level Eye contact, turn taking, social greetings, initiating interactions, reciprocal play Higher Level Topic maintenance, initiation and termination of interactions, figurative language, jokes, nonverbal cues (recognition) facial expression, tone of voice, proximity (videos and role playing)

47. Pragmatic Strategies Initiating interactions Eye contact- don’t ask for eye contact Greetings Reciprocal play & turn taking Body language Initiating interactions Eye contact- don’t ask for eye contact Greetings Reciprocal play & turn taking Body language

48. Social Stories Short stories written in a specific style and format Developed in 1994 by Carol Gray Short stories written in a specific style and format Developed in 1994 by Carol Gray

49. Purpose Answers the following questions in problematic social situations 1. What is happening? 2. Who is doing what? 3. Why is it happening? 4. Reasons governing what people are doing? 5. What are the typical socially acceptable responses? Answers the following questions in problematic social situations 1. What is happening? 2. Who is doing what? 3. Why is it happening? 4. Reasons governing what people are doing? 5. What are the typical socially acceptable responses?

50. Purposes of using Social Stories Positive feedback so child can learn to recognize their own appropriate skills and behavior Prepare for new experience Help a child accustom themselves to a situation Proactive/Preventative approach to avoid extreme reactions based on a lack of social understanding Used as a prompt for socially appropriate behavior Positive feedback so child can learn to recognize their own appropriate skills and behavior Prepare for new experience Help a child accustom themselves to a situation Proactive/Preventative approach to avoid extreme reactions based on a lack of social understanding Used as a prompt for socially appropriate behavior

51. Features of Social Stories The goal is to describe and teach social understanding. In turn this will help develop appropriate behavior Written in the first person and present or future tense… some exceptions The goal is to describe and teach social understanding. In turn this will help develop appropriate behavior Written in the first person and present or future tense… some exceptions

52. Why social stories work… Social stories are…. Visual Adaptable Created at an appropriate language level Promote Theory of mind Social stories are…. Visual Adaptable Created at an appropriate language level Promote Theory of mind

53. Social Story Structure Three kinds of sentences: 1. Descriptive 2. Perspective 3. Directive Ratio: Descriptive/Perspective 2-5; Directive 1 Three kinds of sentences: 1. Descriptive 2. Perspective 3. Directive Ratio: Descriptive/Perspective 2-5; Directive 1

54. Descriptive Sentences Give accurate information about the setting. Provide the basic facts about what can be seen. Give accurate information about the setting. Provide the basic facts about what can be seen.

55. Perspective Sentences Simple information about why things happen, providing information about what others are thinking and feeling Directive Sentences Prompts the child’s appropriate behavior Simple information about why things happen, providing information about what others are thinking and feeling Directive Sentences Prompts the child’s appropriate behavior

56. Advanced Social Stories Control Child suggested strategies Co-operative Identify what others will do to assist child Partial Predictions of others response to the child’s actions Control Child suggested strategies Co-operative Identify what others will do to assist child Partial Predictions of others response to the child’s actions

57. Social Stories Activity

58. Behavior MGMT Proactive vs. Reactive programs Proactive Reactive Proactive vs. Reactive programs Proactive Reactive

59. Setting up Behavior Programs Why is the student producing the undesired behavior? Escape (Does behavior stop when removed from an activity?) Attention ( Does behavior occur to get a reaction?) Power/Control ( Does behavior stop when the desired object is received?) Sensory Stimulation ( Are the child’s sensory needs being addressed?) Communication (Does the behavior seem to be a way to ask for help?) Why is the student producing the undesired behavior? Escape (Does behavior stop when removed from an activity?) Attention ( Does behavior occur to get a reaction?) Power/Control ( Does behavior stop when the desired object is received?) Sensory Stimulation ( Are the child’s sensory needs being addressed?) Communication (Does the behavior seem to be a way to ask for help?)

60. Behavior Programs Cont’d Motivations Edibles, Tangibles, Social Praise, Activities *Avoid Bribery *Ensure child is aware of expectations Motivations Edibles, Tangibles, Social Praise, Activities *Avoid Bribery *Ensure child is aware of expectations

61. Case Study 1 Maurice is 7 years old and is in a first grade inclusion program Frequently wandered around the classroom Poor eye contact Self stimulatory behaviors-mouthing materials, head patting, rocking, rubbing materials Unresponsive to peer interactions Did not complete tasks independently or focus without adult attention Accomplished most tasks through rote repetition rather than with meaningful understanding No intelligible speech Did not initiate signs but imitated some Maurice is 7 years old and is in a first grade inclusion program Frequently wandered around the classroom Poor eye contact Self stimulatory behaviors-mouthing materials, head patting, rocking, rubbing materials Unresponsive to peer interactions Did not complete tasks independently or focus without adult attention Accomplished most tasks through rote repetition rather than with meaningful understanding No intelligible speech Did not initiate signs but imitated some

62. Case Study 2 Peter is a 12 year old boy with a diagnosis of Aspergers attending a regular grade 6 classroom. He is above average academically and highly verbal He is obsessed with dinosaurs He is observed during recess to play by himself or with much younger children He is often observed drawing or fidgeting during class time He is observed to make inappropriate comments in class when his peers answer questions incorrectly Peter is a 12 year old boy with a diagnosis of Aspergers attending a regular grade 6 classroom. He is above average academically and highly verbal He is obsessed with dinosaurs He is observed during recess to play by himself or with much younger children He is often observed drawing or fidgeting during class time He is observed to make inappropriate comments in class when his peers answer questions incorrectly

63. References Bareket, Rachael. 2006. Playing It Right!: social skills activities for parents and teachers of young children with autism spectrum disorders, including Asperger syndrome and autism-1 st ed. Shawnee Mission, Kan.: Autism Asperger Publishing Ernsperger, Lori. Ph.D, 2002. Keys to Success for Teaching Students with Autism. Arlington, Texas. Future Horizons, Inc. Hodgdon, Linda A. 2005. Visual Strategies For Improving Communication; Practical Supports for School and Home. QuirkRoberts Publishing. Troy, Michigan Prizant, B.M., Wetherby, A.M., Rubin, E., &Laurent, A.C. (2003). The SCERTS Model: A transactional, Family-Centered Approach to Enhancing Communication and Socioemotional Abilities of Children with Autism Spectrum Disorder. Infants and Young Children, 16 (4), 296-316 Quill, Kathleen Ann. 2000. Do Watch Listen Say: Social and Communication Intervention for Children with Autism. Maryland: Paul H. Brookes Publishing Co. Inc. Richard, Gail J. 1997. The Source for Autism. Illinois: Lingui Systems, Inc. Smith, Caroline. 2003. Writing & Developing Social Stories: Practical Interventions in Autism. Speechmark Publishing LTD, Telford Road, Bicester, Oxon OX26 4LQ, UK Sussman, Fern. 2004. More Than Words. Toronto, Ontario: Hanen Early Language Program. The Inclusion Notebook: Problem Solving in the classroom and community. Inclusive Education and Autism; Spring 2007 (Volume VI, No.1) www.scerts.com/the-scerts-modelwww.setbc.org www.visualaidsforlearning.comwww.usevisualstrategies.com www.vanderbilt.eduwww.room5ideas.com www.dotolearn.comwww.angelfire.com Bareket, Rachael. 2006. Playing It Right!: social skills activities for parents and teachers of young children with autism spectrum disorders, including Asperger syndrome and autism-1 st ed. Shawnee Mission, Kan.: Autism Asperger Publishing Ernsperger, Lori. Ph.D, 2002. Keys to Success for Teaching Students with Autism. Arlington, Texas. Future Horizons, Inc. Hodgdon, Linda A. 2005. Visual Strategies For Improving Communication; Practical Supports for School and Home. QuirkRoberts Publishing. Troy, Michigan Prizant, B.M., Wetherby, A.M., Rubin, E., &Laurent, A.C. (2003). The SCERTS Model: A transactional, Family-Centered Approach to Enhancing Communication and Socioemotional Abilities of Children with Autism Spectrum Disorder. Infants and Young Children, 16 (4), 296-316 Quill, Kathleen Ann. 2000. Do Watch Listen Say: Social and Communication Intervention for Children with Autism. Maryland: Paul H. Brookes Publishing Co. Inc. Richard, Gail J. 1997. The Source for Autism. Illinois: Lingui Systems, Inc. Smith, Caroline. 2003. Writing & Developing Social Stories: Practical Interventions in Autism. Speechmark Publishing LTD, Telford Road, Bicester, Oxon OX26 4LQ, UK Sussman, Fern. 2004. More Than Words. Toronto, Ontario: Hanen Early Language Program. The Inclusion Notebook: Problem Solving in the classroom and community. Inclusive Education and Autism; Spring 2007 (Volume VI, No.1) www.scerts.com/the-scerts-modelwww.setbc.org www.visualaidsforlearning.comwww.usevisualstrategies.com www.vanderbilt.eduwww.room5ideas.com www.dotolearn.comwww.angelfire.com