Best Practices for Visual Supports – Part 1

This post is about best practicies for visual supports for autism.

Many people have questions about using pictures for autism. Here is an email that I received.

“I’m looking for information about best practice using visual supports (specifically pictures, photos, objects) for 3-4 year old students with special communication needs. . . My specific questions have to do with the preferred size of the pictures, color vs. black and white line drawings, an appropriate number of pictures on a schedule, etc…”

These are great questions
My answers to these “basic best practices” questions have evolved into a 3-part series.  In this article I’ll focus on what visuals to use.  The next two articles will delve into size, layouts, look and some other “technical” guidelines.  The question asks specifically about preschool ages, but I’m going to expand my answer to include all ages.  Here we go. . . .

Start at the beginning
The real beginning is the student.  I think the two most important questions are 1) how old is the student, and 2) what is his/her skill level.  Decisions about visual tools need to reflect the answers to these two questions.

One of the common situations that I am called to evaluate involves the appropriateness of visuals strategies being used for a specific student.  Sometimes students are not responding as expected.  Another common complaint is that students “reject” the visuals.

Stating that visual tools need to be age-appropriate and skill level appropriate seems so simple and logical, but everyone won’t view “age-appropriate” and “skill level appropriate” in the same way.

Here’s the history

I’m “vintage.”  I’m a grandmother.  Back in the “olden days,” when I started to use pictures for autism and create visual strategies to use with my students, we didn’t even have computers.  Pictures came from coloring books and magazines.  We took photos with film that had to be developed at the drug store.  It usually took a week to get the pictures back.  Creating visual supports was very labor intensive.

In that era, a company called Mayer-Johnson created a 3-ring binder filled with stick figure pictures that we could copy on the Xerox machine in the office.  That was the first resource that I remember that offered a “collection” of pictures to help me with my visuals.

As time went on. . . options grew.

What are the choices now?
Luckily, over time, the technology options have exploded.  I’m amazed at how computers, Ipads and Google have made this job of pictures for autism so much easier.  Now, you can use your computer and your camera to get beautiful color photos of most anything you need. . .within seconds.

In addition, there are multiple companies that produce online sites, computer software, CD/DVD programs, and picture card systems that will meet most any picture need you could have when creating visual tools for your students. There are lots of wonderful options.  Which one or which ones should we use?

Here’s what the research says
There has been some research* related to which forms of visuals are easiest for students to understand.  (Keep in mind there are tons of variables that researchers break down related to this.  For example, nouns are different from verbs and some line drawing systems are more difficult than others.)

Here’s a simple list.  The easiest are at the top and most difficult at the bottom.

• Objects (identical & similar)
• Color photographs
• Black & white photographs
• Color drawings (realistic)
• Black & white drawings (abstract symbols)
• Written words

Where do logos (like the logo of a favorite restaurant) fit on this list?  I think near the top (easiest).

So, how do people make decisions?

How do they decide what visuals to use when planning pictures for autism?  People tend to use what they are familiar with.  They use the technology they are comfortable with.  They use the computer program the school has purchased.  Sometimes they try to standardize everything so everyone is using the same images. They create visual tools that are easiest for them to do or most convenient for them.

That’s not bad.  But we need to think about good, better and best.  When we have so many great options available, we want to make sure we are aiming for the best for each student.

So here are the most important questions

What will this student learn to recognize most quickly and easily?  What captures his attention best?  What does he seem to “like” best?  What is most interesting to him?  I don’t think you need a fancy standardized test to answer these questions.  You can spend a few minutes informally with a student and get some useable information.

Here’s where age and skill level become really important
The original question was about 3-4 year olds.  Very slow learners may need to begin at a very concrete stage with real objects.  But most children in this age range will do really well with a combination of photos, colored drawings and real objects.

Young students may understand some abstract symbols and written words. If they do, I might use just a few for things that are harder to represent with a more realistic picture.

Older student’s needs are a bit different.  Skill level is a big factor here.  Students who learn slowly may do just fine with the same visuals that the younger students use.

One complaint that comes from some older students is that they don’t want to use visual supports because they look “babyish.”  How the visual tools look is a big issue.  (I’ll address that later in this series.)

The other issue may actually be the kind of visual representations being used.  Here’s my question.  Do abstract symbols look more “special ed” than photos?  Than written words?

Some additional thoughts

1.  Remember. . .it’s not “one size fits all”
All students are not going to understand all visuals in the same way.

2.  When in doubt, use a simpler form
It doesn’t hurt any students to use simpler forms of visuals.

3.  Think about the group and think about the individual
When creating visual tools for the whole group, be sure to use a level of visuals that are appropriate for all of them to understand.  Then if you are doing something personal for a specific student, you can use a higher level if that is appropriate for him.

4.  All the pieces of a “communication system” do not need to be the same format (in fact, it’s better if they are not)
If everything starts looking too much alike it becomes more difficult for students. Some things are easier to represent in photos and some easier in drawings or symbols.  Think about nouns vs verbs vs adjectives vs words that represent concepts such as “snack” or “play time.”

5.  Don’t worry about moving up to higher levels of difficulty
Occasionally, I meet someone who is concerned about “climbing up a ladder” to make the visual tools more and more abstract and more difficult.

Don’t forget that the purpose of using visual strategies is to give students information to help them accomplish their life routines.  There is no great benefit from making that more difficult for them.  Other literacy skills can be taught in separate activities.

Here’s what I recommend
When people have good systems that are working fine, I don’t think starting over makes sense.  If it’s not broken. . . don’t fix it.  On the other hand, if something is not working well, it might be time to review.

When creating new visual tools, try using the list above as a guide for making your decisions.  As you do that, you’ll have a perfect opportunity to explore more picture resources for the visuals you create.

One final thought.
It’s not all about autism.  Think about how the advertising world communicates to you and me.  Which restaurant do you think sells more dessert?  The one that gives you a typed page with a list of desserts?  Or the one that has a special dessert menu with wonderful colorful photos of the treats? Or the one that brings a huge dessert tray to the table to show you what all those yummy desserts look like?

*Adapted from (Mirenda & Locke 1989)