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Visual Schedules for Special Needs Children - featured July 15, 2011

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Visual Schedules for Special Needs Children

by: Lynn Witzen, MS, OTR of the Therapy Services Supervisor, STAR (Sensory Therapies And Research) Center

Reprinted with the express permission of SPD, Sensory Processing Disorders Foundation as originally published in their Starlights Newsletter.

The children we see at STAR Center face numerous challenges that impact their ability to function in everyday life. Some of these challenges require longer to address than others. However, we often make adaptations or "build bridges" to help them function more successfully as soon as possible.

One of these challenges is the ability to complete basic organizational tasks. For instance, it is not unusual for our children to have difficulty organizing basic dressing or self care tasks that would be typical for other children their age. It is highly frustrating for children and adults because transitioning to school or other morning activities is such a major hurdle.

[Image: visualsched1.JPG]
A STAR client shows his schedule of activities prior to his treatment session

As children come into treatment, this lack of organization is evident in their difficulty recognizing the steps necessary to complete an activity. This recognition is essential to a child's "regulation." If a child understands the step-by-step process, it is easier to work on the concept of "stop and go." The ability to 'stop' and 'go' is the foundation for regulatory process and decreases the impulsivity that is prevalent in children who do not have strong skills in this area.

We use a visual schedule with our clients at STAR to support the development of organizational skills. Most children build their own schedule with pictures prior to beginning our treatment session. It helps to provide structure and a plan for the session. It also provides a visual point of reference in case a child forgets or impulsively begins an unplanned activity. It minimizes discussion or disagreement about activities that have or have not been chosen as part of the session.

Although a child may not yet have the internal organization, the visual schedule provides a "bridge" to the actual acquisition of organizational skills. We often recommend this for home use to support learning activities such as sequencing the morning self care, dressing or the daily routine. It can also be used to prepare for other activities such as transitions, trips or major changes that will be occurring in the family. It is a great support and helps our kids be prepared rather than reactive to events. We find it to be very effective as a compensatory strategy in the short term and for solidifying skills for the long term.

[Image: visualsched2.JPG]
Example of a morning routine visual schedule

This tool is so effective that families can "take a breather" from working on developing better internal organization since their children have become so much more competent and less reactive than prior to using the visual schedules. However, at some point in time, we have parents who begin to panic about the possibility that children will "always" have to use a visual schedule. No, the schedule is truly a bridge for children to be able to build the internal organizational skills and become independent. The expectation is that they will be able to do this during the time they are in treatment or shortly afterward. Of course, some children may need the external support for a longer period of time. Change is always dependent on each child's underlying abilities and skills.



Even after a child builds independent skills in sequencing, there are predictable situations for which a visual schedule would continue to be a valuable tool. For instance, as school begins or change occurs, it is helpful to use a visual schedule for support. It also may be helpful to use a visual schedule while preparing for or during a vacation or holiday activity. The schedule provides extra support for potential stress that may occur due to unfamiliar, unpredictable or new experiences.

[Image: visualsched3.JPG]
This child is using an "engine speed" chart to determine which of his activities slow his
"engine" down, speed it up, or make it just right.


Visual schedules can be easy to make and can be a great project for children and parents to work on together. Children can draw pictures for each step or parents can use cameras to photograph each step of the activities. This is particularly helpful for sequences in morning routines or everyday tasks.

So, the visual schedule is a great tool for children to use on a temporary basis. It's similar to a child using training wheels prior to learning to ride a bike independently. The support is invaluable when children need it, but they will leave it behind when they have the internal skills to organize on their own.






Featured Organization: Sensory Processing Disorder Foundation

The SPD Foundation is a world leader in research, education, and advocacy for Sensory Processing Disorder, a neurological condition that disrupts the daily lives of an estimated 1 in 20 children and adults. Originally called the KID Foundation, SPDF has been providing hope and help to individuals and families living with SPD since 1979.

About the Author: Lynn Witzen, MS, OTR, Therapy Services Supervisor, The Star Center

Lynn began providing family-centered occupational therapy services to children and adults with neurological disabilities in 1978 and eventually specialized in pediatric services for children with SPD, Autism, and other complex neurological diagnoses. In homes, schools, and institutions, she has provided assessment, direct therapy, parent education, treatment coordination, and training about sensory and other childhood disorders for teachers and paraprofessionals.

Lynn is certified to administer the Sensory Integration and Praxis Test (SIPT). In her former home of Stillwater, Oklahoma, she instituted a therapeutic listening program in nine public schools. Her specialized care of pediatric patients with complex neurological disabilities brought her the Oklahoma Health Professional of the Year award from the state's Home Care Association.

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Tags: Article Sensory Processing Disorder Autism OT Newsletter 15 July 2011