Visual Strategies: Visual Schedules, Choice Cards & First/Then cards

What are Visual Strategies?

Visual strategies can consist of visual schedules, choice cards, first/then cards or any other visual tool used to help in the planning, organizing, remembering or completing tasks.  It may consist of pictures for younger children or those who are illiterate or it may be words or lists for older children. The use of visual cues helps to organize the task or daily activities making the expectations clear and understandable. This reduces anxiety and alleviates mental stress.

Why are Visual Schedules, Choice cards, and First/Then cards so important?

Visual Schedules, Choice Cards, First/Then cards are all "tools" that I rely on very heavily.  For JC, understanding verbal instructions or grasping auditory information in the mix of an overstimulating environment is very difficult.  It takes him longer to process information that he hears than that which he sees for a variety of reasons, many of which I don't fully understand (yet).

Primarily, it seems that his mind works more visually. He cues into words and seems to need a visual image of that word to process it. In the case of verbal language, if his brain takes a word and then creates a corresponding image before processing the word, then it makes sense that the processing time would be longer.  A perfect example of this is food choice.  If I ask JC, "what do you want to eat?" there is never a response. It is too much for his brain to process.  For us, it's a simple question.  But for JC, the search through his memory for all the food choices and then the process of labeling each one with a word is just too many steps.  Now if I ask, "do you want a banana or toast" that CHOICE makes it a little easier, but often there is still no response until I use a visual cue showing a picture of a banana and a picture of toast.  Then (and only then) will he make a choice by pointing to the picture.  It's like having a multiple choice test.  Choosing an answer from 4 given choices is easier than answering with an essay from memory. This is why Choice Cards are so helpful for JC.  And because it takes his brain takes longer and uses more energy to process those simple tasks that we take for granted, he is overwhelmed more easily and has mental fatigue after simple tasks.  His daily activities leave him feeling the way I used to feel after a long day at work working with a budgeting committee to iron out corporate budgets.  It's mentally exhausting.  Using the visual cues to alleviate that demand on his brain for these simple tasks frees up that energy to be used elsewhere throughout the day which means his overall mood and emotional/mental state is much better.

Think about why we make "To Do" lists.  I often have so many things floating around in my mind that I start to get anxious that I'm not going to finish then all. So I make a list. This helps to organize my thoughts and provides a visual system which I can refer to and "check off" when complete.

Also consider the power of visual cues.  When we eat at a restaurant, they put pictures on the menu for a reason... Because it is powerful.  I am a lover of Pinterest, the ultimate visual choice board. We would never read all of those articles in activities for children and recipes or cleaning tips.  But with a pictures, suddenly it all becomes easy to process. We are all visual by nature, but some are even more so.
Click HERE to watch this in action!

Visual Schedules:

We rely on the visual cues for many aspects of daily life, not just food choices.  I have 3 different "schedules" that I use daily: morning, afternoon and evening. I adjust the schedule according to our daily plans, and seeing that schedule gives jc an understanding of what the expectations are for that period.
Morning: eat, diaper change, get dressed, go in the car, go to school
Afternoon: eat lunch, diaper change, nap, table/work times, choice time (where JC chooses activities to do)
Evening: eat, play outside, bath, get dressed, book, bedtime

JC understands how this works and if we are having a difficult time in the mornings, I can rely on the schedule to say "look, we ate, now we need to get dressed so that we can go to school". It is amazing what a difference those visual cues make in that simple conversation.

I also have schedules for specific routines like bath time and teeth brushing. JC hates to wash his hair and face. It is has always been a battle.  But with the bath time routine schedule, the pictures show: clothes off, get in tub, wash body, wash hair, dry with towel, all done.  The very first time I used that routine/schedule, JC washed his hair.... Simply because the picture told him too. His visual processing is very strong, and he relies heavily on it so I am learning to use that to my advantage.

Choice Cards:

We use choice cards to allow JC to have some control over his activities.  I can choose some predetermined activities or foods and he can choose what he wants.  It also helps lot limit the endless choices which can sometimes become overwhelming. JC has a difficulty focusing on a take for an extended period. And transitions are also difficult. The choice cards are useful in both of these situations. Imagine being surrounded by a room full of toys and activities and being told to choose only 1. For JC, this is difficult. So allowing him to choose from a few choices with visual pictures makes this choice easier. I also often allow him to choose 2 or 3 activities and we work on transitions. First we do activity 1, he may loose interest flutter around the room after only a minute and at that point I refer to the visual cues and say "you choose cars, are you all done with cars". When he replies "all done cars" we move on to the next activity on his card (which he choose). This models appropriate transitioning and focusing. He cannot move from one activity until he is finished with it, and if he chooses to do an activity, he must follow through with it. It also helps reinforce the importance and adherence to the visual schedule structure.

First /Then cards:

This is my favorite :)  This allows me to direct behavior that I want by using the a goal system. First put shoes on... Then go outside.  First eat, Then you can have a cookie. It works amazingly well!  So well in fact, that I have been able to forgo the pictures in many cases and just use the verbiage: "First... then..." And he understands the directions verbally.  We are making progress!

How do I create a visual system?

There are loads of ways to create a system, and its all about what will work for your child. I like using laminated cards with Velcro tabs which make It easy to customize for the day or activity or need. Magnets work well too but Velcro I less expensive and more portable. I keep all of my pictures and cards in a folder with different sections for food, activities, schedules etc.  For more ideas you can visit my Pinterest page for more ideas:  http://pinterest.com/JCsSPDMommy/

How do I start implementing this visual system?

I started with the First /Then cards. It is only 2 pictures, it isn't overwhelming for the child and it supports behaviors that you need to encourage.
Start with 2 preferred activities: play cars, then color. That gets the child's "buy-in" to the process as a whole.  This is in essence teaching the backbone of the entire visual schedule/card system. Once the child is comfortable using the the first/then card for those activities, add in the behavior that you want to elicit. First, get dressed... Then go outside. You can even use a 3 cue system of First, Then, Next where the middle activity is the less preferred.  First, play with trains, then change your diaper, then go outside. It's the same concept as a reward system, but it just takes it to a visual level.
Once that works well, you can step up to choice cards and allow the child to choose the activities to put on the first/then card. And eventually you can "grow" into a visual schedule with multiple activities visible at once. But until the child understands the basics, seeing all of those pictures at once can be overwhelming and counterproductive.


Even children who do not have SPD could benefit from visual schedules.  No matter the reason, if you choose to try a visual system the key is consistency and patience. It isn't going to change things overnight. But eventually you may start to notice a difference in small tasks, and hopefully in the overall mood of the day.