Visual supports can be the key to understanding in young learning minds, whether neurodiverse or not, and that’s our topic for today! So, whether you're a parent, teacher, or clinician, this episode is sure to leave you with fresh ideas to help your children thrive.

We'll dive deep into how these tools—like visual schedules, comic strips, and beyond—can help kids learn and communicate needs effectively by making expectations clear and reducing anxiety. We'll share personal tips and tricks we've used in the clinic and at home, tackling everything from first-then boards to social stories. We'll also discuss common pitfalls and how to make these strategies work while also highlighting that visual supports are not a "one-size-fits-all" solution, but rather, they should be tailored to fit your unique kiddo's needs, preferences, and understanding. So, if you’re looking to amp up your teaching game with visuals, stick around for some great advice and a few laughs along the way!

Timestamps:

(01:24) - Welcome

(08:12) - Episode Overview

(09:42) - "First-Then" Boards in Behavioural Support

(20:13) - Common Implementation Errors

(37:44) - Transitioning with Visual Schedules

(39:11) - When Visual Schedules Don't Work

(46:55) - Social Stories

(53:07) - Visuals For Executive Functioning & Self Regulation

(01:01:42) - Comic Strip Conversations

(01:08:12) - Video Modeling as a Strategy

(01:17:35) - Visuals for Goal Setting and Progress Tracking

(01:26:17) - Stop, Think, Do

(01:30:00) - Reinforcement & Reward Strategies

(01:36:46) - Closing Tips For Therapy Sessions Or The Home

Materials We Love and Use:

• Elemenoe - Summer Visual Schedule

Articles Mentioned In This Episode:

• Como, Dominique H.; Goodfellow, Margaret; Hudak, Delaney; Cermak, Sharon A. A scoping review: Social stories supporting behavior change for individuals with Autism. J Occup Ther Sch Early Interv 2024;17(1):154–175. doi:10.1080/19411243.2023.2168824
• Ganz, Jennifer B.; Earles-Vollrath, Theresa L.; Cook, Katherine E. Video Modeling A Visually Based Intervention for Children With Autism Spectrum Disorder. Teaching Exceptional Children 2011;43(6):8-19
• Hayes, Gillian R.; Hirano, Sen; Marcu, Gabriela; Monibi, Mohamad; Nguyen, David H.; Yeganyan, Michael. Interactive visual supports for children with autism. Pers Ubiquit Comput 2010;14:663–680. doi:10.1007/s00779-010-0294-8
• Leaf, Justin B.; Ferguson, Julia L.; Cihon, Joseph H.; Milne, Christine M.; Leaf, Ronald; McEachin, John. A Critical Review of Social Narratives. Journal of Developmental and Physical Disabilities 2019. doi:10.1007/s10882-019-09692-2.
• Meadan, Hedda; Ostrosky, Michaelene M.; Triplett, Brooke; Michna, Amanda; Fettig, Angel. Using Visual Supports With Young Children With Autism Spectrum Disorder. Teaching Exceptional Children 2011;43(6):28-35

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Pairing, for example, is a program we run at the clinic where we'll collect data on how long the child's like, staying close to an adult. And so the on the visual schedule, sometimes we'll see something like pairing.

Oh, and when I come in for.

Supervision, I'm like, what? No, no, no, no, no.

Hey everyone, I'm Brittany, speech language pathologist.

And I'm Shauna, behavior analyst, and we're.

Your hosts at neurodiversely Speaking.

This is a podcast where we bridge the gap between research and practice, exploring autism and neurodiversity through the lens of speech and behavior.

Whether you're a parent, we'll give you practical tips to bring into your home or your next therapy session.

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Welcome to the Neurodiversity Speaking Podcast with Brittany Clark and Shauna Fleming from lmno, brought to you by the Sensory Supply.

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You can also send us listener questions to address on the show@helloeurodiversityspeaking.com Neurodiversely Speaking starts now.

Hey everyone, and welcome back to Neurodiversely Speaking, the podcast where we explore communication, behavior, neurodiversity and parenting through the lens of science and real world experience.

Today, we're diving into the incredible and often misunderstood world of visual support. Whether you're a parent, a teacher, a clinician, or someone who just loves a good visual checklist like me, this episode is for you.

We're going to break down the research, share what actually works, talk about when visuals go wrong, and give you some real life stories from our own practice.

Like usual, we'll start off with our learning objectives.

By the end of the episode, we're hoping that you'll be able to differentiate between different types of visual support, like first, then boards, visual schedules, social stories, video modeling, comic strips, et cetera, and identify the unique purposes they serve in supporting communication behavior and emotional regulation.

The second one we are hoping you can explain why visual supports are more than just token boards, including how they reduce cognitive load, increase predictability, and foster autonomy for both neurodivergent and neurotypical children.

Our third learning objective is to apply Practical strategies from both the speech pathology and behavior analysis perspective for designing and implementing visual supports that are clear, meaningful and personalized, individualized without overwhelming the child or you as the adult.

Number four is identifying some common pitfalls in using visual supports like too many visuals or poorly matched to the child's level or no plan for fading and generalization. And we're hoping that you'll discover simple field tested ways to adjust or repair visual systems when they're not working.

And the last objective today is explore how to involve children in tracking progress or tools like goal charts, visual graphs and value based planning to help them see their own growth and stay motivated. Before we jump in, we want to special thanks to our podcast producer, Alan for getting us this roadcaster that we can take on the road.

Shawna and I are actually away right now with our families just for a little mini getaway. As moms and business owners, it's also important for us to get out and have some really nice dedicated time with the kids.

So we're in a different space today.

Yes. Hopefully the audio sounds just fine, Alan.

Awesome. All right, so let's get started with the basics. Visual supports are tools that use pictures, symbols, words or drawings to show rather than tell.

And they're for everyone, not just kids with a diagnosis.

Exactly. And so let's get that out of the way right away. Visuals are not just token boards. It can include first, then boards.

We're talking about visual schedules. We'll talk about comic strip conversations, social stories, more on that one later.

Even simple stick figure drawings that map out what to do or what's coming next.

And for individuals who are neurodiverse and may have challenges with getting messages in or out at times, these visual tools aren't just helpful, they're actually essential. Temple Grandin literally said that she thinks in pictures, and she's not the only one.

Yeah, we saw her talk was it last year and she was actually really fascinating to listen to and hear how that works in her brain. Her brain just works differently than mine, for sure.

I know. I love the opportunity when we get to learn from other autistics.

Yeah.

About how their brain works. I'm like, oh wow, that's so fascinating.

Or even sitting back with some of the young learners that we have, you can just tell that their brains just like processing visual input and auditory input a little bit different than mine does. For sure. I always think the world is like so much cooler to some of my friends.

Yeah, for sure, for sure.

And then from a language standpoint, visuals are so Powerful because they reduce the cognitive load so kids don't have to decode all the verbal stuff. I sometimes like to explain it.

Like, spoken words essentially disappear when they come out of somebody's mouth, while visuals can stay around a little longer, especially for someone, maybe, who has a slower processing speed or, like, other things on their mind, or maybe they're not attending to that specific thing that you want them to. And so that visual just sticks around a little bit longer.

Exactly. And we see this a lot, especially during moments of dysregulation with our own.

Children, and then as well with the.

Children that we work with at the clinic, where getting that message in can be really challenging. And it's not that the child doesn't want to receive your message.

I always say, like, maybe their, like, brain feels like it's on fire, and it's just, like, not able to take in the auditory message.

And so for my BCBA listeners, those verbal SDs, or discriminative stimuli that we're delivering, so those instructions or ideas that we're offering may not even contact their attending behavior. Um, and so the visual stim stimuli can then function as a prompt.

And so I'm talking to them, but then I'm also showing them that visual and those two things paired together might be a little bit more effective, especially during those times where the child might be in a heightened emotional state. Like, they literally may not be able to hear what you're saying and comprehended. And so everyone's sounding like Charlie Brown's teacher that.

Exactly. And so the visual can act as a prompt to support their understanding and help their brain reconnect with the present moment.

And we see this all the time at the clinic, where we feel like we've been clear and predictable and that sort of thing.

And then you go to transition the child, and then they start flopping to the ground, or they're yelling or in some other way, like, indicating, like, I don't want to do that.

And then sometimes we'll bring in a first end ward, or saying, like, okay, first we're going to the bathroom, and then we're going to go to the sensory room, for example. And then we see that behavior change right away. Right? They're like, oh, this is what you're gonna be doing. And so it makes sense, Right?

We thought we were being really clear, but it wasn't clear to them. And then sometimes the visuals can add that additional clarity and help sort of repair that communication breakdown that occurred.

We've seen visuals support autonomy.

Like, you were Talking about sometimes just help the learner better understand so they can be a little bit more independent with making their decisions, but can also help reduce anxiety and then increase understanding. And not just in the clinic. Sett I use a visual schedule and we pulled one out with our own kids just yesterday.

My five year old, she really wanted to know the schedule for the day and we were out of town so we didn't have our visual schedule like we do at home. She's pretty consistent, I would say. We have a nice visual one that's laminated with Velcro. It's stuff that I have on my fridge at home.

But here we're out of town and so we just wrote out the main events of the day on post it notes and we stuck them to the fridge and she actually referenced them quite a few times throughout the day. And then. Is this still happening today? Are we still doing that? Yep.

Perfect.

Yes.

I think sometimes we can overthink them too and think you need laminating sheets. And we need.

And truthfully we do see this at the clinic too where like the therapists love the clients so much that they'll spend so much time making these like really perfect visuals.

When sometimes in the moment, like something really simple like using what you have on hand, like post it notes or something can be like a really nice way of kind of solving the problem in the moment for not feeling like you always have to have the perfectly laminated card for sure. So let's break down some of the types of visuals that we're going to talk about today.

I want to chat about how the visuals can support executive functioning and emotion regulation as well as when they go wrong and the common pitfalls that we see in clinical practice. And then some suggestions and stuff that we've tried out as parents and are seeing some success with at our house.

So the first thing we're going to chat about is those first then or now. Next is a new twist on the first then that I recently came across and I love.

It can be really great for transition, especially when motivation is low. We'll talk about visual schedules, kind of like a build on from a first then.

These can be like a full day, a mini schedule, or even as simple as a bedtime routine, helping with sequencing, time awareness, predictability.

The next thing we're going to talk about is social stories or social narratives which provide some instructions or guidelines or an overview of what to expect expect in a situation.

Next we'll talk about comic strips or comic drawings which can be fantastic for mapping out Thoughts, feelings, and what to do if you're disregulated. We'll talk about video modeling, which can be a really nice way for children to be able to see what those. What an experience is going to be like.

And then the final thing we'll chat about is graphing progress. So how visuals can empower kids to set goals and track their own success, which helps align our goals with their values.

Nice. That's a good overview. So we're going to start with the first then boards. Like Shauna mentioned.

We use these all the time, both very commonly in the SLP world and in the ABA world and likely OT and other classrooms, schools, everything. And so we'll talk about that visual. It's really everywhere in early childhood and behavior support.

Again, like we said, it's traditionally known as a first then board. But we've seen that now next. And I like that, too. And it kind of highlights, oh, no, we're doing this right now. And then next.

This is what's coming up. It's essentially the same, just different language. But we've used both.

Yeah, exactly. We traditionally have always used first then and then school, I think, was using now next. I was like, oh, I kind of like that.

It's like a great twist. And then, of course, clinically, we want to be consistent then, so we're not flopping between sometimes doing first, then sometimes doing now next.

And so we want to make sure that we're keeping that consistent. The thing that I love about these boards is that they're simple, they're usually pretty portable. And so you can use them kind of like in the moment.

It's not just a picture schedule. It's a way of supporting behavioral momentum, delay tolerance, task engagement, especially when that motivation is low or transitions are tricky.

So the first one, I'm looking at what it is that we have to do. And then the then ideally is something that they would want to do for sure.

Exactly. And it helps them to learn what's coming next, what to expect.

And then I was thinking about, from an SLP lens, it also helps kids who have trouble with receptive language. So with the understanding or following directions, it kind of scaffolds their understanding to something they can process.

So, like pictures, symbols, or simplified text to say, like, okay, this is what's happening right now. And then next we're going to be doing this.

Exactly, exactly.

And behaviorally, what we're doing is we're manipulating what we call that motivating operations or their motivation, and setting up opportunities for them to increase the likelihood that they're going to engage in that first activity. And so I'm showing them, as a parent, I respect that this is hard for you and that you maybe don't want to go to the bathroom.

I know it's really important that you go to the bathroom because we're going, going in the car for a long ride or something like that. And so this is something that I need you to do. And then as a. Then it's not a reward necessarily. Right.

It's or a bribe, you know, it's like sort of appreciating like, yeah, this is something you don't really want to do and this is what we're going to do after. And creating that predictability for them can increase the likelihood that they're going to go and do those non preferred tasks.

So we're pairing that first demand with access to a known reinforcer or a known thing that they like, which is clearly communicated in the then.

And you mentioned bribing, which I always come back to. And I know like as an early parent thinking about like, am I bribing if I'm giving my child like saying we're gonna do this next?

But what you're saying is we're just kind of giving them the schedule of the day or the plan or like knowing what to anticipate. And so on the flip side, if I had said like, well, if you do your math homework then maybe does that change it into a bribe or not really.

I think it has a lot to do with when you're telling them this.

Yes. Right.

So I as a parent try very hard to avoid or like provide tools to my kids to avoid meltdowns.

Yeah, yeah.

And so a first then strategy. For example, I never leave the park without a strong then.

Yeah, yeah, right.

My kids are young, they don't care about leaving the like, they don't care we have to go home and make dinner or whatever. And so we always leave the park to go get a freezy or something like that. And so I set that expectation up right away.

So I'm saying, all right guys, we got five more minutes at the park, then we're gonna go home and have a freezy.

Right.

And so I've set that up. It's not that they're, I'm saying, okay guys, time to go. And then there's saying, I don't want to go. And then I'm coming in and offering the freezy.

Ah, that's what flips it.

Yeah, I'm like setting up this Opportunity, or I'm setting it up, telling them this is the rules, this is my boundary, and then following through on it. I'm not in the moment of dysregulation or a moment of sort of back talk or something, trying to then offer them anything to get them to comply. Right.

And then I also think the other thing that you mentioned, it's like if you do your homework, right. It's not really optional to me if we leave the park.

Right.

So again, I don't really want to word it that way because then I'm setting it up for a way where I'm relinquishing my power really as a parent. And I'm telling them like, if you do this, then this.

Whereas I should just say like, first we're doing your math homework and then we're gonna go play outside together, then we can read a story together, whatever that then is.

Got it, Got it. Okay. So we're the key things there are. We're not saying like, if you do this, then I'll.

It's just saying first and, and then the second thing is setting it up beforehand. So it's a planned reinforcer, it's not a bribe, it's a planned reinforcer.

And we're just saying, here's the plan, we're going to do this and then we're going to do that. And maybe that next thing is something really cool like going for ice cream or getting a smoothie or something.

But I'm setting it up beforehand and then I'm not just putting in that.

Then after like a moment of dysregulation so my kid's not crying, having a tantrum and then I'm saying, okay, fine, I'll give you a smoothie or whatever.

Exactly.

And when you first introduce these tools, I know later on we're chatting about sort of common pitfalls, but it aligns with this conversation is initially I want to have a really powerful then.

Yeah, yeah, right.

When I'm starting this first then strategy. So for example, my kids at the park, I for a long time, like, let's go home and get it freezy. Let's go home and get a freezy.

Right.

And now they're pretty good. Because sometimes like you can't go home and get a freezie, right. You gotta go and do some other errand or whatever the thing is.

But because I've paired this strategy so often, they're used to it, they know what to expect, they know it's predictable.

Right.

And so getting that buy in from them Initially by going in with some strong reinforcers or known preferences can be a really nice way to build success in it. With the kind of now next or first then board right away.

Cool. And that's something that I learned from ABA that I wasn't sort of.

It's not really like ingrained in me right now is the behavior is getting reinforced and it's being associated. Those two things are becoming associated with one another and then it gets stronger over time, which is really cool.

So then the first thing gets a little bit easier to complete.

Yes, exactly. The contingency is like very clear to the child. They're used to it. You use this language all the time.

If you have a, like an actual visual board, again could be something so simple like a sheet of paper.

Right.

First and draw a little picture on it and then on. Then draw a little picture there. Or it could be something like a laminated sheet with Velcro and all the bells and whistles.

So cool. That's perfect. So it gives kids that preview what's coming next. It supports those predictive abilities and their emotional ready readiness.

So we were talking about like we're not throwing this in at the moment of the meltdown. We're putting it in beforehand as that anti antecedent strategy or like anticipating what might happen. So we're coming in ahead of time.

So it supports their engagement and compliance.

Even though I hate the word compliance, it me, it means just like we're helping them kind of follow through with their tasks without us needing to escalate instructions. Exactly.

I do think around the compliance piece like a future episode for us beyond supporting communication in those moments.

Yeah.

Right. Because sure. I've definitely had a time or two where a transition's been really tricky with my kids.

Yeah.

And in those moments I'm not, I'm holding a boundary, but I'm also teaching them to use their words instead of.

Yeah.

Flopping to the ground or throwing their arms up in the air or something like that. So for sure. Yeah. Cooperation over compliance. For sure.

Yeah. Yeah.

And then so by doing this, we're reducing the aversiveness of transitions by increasing what we say in aba, the stimulus saliency, which is just a fancy way of saying that the board helps the next step make sense. It becomes a cue that organizes their time and their effort and shows them kind of that all good things are not coming to an end.

For example, if you're at the park or that you're not stuck in this like kind of terrible thing that you don't want to be doing either. There's other good stuff that's coming along today.

Yeah.

So we, we're talking about using them intentionally and then we're not just helping them with their behavior though, we actually are helping them along. We' helping to shape their executive functioning skills too. So you can break down what that means.

Yeah, exactly. I think there are so many executive functioning skills.

And another thing that I was just thinking about too, that you and I often talk about is like the concept of time is so abstract. And so even my four and a half, almost five year old, if I say later, he's like immediately so upset. He's like, no, I want it today. Right.

Well, later it could be today. But it's like sometimes later isn't today, you know, and so it's so abstract to hear that again. The first then keeps it in the now next time frame.

And so through these type of tools, like a first then board. As far as executive functioning skills, that's kind of like the front part of your brain or control center. We're supporting response inhibition.

So the child has to wait to access that highly preferred thing. So they have to do this other thing first. And then we're going to go and get access to this other thing that you really like.

We can build task initiation so they learn to start something that they maybe don't want to do. And we're reinforcing goal directed persistence. So I can finish this and then I'm gonna get to play with my magnet tiles or whatever that thing is.

Cool, I love it. And then I always like to thinking about from an emotional regulation lens, you're reducing that uncertainty.

You're kind of saying, okay, here's the plan.

We're giving kids a way to understand and process those expectations and then help them do that visually so the predictability lowers that anxiety for some of our learners and then helps them stay calm and focus and better able to cope with what's happening around them. We like our learners. There's an acronym hre. You'll probably hear us say that.

But we at the clinic, we use that a lot to say, like, are our clinic or sorry, our learners happy, relaxed and engaged. Hre. So it kind of helps them to stay in that sort of state of being happy, relaxed and engaged.

Exactly.

And as we mentioned at the beginning, when kids are dysregulated, like during a meltdown or a tantrum, we know that that auditory channel is going to be compromised. And so visuals like a first then can cut through noise. And we've seen this so many times at the clinic.

A child is mid escalation, they'll pause, look at the board, and then they're just like, oh, okay, sure, yeah, I can go to the bathroom.

Yeah, yeah, yeah, yeah. Exactly. And we see the same. Like, we know our children can't really, like, hear us in the middle of a meltdown.

So at that moment, we're not going in with the rationale or even offering a way out. We're as. Sometimes a visual can help them to communicate in that moment when the words don't come.

Exactly. Exactly. All right, let's talk about common implementation errors. We've seen lots of them.

Yeah. And we. Them too ourselves.

Like using abstract visuals that don't actually match the child's understanding, or pairing then with something the child doesn't actually want.

Yeah. Then the contingency just falls apart, making that first demand too large. If the task has too high of a response effort, we call it aba.

So it requires a lot of effort. The reinforcer might not be enough, you know?

Right.

And I. I talk about this often. There's a lot of things that I want to do. You know, I want to go to the gym three times a week.

There's no then that really makes that possible for me for so many reasons. You know, time, motivation, etc. Like, and so we really need to be thinking about, like, what are we asking them to do?

Right.

And is, like, the payoff sort of worth it and, like, being respectful of that too? Right. Like, it wouldn't come to work if you were paid, like, 10 cents an hour.

And if it feels like that to the child, then sometimes you'll see that contingency breakdown.

Right, Right.

And that's again, something SLP listeners thinking about it a little bit differently and learning from our ABA counterparts that, like, oh, there's a little bit more to it. And we want to think about some of these nuances of teaching and learning using this strategy. So we were. We talked about this a little bit too.

But using the first then board retroactive, like, reactively. So, like during. In the middle of the meltdown with prior teaching history.

So you don't want to just, like, whip out the first, then in the middle of that tantrum or meltdown for the first time if they're screaming. And so we.

We've learned again from aba, that the visual alone doesn't work unless it's been paired with reinforcement and has that clear learning history.

So SLP listeners, or OT listeners, think about how you're teaching instruction like, you're going to be using this in those calm moments and then pairing that with reinforcement to create that learning history.

Yeah, exactly. So what we'll do at the clinic is we're using it kind of throughout the session. We're not saving it just for a transition every. Or a hard transition.

We're kind of using it every time. We're going from one thing to the next thing.

I wanted to take a step back.

Too, and talk about one of the pitfalls that you talked about is those abstract visuals. It's something that, like, just irks me so much. And a clinic perspective.

We'll see things like, I'm trying to think of a program name that we'll be running. Like Pairing, for example, as a program we run at the clinic where we'll collect data on how long the child's, like, staying close to an adult.

Right.

And so the. On the visual schedule, sometimes we'll see something like pairing.

Oh, and when I come in for.

Supervision, I'm like, what? No, no, no, no, no. Or sometimes they'll call it, like, therapist time.

Yeah, right.

Like, what does that mean?

Right.

And then it's a picture. Not of them. It's a picture of just a random adult or something. And I'm like, okay, this is so unclear to them.

Right.

And so those abstract visuals, I feel like. And then at home as well. Again, you don't have to be super specific either. It is a fine line. Right.

Like, we'll often say, like, you don't need their water cup, per se.

Right.

But it should, like, look somewhat like, if they have a sippy cup, I would use a right photo of a sippy cup, for example.

Right.

And so I feel like that's something that can sometimes be where, like, the visuals don't match what the learner knows or something like that. Using language, it's more like a different adult like, than childlike.

And it's not always so easy. Sometimes it's like, what should the visual be for this abstract concept?

That.

That can be really tricky too. So we've been there. I'm thinking of.

Just last week, I had a discussion with another BCBA at the clinic about what sort of representation we should be using for break. And that's tricky, for sure.

I don't know what the right answer is, but the one that they have on this learner's visual schedule right now is the two hands together, like, the sign for our break. And I was like, okay, guys. Like, that's so abstract. Like, I wouldn't even known what that is.

And so, yeah, we had an interesting discussion about it and I was saying, like, well, often in break, she likes songs and they want her to expand her repertoire. Anyway, it became like a challenge. I don't know what the right answer is, but I was thinking how abstract that little break symbol was.

Yeah. And this idea of break. Right. Is so abstract as well. Like, what is a break? And it looks probably different every time.

So I do like your idea of probably putting music, if that's what the break is going to be, or. And then the first breaks music and the next break is like the petals and flowers that you like to play with or whatever, you know. Yeah.

Would be my thought.

Yeah, yeah.

Sometimes we. Like. I'm not against a break card, for sure.

It has a time and a place.

It'S easy, you can use it across a lot of different examples, etc. But I do think it can, like, it's quite vague.

It's so vague. Yeah.

And then the pictures. Vague. The language is vague. Yeah.

So a little tangent there, but absolutely. Like, if we're. We want to be really conscious about what visuals were we're putting on there.

It was when you were talking about pairing, I was thinking probably half our listeners don't even know what pairing is.

Right. Like, that's a whole other episode.

Yeah, yeah, exactly. All right.

And so what we want to look at too, is that we want to check that the reinforcer has been assessed. So, like, is this truly valuable in the moment?

Like I was saying before, sometimes you might be asking them to do something that to them is a big effort with very little payoff. And none of us do those things. It's not. Again, it's not bribing. It's being respectful of our expectations of them.

Right, right, sorry.

And so the first time we do this, we want to make sure that the then is amazing. And then if it's not working, if my strategy's not working, I might not.

Instead of thinking first, then doesn't work, that would be the first thing I would look at is what did we have in the then? And should I rethink?

Yeah. What's your then? Shauna O.

Depends on the item, I think. Wine.

Yeah. After the podcast today, we're hoping to.

Go for a walk or something.

Right. Just be out in the. In nature for a little bit. Yes, that's a nice then for us. It is. Yeah.

Yes, for this time. But then again, like tonight.

Yeah.

It wouldn't be that motivating to me. I don't really want to go outside. Yeah, I want to be cozy in.

My pajamas thinking about the time of day, the context of setting. You're right. Exactly. Yeah.

And our motivation changes all the time based on. On a whole bunch of factors. Right. And so even right now, I'm thirsty. I was just having a hot coffee.

Now I'm like, oh, water would be really, really nice. Right. And so the coffee was sort of a setting event for my motivation for water. And so my motivation is changing all the time.

Our kids motivation is changing all the time. And something that worked the first time, you might find another time it's not working.

And so those are some of the things I might think about, like what was going on in the environment around then, what was the task I asked them to do and was my reinforcer a good option or not?

So funny, because we think with our learners, like, well, they love bubbles, like, why aren't they liking it today? But just like what you said, like, well, it's morning here where we're recording this. So coffee is what you're drinking.

But you know, if it was 5 o' clock on a Friday, we might be having a cider or something like that. And so our, you're right, our preferences and our motivations really change too.

So how can we expect our learners to just like the same things all the time in every context?

Exactly, exactly. We call those establishing operations and abolishing operations.

For my BCBA listeners, looking at how does the environment change what your motivation is for?

And some things create an effect that make you want something more, and then other things create an abolishing effect or like, get rid of your desire for that thing. A common example I'll use in toileting, for example, is you need the kids to drink so much liquid, hopefully, so you get lots of practice in.

Right.

And so I would give them lots of salty snacks, Right. So that then they become thirsty. And then I'm gonna have like a really awesome drink for them. And so they like, want to drink too.

But then my salty snacks make it so that hopefully they want to drink even more. And so those are some of the ways again, that you can kind of manipulate motivation in the environment.

Yeah, exactly. If you're potty training now, pretzels are on the table.

Exactly, exactly. Pretzels and pop, like for two or three days.

Yeah. Live your best life and learn to potty train. Perfect. Okay. I feel like we're off on a bit of a tangent, but always good.

So we're talking about the now next versus then board still. And Coming back to that, we want to make those sort of demands achievable. So behavioral momentum is a word that I've learned from aba.

And it's like, first at the table, then music. And then we can build that momentum by saying, like, okay, maybe first three math problems, then music. I don't know.

Is that making sense in terms of behavioral momentum? I always get nervous when I'm talking. I'm the one talking about ab.

Yeah, yeah. Like, we want to. You can think of it as regular momentum. Right. Like, how you might build that up.

Right, right.

And so in the. If I came in right away, I was like, all right, first you got. I think first you've got to do this whole math.

And they've never done a single math problem. Right, right. And then I'm just like, here's your math sheet. Finish it. And then we're gonna have a freezy.

Yeah.

Which might be like. Like, that could be a problem for so many reasons.

Not defiance, but could be because, like, it's a lot of planning to figure out, how am I gonna do this worksheet? What are the instructions? Do I know how to read them? Do I have a pencil?

Do I. I don't know.

All those things that come into, like, completing the math work, and then also the idea that I've got nine problems to solve on my own, and I've never even done one on my own, for example.

And so then what I'd be looking at at is I want to take a step back and really break this down, and then start probably at the easiest thing, which is just come into.

Sit.

Let's come sit. Make sure you got your pencil and your eraser and your sheets there. Okay, that's perfect. Let's take a break now and go do music.

And then I might come back and do another first, then. All right, first, let's do the first problem, and then we're going to do music again.

And then after we've done that, come back and be like, okay, let's see if you can do this first problem by yourself. And then I'll be over here ready to check it or something like that.

So I'm, like, kind of fading myself out, but I'm there to coach them and provide support along the way that I'm getting that success right away.

Got it. Makes sense. All right.

And then the final thing is to generalize it. I love these strategies. The first, then, and now next, because you can really use them across, like, so many activities.

All you've got a bedtime Routine if you're working on toileting, if you're going out to run errands, etc. And can be good for if you're not ready for a visual schedule, either as a parent or your child maybe isn't ready. And then we'll.

We are jumping over they are to visual schedules next. But I would say if your first then strategy is not working, don't think of it as a failure always.

Like look at all these variables that we talked about today and think about, okay, could I sometimes we'll change up the first then board to make it really motivating. So it's got Spider man all over it. Should I rethink when we're practicing this, did we have enough practice in like calm cool moments?

Should it be changing up my then strategy and all these types of things.

So using it as some data that we collect, adjust our expectations, change their motivation or change the way that we're delivering that now next strategy. And so we want to be flexible in the approach and not necessarily just.

Say, oh, this doesn't work. Right. Yeah, good. Very good point. Awesome. All right, I think that's a perfect segue then to start talking about visual schedules.

So visual schedules, you kind of zoom out to the whole day. And then we also think about it in terms of teaching, sequencing transitions and getting more independent. And so let's jump in.

Exactly.

These are big picture tools that can help organize longer periods of time usually than a first then, but not always, could be a same amount of time, but maybe more events that need to get done.

So I'm thinking in a bedtime routine or something, a visual schedule may be better, but it could be the same length of time as like doing first brush your teeth, then book like maybe that is all you're doing in your bedtime routine. And so it is the same amount of time, but you might break it down more in that visual schedule.

And so for many of our neurodivergent learners, visual schedules are the difference between calm engagement and total chaos.

While for others, I actually find the visual schedules are anxiety inducing, they actually can then become stuck on what's coming up instead of being able to live in the present moment. And that might be another time, clinically or as a parent, that I might shift away from using a visual schedule.

And so I'm really looking at how the tool is functioning for that individual.

And so in aba, we use these a lot, all about task sequencing and creating a reliable structure so that it's predictable, reduces uncertainty, and then it provides that Signal of what's coming up next with the goal of the child or individual being able to use it independently to understand how they can transition and be more autonomous, anonymous in their everyday life.

There's such a link.

Then we're seeing is a lot of parallels in between the first then board and a visual schedule because it can help them stay regulated throughout the day or just in a therapy session or at school by giving them those clear expectations so they know what's coming next, just like the now next board. And so it can be easier for them to stay focused and calm in that sort of happy, relaxed, engaged kind of state. Like calm and cool.

What you just mentioned, I like that too.

But I'm the same way, like if I walk into a meeting or without a clear agenda and I've got other professionals that we don't collaborate all the time together. Like, I want to know what the schedule is so that I can feel regulated myself. Otherwise I'm feeling scattered.

So sometimes I'll just be like, okay, we need an action plan here. Here's what we're going to talk about. And so I think we all kind of have that exact need for that.

Exactly. And I think as adults we sequence so many things all the time and we have so many priorities up in the air.

And so it's sort of it being becomes something that you do naturally.

Yeah, yeah.

And so what a powerful tool to give your child to that they can start learning. Like all of those complex planning and task initiation and execution skills. But like any tool, it'll only work if it's used strategically.

And so a schedule with 15 icons, four types of arrows, a different color for every subject. That's not going to work. That's going to be a cognitive trap.

Exactly. We've seen visual schedules that are more confusing than clarifying. So we want to keep it meaningful.

We want to tailor the number of steps to our learners. Really want to think about what those symbols look like we talked about already. And then the layout is also really important.

Everything to the learner's discrimination skills and visual scanning ability.

Exactly. I think those are really important things and very similar to the common pitfalls we said with the first then or now next ideas.

So don't forget about personalizing it. And again, looking at where what your child prefers.

So like I said, you could have something really simple like paper pencil and make a new one every day. Make one at a restaurant on a napkin. You could have Velcro schedules other kids might really like. There's some really cool apps that you can get.

Some prefer real photos, some might like cartoonish images. And so seeing what the child likes and then sometimes even involving them can be a really nice strategy.

Because if you're scheduling is aversive to the learner, to your child, of course they're not going to want to follow it, right?

Yeah, yeah, that's so true. So then we're thinking about why this works and sort of how it works. The visual schedules are fantastic supports for executive functioning.

So again, talking about that front part of the brain where we're looking at working memory, planning, shifting tasks, that kind of thing.

Exactly. So you're building that visual framework.

Instead of needing to remember multiple instructions or to come back and clarify with you or rely on your verbal instructions, the child can refer to the schedule to navigate the expectations on their own and kind of check in throughout the day. Okay, we're like, you're saying like with the one that we have here, then they're like, okay, right now we are having lunch after lunch.

Oh, it's like rest and recharge time.

Okay, I know what to expect.

Yeah, yeah, exactly. And then it's also teaching them that cognitive flexibility.

Like if a change happens, we can show it visually with either with that change card or something like my change unicorn I think we talked about in a previous episode. And sometimes those changes aren't necessarily scary, but we can sort of change things up and again show it visually.

So the post it notes is a perfect example of like what we're using today. Here we've just got those like rest and recharge and brain challenge. We've kind of identified, made it fun in our visual schedule.

And we can just change the order. You know, like yesterday we thought we were going for a bit bike ride right after lunch or whatever it was.

And it was like, actually no, it doesn't make sense because somebody's napping. So we're going to change this up. And so just a shift there.

It helps visually understand what's going on when time is challenging and so much going on.

Exactly. And that then gives our kids some independence. Right.

They can kind of work within the framework that we've set up and helps reduce that, like kind of nagging a feeling of us being like, and this and this and this. And then I was thinking the other kind of fun thing that we've done is we came up with fun names for each of the things.

So we want them to like, do some schoolwork while we're here or like some more academic type things and. But we didn't call it school. Yes. Actually learning it. Right. Yeah. I truly can't remember the name but like brain boosting. Brain boosting, yeah.

And then our picture is of a brain that's like really cool and strong. Yes.

Perfect. So I think, I think as parents, like we end up being like marketers almost. Right.

You're trying to like sell something, give it a fun spin versus like calling it a really boring name can be one strategy to help for sure.

Yeah.

So these visual schedules can be really helpful for kids who struggle with emotion regulation too, especially when transitioning.

So at the clinic we certainly have some autistic individuals that can struggle transitioning and actually I would just say all of us can struggle transitioning back.

Yeah.

At the clinic we work on this a lot.

Yes.

But at my own house I think about it too.

And so some the of of the things I often will say to our staff to think about with transitions is go from like a really dense schedule of reinforcement. So like doing like your most favorite thing all the. And then we would call it an aba, a lean schedule of reinforcement.

Like going to the bathroom or like washing your hands. Like no reinforcement. I don't want to do this at all. Is very challenging. One of my favorite tools at the clinic is like a transition hierarchy.

I like to think about it. Or a transition ladder. And again this is supported by research as well.

And so going from like a really highly preferred activity to like a moderately preferred and then maybe into that non preferred.

So instead of going like from the iPad to bedtime or something like that, I want to have like a bit of a ladder approach where I'm helping them kind of work down from their like most favorite thing into that non preferred thing.

And I find that can be really helpful for kids that are struggling with transition transitions can help give them some of those tools that they need to transition more effectively in the future.

Cool. All right.

So when visual schedules don't work, we're usually looking at kind of three common pitfalls with them. So either when the schedule was first introduced, there wasn't enough prompting support and or like reinforcement provided for following it.

It's not matched with the learner's scheme skills or using it inconsistently. So it's used one day and then forgotten the next.

And happens so easily. Yes. So it is hard to be consistent as a parent, I know that for sure.

And sometimes my like daughter will prompt me to say yes, hey mom, what's on the schedule? We haven't updated it yet, so sometimes I'll put Like a reminder in my calendar, like Sunday night, go through it with her.

And I try to do that, like, oh yeah, this week we're going to be doing this and so let's put that special thing on the calendar. But that consistency is so tricky. And so sometimes too if the, we're talking about pitfalls now.

If the schedule is not visible or like easily accessible to the learner. So we've all had these like seen these beautifully laminated boards left on the counter.

And so if it's not within the child's view, it's not going to like cue anything or help them like learn what's coming next.

And I wanted to take a step back and remind me of someone at the clinic, one of our amazing team members who's I feel like nailed using visual schedules. I wanted to like post this video to the world to show how amazing think she's doing it. I think you know who I'm talking about.

The therapist actually wears button down tops every time she's with this one client who benefits from the visual schedule. It's like a long schedule that she has and so she wears it and she's like clipped it to her top button and it's so cute.

So the schedule is like right on her body no matter where they go.

Because this learner also likes to walk.

Around and they're not just in their treatment room, they're like going for walks over to the sensory room or like through down the halls and stuff. And so amazing therapist. And yeah, she's got this like beautifully laminated visual schedule clipped to her top every time.

And it just means it like so easy for her to use.

Exactly. And we've all seen those schedules with steps that aren't functional. We talked about this a little bit with using kind of vague visuals.

So sometimes I'll see things like circle time on the schedule. Um, and sometimes at the clinic we do have a consistent circle time. Like it follows a very consistent pattern of activities.

But other times there's more flexibility. And so this idea of circle time on a visual schedule for some learners might be totally fine. But for some of our other clients, what is done?

When does circle time end?

I see.

I don't really understand. So the child's just like floating through space, you know, like, okay, I see that we're in circle time, but I don't really know when this ends.

And so then they're kind of confused.

Right.

And so the intended use of the visual schedule schedule is lost because the child doesn't actually know what Circle time is or doesn't know when it ends.

Right.

But like I said, some children or if you've got like kind of a consistent routine that you follow, then it could be just fine to have circle time. So that's where you gotta kind of think about your use and who's using it and what are their skills.

Right, right. And so how do we fix it?

First reinforcement, of course.

So I want to pair the schedule early on with reinforcements, like I was saying before, for building that behavioral momentum by only having one or two items maybe on the schedule at the beginning. Over time I'm gonna. And I usually have an awesome item.

As my last item on the schedule.

So I've got. And maybe first time I'm using it, it's just one item and then a reinforcer preferred activity.

Right.

And then I'm slowly gonna build that up.

And so, for example, if I wanted to introduce an after school visual schedule in my house, I want them to unpack their lunch, grab a snack for themselves and start their homework. I'm probably not going to go in with all of three of those right away on my visual schedule because I've never done this before.

Right.

And so I might just start with unpacking their lunch. And then I'm also going to be there. Yeah, I'm going to help them know how to unpack it. I'm going to let them know they're doing like the right thing.

And that's a good job. And then the next item on the schedule could be like playing with your leg all which is something my son really enjoys right now.

And then the next item on my schedule could be that they're grabbing a snack, but I'm there to support them again. And so I'm adding in that prompting and support and then I'm breaking up the tasks with breaks with their like favorite things.

And so that's sort of how I would tackle it at the beginning.

We did that last summer with my young girls and they loved it. And they also liked the interactive nature of it. And so they were like checking off their items. But in ours I made like a strip.

And then they would peel the piece off, which is often how we're using visual schedules at the clinic and to. So they would be the one to like peel the things off.

And then once they became really comfortable with it, they would sort of decide what order they wanted to things to go in. So like taking lunches out was something that we had.

So after you get home from camp or whatever, you're taking Your lunch out of your backpack and then maybe doing a little bit of brain busting, kind of learning stuff. And then it's like free time playtime.

And so they would like kind of rearrange when they would do stuff like maybe I'm gonna put my snack away just before free time or something like that. So I'm sure go for it. And so it increased the buy in a little bit by having them like move the icons around and build the schedule.

And then it also promoted that like self monitoring. So they're checking in and I'd be like, oh, yeah, as long as we get all these things done, then cool. We can have whatever free time you want.

Exactly. Love it. So now the schedule becomes a tool that supports them being autonomous and developing their own, like you said, sort of style.

Like, I don't want to empty my lunch right away. I prefer to get right to work and then I want to empty my lunch. And again, we all make those choices.

And I think it's just respectful to our kids to give them the opportunity to make choices. Some, like, some kids won't care. Let's follow the schedule. But if you do have a preference, great. You put them in any order.

And we often do that at the clinic as well. Be like, all right, we gotta get math. John, we gotta do some language activities. And I really want to chat with you about recess time.

What's the order that we should do that in? And getting that buy in right away.

Yeah.

So it becomes a tool.

Yeah.

That provides structure.

Yeah. And speaking of it being a tool, it's actually more than just a schedule or like, it's more than just the routine itself.

They're tools for building language. Like we talked about independence and regulation.

And so when this tool is used clearly and consistently, they support those transitions, that emotional flexibility. And then I was thinking too about how we can use it for sequencing and retail.

So, for example, yesterday at the end of the day, I was Talking to my 5 year old and he said, like, what was your glimmer? What was your glow from the day? And we did so much yesterday.

And I knew that she was only thinking about those, like, last two things kind of that happened before dinner. And so I got the visual schedule in my mind and I, you know, had we been out where it was, we could have used the visual.

But I was like, well, first we did this and then we did this, and then we did this and then we did this. And I know in her brain she was like, oh, wow, that was all. And so like, we did so much cool stuff. Right.

And so I was thinking about how the visual schedule helps that building the language too. Because for a child at 5 to be able to come home and for the parent to say, like, how was your day?

Like, especially if everything's new and exciting, they're at camp or they're like doing something with a new friend or something, like, being able to go through the language of that is very challenging.

Yeah, for sure. And same kind of thing that we said with the first then now next. Like such, such powerful tools.

But if it's not working for you, don't like the tool is ineffective.

Yeah, true.

Kind of think about those environmental variables that we can play around with.

Adjust the layout, change how you're supporting it, add in a little bit more reinforcement initially and so evolve the schedule with your child or with the learner and adapt and take their feedback along the way.

Love that. Yeah. It is not just like a one size fits all either. Like you can change things up. Exactly. Awesome. All right, let's move on to social stories.

Social stories. Let's talking about them. They're quite popular in the SLP world to prepare kids for new situations.

I've honestly, I've seen them used well and other times a bit of a band aid solution. Almost like they need to be used with purpose. And not every challenge calls for a story. And so let's talk a little bit more about them.

Like what they are, what the research says and when they're used. Well, and then when they. Maybe it's not the best strategy out of the toolkit.

Yeah, exactly. I think there's some really interesting discussion in the ABA literature around social stories. Some of it's a bit combative.

I think some behavior analysts are in the discussion anyway, suggest that the social stories by design don't include enough components in them that really result in change. And that's what we're going to chat about.

Yeah, yeah, yeah.

And so I used to like the word social stories would make me like shiver because there was so much discussion in the world about it. And now I've like sort of come up with my own own way that I like to use them.

And so I prefer to call them contingency stories where they map out like a cause and effect relationship or a social narrative is a more general term for them, that way of talking about something they've maybe never experienced before, like a fire drill or something like that. And so what these tools are.

So we've got like social stories are a trademark name and then More broadly, the social narratives is really probably the wording that we should use.

So they get tossed around a lot, but they're not always using the men using the way that they were meant to be or should be to actually result in outcomes or changes.

Right.

And so social stories, or social narratives, sorry, are story based tools, often with pictures and they can explain a social situation or expected behavior.

And the idea is that it helps people anticipate and navigate things like making a friend or asking for help handling a loud arena or something like that.

Yeah, exactly. And so I've seen them done, made beautifully.

Sometimes they're like using real pictures from the child's life, but we want to make it meaningful and not overwhelming.

Exactly. So what I think of first is intention and clarity. So a good social narrative isn't just pretty, it's tailored to the individual.

So I'm thinking with intention and with a clear goal mind.

Yeah.

Though like I said, the social stories are a trademark strategy. They follow specific guidelines written in the first person using positive language.

I think you have to stick to a two to one ratio of descriptive versus directive sentences and that sort of thing. So they've got some more specificity around it if it's a social story. Whereas the social narratives are much more broad.

Yeah, right, right. And so you were talking about intention and clarity and like having that in mind before we create a story or a social narrative.

And then from the SLP side, we're thinking about that comprehension load too. So are the visuals, we've been talking about visuals a lot. Like, are they concrete? Is the language accessible?

So that's something that I find is where I might, I kind of get that like icky feeling sometimes when I hear like a social story used for a learner and like the language is not accessible for them. So keeping that in mind, does it match the receptive language skills? Like, are they understanding what's happening in this story?

And then for some kids, a single picture might do actually more than a paragraph.

Exactly. Yes. Are we using too many words? Is a question I often have to ask myself. Or I'll use when evaluating something our team creates.

Yep.

Are we piling on too many visuals at once or are our visuals too abstract? What are those common ones for social media, those stories? I think they're from Board Maker, something.

Like those little stick things.

And so many of the pictures I'm like, I would have no idea what that means.

Totally. Yes. And that's a good take home message from all this whole discussion about visuals. Like if you took Away the word would. I don't know what that is.

And if not, then we maybe question it.

Right? Yeah, yeah, exactly. Like from an AVA perspective, there's something to be said with like pairing an abstract.

Like you could pair any visual with this scenario and do like, Right. Team teaching. But I think it adds in like a complicated layer to your teaching that really like a better visual could just solve.

Agreed, agreed. And, and on the flip side of that too, like thinking about, you were talking about visuals like too many.

But then there's sometimes visuals that are like way too generic too. And so visual schedule and the visual says like be kind or something like that.

It doesn't really mean that much unless we're breaking it down with like real life relevant context. Like being kind with your sister maybe, or something like that. Especially if a child has difficulty with perspective taking and inferencing.

Yeah, exactly, exactly.

Or like gentle hands is something that.

I've seen come up.

And so like what is gentle hands?

Right.

Is even something like I've seen like a quiet mouth.

Yeah.

As another one. Like if the child knew what loud and quiet was, then maybe that's how helpful.

But if the child has a language delay, they probably don't know loud and quiet.

Always reminding the ABA team of that. Or like any learner or any instructors in the clinic. Right.

Like, okay, you're telling them these things, but I bet you if I probed like, do they know what you know? Loud and quiet is a huge one. These are concepts that are actually really hard.

Like we assess a lot of our learners using this basic concept scale and concepts are just tricky.

Yeah.

Like they do really, really well with concrete things like numbers, colors often. Right. We'll see that.

And then as soon as I get get into like high versus low or long versus short or loud and quiet, like those are tricky and they're abstract.

Exactly. And that's where a story is probably not going to do it. I'm not saying you can't say I probably wouldn't use quiet mouth.

But yeah, gentle hands or whatever. Not to say that you can't do it, but a social story is not going to do that for you because they don't know what gentle is.

They don't know what kind or quiet or whatever that descriptor was. And so you need to do like in the moment teaching. And that's where a social story is not going to be your answer.

Right, Got it.

So visuals aren't just about teaching social skills. They also support executive functioning and self regulation.

We've been talking about executive functioning a few times in this episode already.

So again, things like transitioning, planning, managing our emotions, a social story or a social narrative might help a child anticipate what's coming next. We've also talked about that lots today and then rehearse how to handle it.

And this is where the social story is a little bit different than some of those other things. This is now more like the rehearsing, like what comes next and how am I going to manage through that or what am I going to say?

And so it can like cognitively prepare them to reduce that anxiety and like it gives them the language for what to do in that certain situation. Which is different from like a visual schedule, right?

She really enjoyed swimming and her mom had signed her for swimming lessons. And after the first lesson, every single time, the transition in was so challenging, but we didn't really know why.

And so we created this so short social narrative about like what to expect when she's at swimming, including like the sounds and the smells and like if it. We thought maybe it was like, like a lot of people.

So if it's too busy, we had like some hypothesis together or we had some hypothesis about what could maybe be impacting her ability to attend the swimming lessons.

And so I put the story together and then I'm reading it with her and she mentioned that the hand dryers are really loud and then the automatic flush on the toilet.

And so that was so it's like the story actually gave like an entryway into us having this conversation that then I was like, ah, okay, hey, I can help with this. We can come up with strategies.

Yeah.

And so it gave us really good insight into like what are some of those next steps that might make this easier for her. And so that was like an awesome strategy.

Whereas I've also seen young autistic child like three years old, we see this often be given a social story about not hitting. Most children, whether they're neurodivergent or not, are not hitting because they want to hit someone.

And so the instruction of don't hit or gentle hands is like really unhelpful. And so that's where a social narrative telling a three year old not to hit is like unlikely to be successful.

Kind of like what I was saying before is like they're not hitting on purpose and then they don't know what else to do in that Moment like.

Their body is dysregulated.

And so a lesson about kind hands.

Like, what are those?

I know, it's like just like not gonna be successful. Real world practice.

This is really good parent listeners too. Like, I know as a mom I've got at least two kind hand types books on my bookshelf for sure.

But you're right.

Like when my 2 year old was going through that hitting phase, I thought, oh my gosh, we need all the books about kind hands and gentle hands.

I'm read all them and like it's a different, it's not a social story, like trademarked, but this is like a different way of talking about in kind hands and hitting and stuff. And I know, like I knew that this isn't gonna lead to behavior change, but they're out there. There's so much.

Yeah, I think the stories are just like too complex, too vague. But like you said, it's not like teaching in the moment and that's the biggest thing.

Like, and then you're also not whipping out the book if they are hitting.

Yeah, exactly, exactly.

It's like, like you said, like, sure, maybe buy the kind hand book and it gives you something to chat about with your child if they're at that language ability. But then I'm gonna go in with like real life practice and that, that's really my preferred way of using social narrative.

It sets up like a stage for learning and then I'm still going in and doing that hard work with them in the moment.

Yeah, yeah, yeah.

And so that brings us to some of the research. And so the evidence is very mixed, as they sort of alluded to before.

Leaf and colleagues have done a few articles on it and they're again, a little bit contentious. I. And so they reviewed 15 studies and found that only one showed convincing evidence.

And I think really if you boil down that research, it's really looking at either the social story or social narrative was not well matched to the learner or there wasn't that real life practice. It just didn't result in the behavior change.

And so really your population or the learning profile of the person is a critical factor in knowing if a social narrative is going to be effective.

That makes so much sense. That's exactly what we're saying. Like if the ma.

If the story doesn't match the learner and their abilities in terms of their language or their cognitive level, then it makes sense. It's not going to like work. And then if you're not doing that work in the moment of Course it makes sense also that it's not going to be effective.

So I think that's we have a shared mentor, we've talked about her quite a few times. But I know from her like she would always say like social stories and they've been around forever. Right. Like they've been around since 90s.

And so in previous reviews, over 90% of studies only showed partial or no convincing evidence. And that's what I can hear Tracy saying in the back of my mind.

Yeah, yeah, exactly. And for me again, as an early career behavior analyst, I was almost like afraid to use the word. Right.

And still I would say I'm pretty protective or I don't know, I, I, there's so much snake oil or pseudoscience in the world that I work in, like in autism, some services. And so I'm like really cautious to even slightly promote something that doesn't have.

A lot of evidence behind it.

And so that's where social stories I think can become or feel a little bit sticky for me. But I have found ways to adapt and use them in practice. Certainly now that I'm clinically more knowledgeable, I can find those nuances.

But I think sometimes we think of these as like a really broad strategy that can work for many learners.

Yes.

With the way that we started with social stories or social narratives.

And I think we're just like fine tuning the science every year and sort figuring out what are those ways that you can use them in a way that supports autonomy and is respectful.

For sure. Yeah, we'll put that in the show notes.

And there's also, I think some executive functioning targets like following multi step directions, initiating joint attention and some of those big skills.

Yeah. But I, I do think the paper mentioned that the effectiveness varied depending on the study and the goal. So they did sort of like a big review.

And overall the takeaway from the Como article was that yes, these are widely used and we know that clinically, yes, they can be helpful, but we need better research to say yes for sure.

And then we also just want to be so careful if we're trying to take information from that study to say, is it appropriate for my learner in this situation, their language, et cetera.

Exactly, exactly.

And then we're also looking at another thing we could consider with these social narratives, just to kind of wrap it up, is similar to how we said with the visual schedules is the mode. And so there's interactive apps that you can get to make a visual schedule. You can draw it out.

And so personalizing the content, content can be like super helpful. So yeah, like customization can really be important in helping the child and having the child co create the visual with you.

So they could draw it, they could help choose images or they might even help you write the story. And so with social narratives, here's where we land.

They are popular, definitely.

They have face validity, they have some validity, are often part of naturalistic neuroaffirming approach approaches. But the rigorous experimental evidence still leaves a little bit to be desired.

Yeah. And I like how you said using your clinical judgment to kind of bring the best out of it and using them thoughtfully.

We are going to individualize them, we're going to pair them with real world practice, real world, real world scenarios that are from that child's life. And then we're going to track some data, get curious, stay curious, see if they're working.

Exactly, exactly.

So.

So let's switch over and chat about the comic strip conversations.

Yeah, yeah. These are such a fun visual way to support emotional expression and social problem solving. Yes.

This is one of my all time favorite strategies, especially for clients that are working on perspective taking and emotion regulation. There's just something about putting emotions and thoughts into pictures that helps make those abstract social media social concepts click.

And I like the flexibility of this approach.

What's a. If you were to say like what's on a differentiator between a social narrative then and a comic strip conversation?

I find that comic strips are a little bit more dynamic in the moment. So I'm gonna use these throughout my session. Whereas the social narratives tend to be more like static. Right. Like we're reading about a fire drill.

Okay.

It doesn't really change every time, like the story doesn't change. I'm reading that same social narrative Right. About the fire drill so that they get used to what to expect.

I'm usually using comic strips actually as a problem solving strategy with the learner.

In a Session in the moment.

Yeah. To be like, okay. Like, usually the parent might say, oh, they hit someone at school today because they closed the door or something.

And so I'm gonna then use that information and then work through a problem with them using this, like, comic strip style. And.

Yeah, cool. I have. Honestly, when we were prepping for the podcast, I didn't heard of this one. And so I looked into it. I think it's really cool.

And I can see it being such a valuable tool in the moment to help with language, cognition, and, like, social pragmatic skills. I like it a lot. Yeah, thanks.

I love it. From a behavioral perspective, what we're really doing is shaping complex verbal behavior.

We're teaching kids how to label their own pragmatic, private events, like their thoughts and feelings, to discriminate between their internal states and their external behavior. So their internal state, I feel angry. My external behavior, I hit.

Right.

I am supporting foundational things like self monitoring, behavioral flexibility, ability to sort of look back on something and how I behaved and reflect. And so I've had so, so, so many client breakthroughs using this strategy because you do it together and you're getting their input along the way.

And we have the. When they have the opportunity to explain their thinking in a situation, it's so insightful. They. Oh, okay. Well, that's really interesting.

I would never have guessed that that's what you were thinking in the moment.

Right.

And I see where the misunderstanding happened here. And then I can help them.

Especially because most of the individuals we work with with have trouble with social communication and perspective taking and emotion regulation.

Yeah, that's the, the number. Like, those are the three top goals. I would say we're working with our, like, teens and youth with autism for sure. All ages. But.

And so when, like I said, this wasn't very familiar to me as an slp, but when I looked into it and prepped for the podcast, the structure is really simple.

So you draw out a social situation, you're just using stick figures, and then you're using speech bubbles for what was said and then thought bubbles for what people have been thinking. Again, like you said, it helps give a window into, like, what that child or learner might have been thinking about.

And that's where those big aha moments coming in.

Exactly.

And, like, tying into theory of mind and perspective taking, that ability to know and understand that others have different thoughts and feelings and information than you do. So, like, if I didn't see it, I can't know it. If I didn't Hear it? I don't know it. If mommy didn't hear it, she doesn't know it.

Right.

And so some of those types of perspective taking skills and then because it's a visual and a comic, I often find I get a little bit more buy in. And it gives me a lot of flexibility too. I can incorporate their special interest very easily. And like, a lot of kids don't really want to.

Like, if you're just like, hey, I heard you hit Jimmy at school today.

What happened?

Yeah, they're probably not going to say anything.

Right.

And so actually when I do this strategy, it's like certainly for the first, like long time that I'm working with them, it's never them in the situation.

Yeah, yeah.

It's not that you hit Jimmy, you know, like, I just like change the details a little bit so that it's a little bit dissimilar from the situation that their parent had told me. And then also I'm not like criticizing them right away, you know.

Yeah, it's not meant to be punitive. It's not like you gotta tell me and like, I'm gonna get you in trouble kind of thing.

It's like working through it so we understand how to help them in that moment.

Exactly.

And so we're working through it, like, what did you say? What did they say? Or what were they thinking? What were you feeling?

And we're literally drawing out and then the options, like, what could you say next time? And I like how that sort of slows down time for a bit and gives you a chance to be like, okay, what could you say next time?

And you're taking that time to write it out.

Because we all know that in the moment, in the real moment of when things are happening, getting the perfect thing to say is hard no matter who you are.

Exactly, exactly. And that's where like social problem solving really peak can come in.

We're reinforcing those alternative behaviors, talking about what those alternative behaviors are so that the social responses that are more likely to result in reinforcement are the hopefully then becomes a tool in their toolbox that they can use.

And I like how it's like low pressure, like you said, just use it in the moment, grab a piece of paper and then draw it out. And it. You don't have to be a beautiful artist. I certainly am not myself.

And then you're taking, taking away that like you, you're helping them through those moments and you're taking away any like, feelings of shame or anything like that. You're not lecturing. You're not like punishing them. You're really just collaborating to help learn how to do it better.

Yeah, exactly.

So many of my best sessions have just been stick figure masterpieces, complete with exploding thought bubbles, angry scribble clouds, big oops moments. But it creates like joyful learning. We can laugh kind of about what these things are happening.

The kids are reflecting on the things that have happened to them and they come away with a better understanding of themselves and the people around them.

Yeah, I love it. It's a really cool strategy.

I want to start using this in my sessions because I find it creative, it's empowering, and it's one of those tools that you can really grow with a child too. So if they're five, you might be doing it a little bit differently than with their 15 and just like help make sense of those messy moments in life.

Exactly.

Cool. All right, so take that one and we'll put again some more resources in the show notes.

But if you're a teacher or clinician, that's a cool strateg strategy you could start learning using tomorrow in your next therapy session. And parents too, of course. So next, let's talk about video modeling. This is another visual support that we use and it's seriously underrated.

I know you and I've talked about this many times. I've even taken videos like, of our own kids, like playing with toys and stuff. But video modeling can be used for so many different things.

So whether you're teaching social skills, daily routines, emotional regulation, it's one of the most low efficient and then what we call low lift. And so like easy to use and actually fun tools that we have in our toolkit. Exactly.

It's one of those strategies that hits so many core learning targets with minimal prep.

So we're looking at observational learning to teach a specific behavior and then reinforcing it once it shows up or providing some structured opportunities for it to show up.

Yeah.

So it's again like coming back to promoting language processing, sequencing, social pragmatic understanding, and you're showing not just telling how something is done. And so for many, many kids, that's really what clicks.

You're not just saying, okay, here you first you're going to do this, then you're going to do this and you're going to do this. They're like seeing it in the moment happen.

Totally all about reducing that response effort.

So instead of remembering complex verbal instructions from their parent, like, go to your backpack, get your lunch, unpack it, go get Your math, et cetera. Then they can see the entire sequence modeled in your house. And often with natural reinforcement just built right in.

Yeah, exactly. And then the beauty of it is the video can be rewatched again and again. You can pause it, talk through it.

I'm laughing because I'm thinking about the equipment to set up this for the. This is so tricky. And I'm like, if so my husband Evan usually helps us set them up.

And if he were to just be like, okay, well first you do this and then you do this and then you do this and then you do this, I'd be like, I have no idea what you're talking about. But today we watched him do it and like, maybe I should have videoed it.

We should have.

Yeah. And then we just watch that video again and then we know how to set it all up ourselves.

Exactly.

That's really cool. You know, all of us are learn often well by like watching someone do something.

Yes, exactly. And then it also taps into rule governed behavior.

So we want to create a script or like a flow for the video that the learner can then start to follow these generalized rules from what they're observing. Like when someone greets me, I greet them back. And then it's also an aba, we call it cheap chaining.

So you model one thing and then that thing is like the trigger for the next thing. So first you put the toothpaste on your toothbrush and then you put the toothbrush in your mouth. Then you start brushing that first activity.

Then as their signal to start the second activity. Can't go into brushing your teeth if you don't have the toothpaste on.

Yeah, exactly. And then if we want to shift and talk about best practice, then what you were just saying there, the example is exactly what I was going to say.

Like making sure the language to the video is matched to that learner's level. So I like in your explanation there, you're like, first I'm going to do this and next I'm going to do that.

You're like embedding some of the strategies we've already talked about first, next, and then just keeping it really clear.

And so if the model in the video was using like these really long, complex sentences, but the we know the child's processing or like language level is more at like a short phrase, they're going to miss that key info. So making sure that you're not like having just something really complex again, just like the social narratives we talked about.

If it's too complex for that learner's level, then they're really not going to like take what we want or they're not going to take what we want away from it.

Yeah, exactly. And similarly in aba we're saying like be precise.

Y.

And so I want to choose a behavior that's observable, measurable, achievable, and initially I want to be really consistent. So if I want to teach them to say my turn, for example, instead of hitting, then the video should use that exact phrase of my turn.

Right.

Can I have a turn, is it my turn, etc. I'm always using just my turn for now. And then once they're doing that consistently, then I might add in some more variation.

Yeah. And there's a learner at the clinic. I'm thinking maybe we should try this strategy because it's hard for him to do that exact same thing.

But I was thinking we want to consider the model and so I could just radio record myself doing it. An adult saying my turn please, or whatever. But peer models are great when you want to promote that generalization.

So that's a term we use often, but for parents it just means like outside the clinic. You know, I want this to be generalized into the school setting and at home.

And so adult models can work, but we've seen better outcomes when the model is someone the learner can relate to.

Yes. And keep it short. Yes, 30 seconds to 90 seconds really should be the longest. Maybe if they're older you could go a little bit longer.

But you don't want to give up too much information that then it dilutes any meaning from the videos.

Yeah, cool. Good point. And again, I wouldn't have thought of that. So when does video modeling not work? Let's talk about some of those pitfalls.

I think similar to the social narratives, when there's a lack of structured practice sessions and reinforcement. So watching the video alone is not going to change their behavior unless there's some sort of follow through.

And so either the individual has like a value and wants to change that, like has the motivation already. And then maybe, maybe watching the video could be enough. But for most of us, we're going to need some of that practice time and support.

So we're going to prompt them along the way, capture them doing it successfully, reinforce them immediately. If we're not reinforcing, then we don't expect them to be learning a new skill.

Right, right.

And so we also don't want to teach something like too complex too soon, like we've talked about Lunchtime routines, for example, people like, we're not going to show them the full lunch time routine when they haven't mastered, like, some of the individual first steps. And so from you or your world, I feel like task analysis, what we would bring in here. Right.

It's like breaking it down and then maybe even like filming each part separately.

Yeah, exactly. Like, keep your video short. Right?

Yeah, that would work really well for if you had something that was a bigger picture skill and then another one I see sometimes is like a mismatch of the context. So the video shows a skill happening in a different environment. Environment maybe like meeting, greeting a peer in a classroom.

When they only see that peer at the park, for example, they might not generalize it on their own. And so it's better if we can do it in the right environment.

Ah, very cool. Yeah. Right.

And then one more thing I was thinking about if the learner isn't attending to the right part of the video, so they might like, focus on the background music or something or like, miss some of the social cues. Do you think that probably happens for sure?

Yeah, most definitely. If there's, like, too much going on.

Yeah, yeah, yeah.

Other things to pay attention to, especially with our neurodivergent learners, we know sometimes they can either see really fine details and miss the big picture, or sometimes only seeing the big picture and missing those small details. Um, and so, yeah, that can definitely be an issue. And we can fix that by previewing the videos with prompts.

So let's look at how he asks for a turn, and then I'm gonna play the video kind of thing.

Cool. Right. And then you want to also, like, watch the video and then practice it. Right. So you're going to watch the clip, talk it through, or maybe prime.

So with a prompt, like, let's look at how the boy is going to practice asking about his turn or something. And then we're going to watch it and then we're going to follow through with an activity.

Yes.

Where I'm going to be right there supporting them and, like, reinforcing them for doing it. Practice, practice, practice, practice, practice.

Ones that are truly just practice and others where you're setting them up for success, but in the real world.

And then, of course, my suggestion is to collect a little bit of data, whether it's formal or not, track when the skill appears and under what conditions, and that helps you figure out how you might tweak your video model or your reinforcement plan and know when they're ready to do it without your Support.

Right, right. And then really cool add on too you could do is like have the child themselves star in the video.

So we call it video self modeling and it's been shown to increase engagement and motivation, which makes sense.

Exactly. I love it. Also a great trick.

If they're hesitant to try something new, you can show them succeeding on the video and get a model and reinforcement history kind of all in one.

Cool. Yeah.

So whether you're working on brushing teeth, asking for help, or handling a tricky emotion, video modeling gives kids that front row seat to see what that success looks like. And I think that's where the difference comes in. Some of the other tools.

Exactly. And like, obviously kids love screen time.

So yeah, that's it.

But keep it close, clear. Sure. And make sure to set up those times to practice and reinforce the behavior in real life so that they are able to try out the goal.

You can figure out if maybe you need to change your phrase or change the strategy slightly. And so that in the moment practice is so, so important.

Yeah, I hear that.

And that's something again, for some of those non ABA practitioners listening to this, those are some of the take home things that I would think, like If I'm an S. L.P. here, I want to remember to like extend it beyond just the story or just the video or just the visual schedule or whatever it is. And like practice those in the moment teachings.

Exactly. And like even with my young kids, my two and a half year old is biting right now. He will usually say like, that's mine, give it back.

Like some sort of phrase. And then the person, the child does not. And then he screams and then he'll bite them. So it's like a very predictable pattern.

And so in his case, sometimes I'm fast and catch it and other times I miss it. And so even right in that moment, I'm stopping, going back and saying, let's do that again. So my turn. They say, no, not right now.

And then I'm there providing that coaching so you don't scream and bite. So similar idea.

Yeah, very cool. Okay, so then next up we're going to move on and talk about visuals for goal setting and progress tracking.

This isn't something that I think most of you will think about when I if we, you know, we told you our podcast is about visual support. And so this is kind of a cool thing that we do.

In the clinic that we wanted to share with you is another potential take home for your school setting or home or your clinic. It's where we shift from Visuals that support those day to day routines. That's kind of everything we have been talking about to this one.

That helps build motivation, some independence, self determination, kind of like self pride I would call it. Like hey, I'm actually getting somewhere. And the visual shows me how well I'm doing.

Doing exactly. I think you and I are so aligned in this. Like we try to talk about values and even for the young kids, like what are your values as a 4 year old?

Right. Even 4 year olds have goals and values. And so I think that's where I love this strategy.

Combining kind of the science of behavior, what we know works with hard and compassion and autonomy and pride. Like you said, it's not just about shaping those individual behaviors.

It's we're supporting kids and teens and youths to track what matters to them and then also how to define progress on their own terms. And I think seeing it play out visually can be really motivating.

And let's take a step back too and talk about like this is so motivating for all of us. Shawna and I just actually had a review where we like talk about our business and stuff. And the graphs are so exciting for us too.

Like ooh, look at how many more clicks on our website we had. Or like different metrics or your showing us like different revenue graphs and stuff.

And like it's a nice way to visually see how well things are going. We know graph everything in our speech sessions too so parents can see like oh the different cycles.

Like look at how we actually are making all this really cool progress. Graphing has always been part of ABA and I think that's like very familiar to our ABA listeners.

But think about how graphing can show you this kind of stuff in other aspects of life too. So let's start with the why.

And this is sort of why I'm trying to bring it home is like it's really can be beneficial for so many different applications. And so visual goal tracking is great for executive functioning. Again we've talked about this a lot.

It helps support that planning, the sustained attention and then reflective thinking.

But it also helps language learners, especially those with social communication challenges because it helps us like concretely understand understand these abstract ideas like progress and effort. Like what does that look like effort? And so it kind of makes something sort of less concrete more by having a visual assigned to it.

Yeah, exactly.

In the ABA world some of the things that we might chat about are that the visual goal tracking is a great way to encourage self monitoring behavior as well as delayed Reinforcement. So oftentimes we're using this monitoring either to check or own progress towards maybe achieving a final goal.

Right.

It's like some of the, those little steps that I'm working or sometimes we might track our progress. I've, I think you've done something at home with your girls with like reading charts.

Like Once we get 10 books read or something like that, we can cash in and then we get to go and have special mummy time tonight or something like that. And so tracking that or having that delayed reinforcement is a really excellent skill to teach kids who tend to want things now.

Yeah, for sure. We did it with T Ball too. If anyone's read my T Ball blogs that like was so life changing for me going through that experience with my youngest.

And so we did have like a visual tracker like of how many games are left and stuff too. And then at the very end we took them on a big play date kind of thing.

Yeah, exactly, exactly. That value is really coming in there.

Yeah, yeah, for sure. So then it's also this opportunity to like have the learner or child involved in co creating their goals.

And so we're not just deciding like, okay, Charlie needs to sit for 10 minutes, we're saying like what's important to you? What do you want to work on? And so we're building these like sort of smart goals.

Like specific, measurable, achievable, relevant and time bound is what time smart stands for. Sorry. And probably that's familiar to most of our clinicians listening in here.

Yeah, exactly. I think that tying it into what's really important to them is a key factor because we want them to be motivated and think we want their buy in.

Right, yeah, yeah, that it's going to be so tricky. It reminds me of this teen client I was working with. Super bright, very funny, he was very into gaming.

And so he, him and his mom like kept butting heads at dinner time. She thought she was just saying like something innocent and then it would just like rile him up.

And so we were kind of chatting through it and he like had said he's like, yeah, I don't really like it. Like I don't want to argue with my mom during dinner. Right. I feel like I'm a bad person after that.

And so his confidence was down and like he felt like it was kind of like disrupting the family dinner. And so he really did want things to be different. So that was a key factor here.

Right.

And so like I said, he was just sort of reacting to something that she Said it just like hit a nerve with him and he would just go like 0 to 100 kind of like right away.

And so instead of just saying, all.

Right, let's work on dinner behavior, we had this full conversation about his values to get that buy in right away. What's important to him, what made him feel good, what didn't. And so I always come back to these values.

Driven behavior change is so much more sustainable than those compliance based goals. Right. It's like cooperation over compliance.

Totally. Yeah. I love that. It reminds me of the visual that you were talking about again A couple episodes ago.

We had the example of the, the eight year old boy, I think it was like in the shower and how you like timed him. And so the visuals again could be really cool there. Right. Like a visual timer saying like, this is how much time I have left or something.

I don't know.

Exactly. Yeah. For those of you that didn't catch that episode, the boy was taking super long showers.

We graphed his first day and after that he started taking short showers.

Right.

Because he was like, oh, wow, that is a long time.

Yeah.

Part of my values to spend most of my night in the shower.

Right. And so another cool visual representation.

You graphed his sort of like performance or shower time, whatever, and then he made that behavior change because it didn't tie in with his values.

Yeah, exactly. And so this other youth that was arguing with his mom, we created a visual progress bar, like in a gaming system.

Ah.

And the goal was to stay cool during dinner. And so stay cool during dinner is a little bit abstract. What does that mean?

And so with him, I was able to break it down into like some observable behavior. So using a coping strategy, like taking a deep breath, taking space. So like leaving the table if you're feeling like you need to.

If you're feeling like your mom hit your hit a nerve or asking for clarification instead of jumping to conclusions.

Right.

And so we would practice some of the different things mom often knew, like what she said that was a trigger for him, him. And so we were able to then practice them in a safe space. Right. He knows that we're just practicing.

And so he knows ahead of time that I'm not trying to hit a nerve. I'm saying this sort of innocuous thing.

And then let's talk through what you could say if that really bothers you, that someone said that, you know, for him, he liked things to be really factual. And so if mom was using like an idiom or a metaphor or something might find that, like, really agitating.

And so then we could practice these strategies. And then each night after dinner, he would color in a bar if he was able to stay calm and cool.

And so I was like, did you do something that helped you stick to your goal?

Cool. That's so cool. And again, we've said this a few times, but it's not about compliance then. It's about alignment with his values and goals.

And that way, it's so powerful. So we're not going at this from a compliance angle. We're coming saying, let's be collaborative here. Tie in your values.

And that's how we're gonna sure make. Make lasting change.

And then that's how exactly like, that lasting, real world change that matters. So in his case, what he really was working on was learning to stop and think about it and then do an action.

So at the clinic, we often call it a stomp, stop, think, do sort of strategy.

Right.

And so what I needed him to do was to monitor his own behavior and actually inhibit that natural response. Right. His natural response was to go from 0 to 100 and be really upset.

Right. And instead.

Instead, what I needed to teach him was it pausing. Take that deep breath. What are my choices here?

That shifts and, like, really has changed the way that he interacts with everyone, not just with his mom. People are bound to bother him in life or see things that hit a nerve, but it's our job, sort of how we respond to those things.

And so teaching him to stop and think is, like, such a big skill.

And then how do we do that? Because it sounds like, oh, yeah, that makes sense. I hear you think, say, do. Is that what you said?

That's a different strategy.

Thanks to love.

Are we gonna talk about it today? You just said, stop, think.

Oh, thank you. Stop, think, do. Yes, you're right. You're right. Okay, so stop, think, do. So how do we do it for our listeners? Explain how you think you would do that.

Well, yeah, I think the biggest thing is to make sure it's really clear and observable.

Right.

So be good. Very vague.

Oh, yeah.

Use a coping strategy when frustrated at dinner is something that we can see and measure. It'd be even, even better if I had the specific coping strategy that they like.

Like, use my breathing.

Exactly. If I like breathing, I often use this example as well.

Like, there's nothing more frustrating to me if Tim, my husband, was like, shona, you seem really upset. Do you want to take a big breath? Oh, yeah, man.

I don't know, that would be terrible to me.

And so it's like, you want to again get that buy in and those values driven coping strategies identified.

If he just said, shauna, can I get you a glass of wine?

Exactly, exactly.

Yeah. Can I give you a few minutes without screaming children? Exactly.

Are you feeling overwhelmed right now? Yes, I am. Thank you.

All right. Yes, exactly.

Okay, so being clear and observable, so important, then next we want to make whatever visual tracking tool that we are using meaningful to the learner. So. And you talked about kind of like a gaming progress bar. I love that.

With my daughter, when we were doing the T ball games and showing how much longer we had to play T ball. She loves stickers. And so we just made a cool chart. It had like different squares on it, I guess.

And then we put big, big unicorn stickers in the chart. And she just loved that. And then she would draw all over it, too. It was on her door. It was very.

It was down at her level so that she could kind of color it and stuff too. But she knew that I, We. We could only put the stickers on for this. For this, like, if she achieved a game or if she did it.

So that was important, too.

Amazing.

And so you could use checklists, graphs, emoji, logs, kind of whatever works for your learner, whatever's meaningful to them. We've even seen, like, marble jars or like skill trees or something used for kids. So there's lots of stuff out there on Pinterest too.

Exactly.

For sure.

And then that final piece we don't want to forget is the reinforcing.

Yes.

So especially early on sometimes I'll see with some of these progress tracking things, for example, if you're using it as like more of a token board. So, like, once this is full, we're going to go to the arcade.

This is full, we're going to go to Starbucks and get your favorite treat, whatever it is. That might be too much right away. Right. To go in. Like, even in your case, I'm not sure if you guys did any adjustments with your baseball one.

Yeah.

But like, saying the whole season might not be very motivating. Right. If I had to see that, I had. I got to do this 20 times.

No, thanks. Yeah, we did five.

Yeah. So starting small is a really great strategy. Strategy. Depending on the age of your kids, really.

And, like, how long they can wait for delayed reinforcement is a good thing to think of. You know, if your kid's not usually one that can wait, then even one sticker for the first time might be where you should start.

Yeah.

And so it really does depend on the individual. And ideally, we want to pair that reinforcement early on because we want the tracking itself to be motivated.

Right.

And so by pairing it with something that they already like, we make this system make sense. It's predictable. My brain likes things that are predictable. And so for myself, I love a checklist.

Obviously, no one else cares if my checklist gets completed except for me. And so maybe. Yes. Yes, you might.

Yes.

And so I, for me, just like task completion, but for young children.

Right.

Like, task completion might not be intrinsically reinforcing if we haven't found the right value to tie it to.

Right.

And that's where sometimes we might use some extrinsic rewards, like special time with mom or going out for ice cream or something like that.

Right.

And so by pairing all these things together, we want to celebrate their effort, not perfection. For sure. You can try again.

In the discussion that we're having right now, it made me think of a classroom example of this that my daughter, her teacher used, but they were also taking things away. So I, I know that's like a, a big discussion. I don't want to open a whole can of worms.

But in this tracking bar, for example, that you're using with the client, the gaming style one, are you then taking stuff away or is it only adding to.

Yeah. So I would really avoid punishment at almost all costs. Like, we could call that like a response cost sort of system in the ABA world.

But there's so many problems. Problems with punishment mostly around, like, coercion and like, it doesn't feel good to be punished.

You know, like, if you think about the way that your boss communicates with you and that sort of thing.

Yeah.

Nothing really good comes usually from a punishment approach. And so I would not take away. There's. I'm never saying never.

Yeah.

But my first strategy would be to go in with just like, we can try again tomorrow.

Same.

Right.

Okay. That's what I think too.

And, and I wanted to like, bring that home for our listeners to say that we're not like, just celebrating all the add ons and then also like penalizing if they don't do something. It's not a punishment. And sometimes as a parent, if you hear punishment, you think like timeouts or something like that.

But taking a sticker away in this case would also be.

It can also be demotivating. Right. They might be just like, screw the system. I'm not buying into this. I can't Achieve it. Right.

Whereas if we're providing that positive encouragement along the way, and then as a parent again, my job, if they're not meeting the expectation, is to sit back and think, like, yeah, what am I missing here? Why didn't they achieve it?

Yeah. Did I not set it up right? Yeah.

Should I have. Is it too big?

Yeah.

Are my goals not clear?

Right.

Did we start with too many goals? Like, what are all those things that I could look into and tweak my approach before I went in with a punishment strategy? Like.

Like taking something away that's already given.

Yeah.

Yeah.

Okay. I'm totally in line there. And I felt like, yeah, so interesting. But you see it done, right? Where, like, it's. Something is taken away.

And so our recommendation would be, look, take.

Take that as like a data point, step back, and then notice, like, if your child or learner or whoever is not meeting that and not making that progress, then you need to revisit. Revise something likely. Yeah, exactly. In a collaborative way. And then you could even have it as part of the discussion. Like, hey, if.

If they're a vocal learner or something. Like, hey, I noticed this is really tricky. Like, where can we put some more steps in here?

Yeah, exactly. And getting that buy in again, like, so crucial. If they're not bought in, then you're doing something compliance based.

Right.

It's going to unravel at some point.

Okay. Right. Really good learning opportunities here, I think. So if the goal stops being motivating, that's also data. We need to revisit that.

And then goals should be these, like, living tools, not like a static rule. And so we might be, like, shifting the wording or like, updating the visual or something along the way too. Right.

It's not like this is the same thing we have to use forever.

Exactly. And you'll know your kids best. Like, I think one of your kids maybe would like something to be the same all the time.

Whereas I think my other one of my kids might enjoy something that's, like, novel each time. Like, it's a different superhero that shows up on each tracking sheet or something like that.

And so I think there's no hard and fast rules, but know your kid, and if something's not working, try something else.

Yeah.

My final tip here, help your child to reflect on their own data. So not just did I do this, like, did I meet the goal? Or, like, did I do a perfect job today? Like we were saying, more so, like, what helped me today?

What was hard today?

Yeah.

And that Helps like to get them to self reflect and helps build those self regulation skills over time.

Yeah.

Really bringing them into it. Especially when there is failures. You know I often find like kind of at bedtime is a nice time to chat about about it with my son.

But again I feel like all kids are so different. But if we're going to talk about like a hard moment that we had that day, I find bedtime's a nice time.

He's like happy to chat because he wants me to hang around and so more likely to open up and kind of dive into like that was really hard today. What can we do to do better tomorrow? Like you were saying for sure.

Yeah. Or if it, if it was sort of like a mistake we talk about in our house like mistakes are how you learn.

So like really normalizing that that and like we won't learn if we don't make mistakes. So we're always trying to like do better and learn more and like that's a good value thing to talk about with your children or your learners too.

That like we're all just always learning.

Yes. And like big emotions too. We all have big emotions. We all have times where we make choices we're not proud of. It's not just young children.

Yeah.

And then giving them that grace too. You know like I think as adults not as held accountable to that emotion regulation we should skill. Whereas with kids we have sometimes like.

Too high of expectations for them. So. Yeah.

Anyways, wrap it up today we covered so much.

Yes.

Yes.

Thank you for listening. Big discussion first.

Then boards, visual schedules, social narratives, comic strips, video modeling and then finally wrapping up with that goal tracking. One thing I stayed consistent. Visuals will only work when they're meaningful, individualized and used with intention and structured practice.

I would say.

Yeah. And one thing I want to add is appropriate to your learner's language level.

Both their understanding, their expression, if they're vocal, non vocal, et cetera. You want to be really matching whether it's first. Next you want to be thinking about what's their language level or visual schedules.

Everything we talked about today, make sure that you're matching it. Otherwise it's not going to be as effective or maybe not effective at all if you're not matching it to their level.

Yes.

In our own practice we use visuals to support communication and be behavior, emotion regulation, executive functioning, like you name it. But it's not always about using more visuals. It's about having the right visual at the right time and using in the right way.

Exactly. Yes, exactly. Like we're all learning and adapting and so some of the most common pitfalls we see.

So things like kind of your first thoughts if something's going wrong. Using a visual that's too abstract or too complex.

Not teaching with them first and just expecting them to work, not matching them to the child's actual needs or making them specific enough to the child's actual needs and then forgetting to like fade out your support or something like that.

And then generalizing too. Again, two things that are really talked about a lot in ABA and maybe not some of the other fields like we were.

We really want to be fading those prompting and then like making sure that it's applicable in a variety of settings.

Exactly. Yeah.

Cool. Okay, so here are last few quick tips you can try your next therapy session or at home. Start with visuals that are familiar and functional.

Build that buy in before layering in and making it more complex. Involve the child or the learner in making customized visuals and having them have some ownership over it.

If possible, use visuals to support independence, not just compliance. Always pair your visuals with modeling practice in the real life moment. Reinforcement and importantly, watch what's actually happening.

So if it's not working, it's not necessarily a failure. It's data and take a step back.

And sometimes it might mean analyzing sort of what was the real purpose of the visual or what are we trying to convey here? Don't be afraid to try these in your next therapy session. You don't need anything fancy, remember, just start with stick figures and post it notes.

Go from there.

We hope this gave you some ideas to refresh your toolkit or rework systems that just aren't landing.

And don't worry, we'll be back with more about visuals, which is hard to imagine, but especially when we look at AAC or augmentative and alternative communication.

Definitely.

We'll link some of our favorite templates, including some of the favorite visuals we've made for the clinic and that we use in our houses or in home, and some research in the show notes. Thank you so much for hanging out with us today. We loved having you here.

If you found this helpful, share it with a friend or a teammate or a colleague and we'll catch you next time on Neurodiversity Speaking. Bye. Thanks. Before we go, we want to remind our listeners that topics we discuss in the podcast are not a replacement for professional medical advice.

Please contact a professional if you have questions.

And just a heads up, we'll use both identity first and person first language to respect different preferences we'll also say treatment and therapy, since we come from a clinical space, but always with respect and a focus on what works for each person.

See you next time. Bye.