What is it?
A visual schedule is a visual representation of what is going to happen throughout the day or within a task or activity. Specifically related to medical procedures, it is helpful in decreasing anxiety and rigidity surrounding transitions by communicating when certain activities will occur throughout the day or appointment.
How do I teach it and use it?
Choose the activities that you will include on the schedule. Try to mix in preferred activities with non-preferred activities if possible.
Assemble the visuals on the schedule in the order that they are likely to happen. This can be a portable schedule such as a binder or clipboard. The schedule should be visible and available to the individual prior to the beginning of the first activity on the schedule and continue to be available throughout the remaining activities.
When it is time for an activity on the schedule to occur, let your patient know with a brief verbal instruction at the beginning of the next activity. When that task is completed, tell your patient to check the schedule again and transition to the next activity. Some children respond best to breaking down each task that will occur during the procedure in a very detailed way. This may make other children more anxious and, for that, child, a more general schedule might be more appropriate.
Provide praise and/or other reinforcement to the patient for following the schedule, transitioning between activities, and completing activities on the schedule. Place a preferred activity at the end of the schedule in order to provide the patient with something positive to focus on and motivation to complete the items on the schedule. See rewards section for tips on choosing effective reinforcers.
What if challenging behaviors occur?
Continue to focus on the task and praise the aspects of the procedure the child is completing. Rather than shifting attention to the challenging behavior, provide brief statements or a visual that tell the child what you would like for them to do (e.g., “Hold your arm out”). Then, move to the next task when that task is complete. Provide any rewards that are shown on the visual schedule when they are supposed to occur. This is because the focus of the visual schedule is on completing the tasks, not on addressing challenging behaviors that occur.
If you anticipate challenging behaviors, encourage your patient’s parents to introduce their child to the visual schedule before the visit and practice them during preferred daily activities.
If challenging behaviors become more difficult to manage, it may be appropriate to recommend behavioral consultation with a professional to address these behaviors directly.