The 5 W's of Visual Support

1. WHO

Who can benefit from visual support? In general, any young child with an intact visual system and some auditory or attentional processing difficulties may benefit. In addition, most individuals on the autism spectrum, those with Down Syndrome, with language processing impairments, and with traumatic brain injuries that affect short-term memory or language comprehension are likely to benefit. The easiest way to find out if a particular person will do better with visual support is to try it, then ask yourself these questions: Did he or she attend longer? Respond more quickly? Spend less time off-task? Accomplish more during the session? Seem to enjoy the lesson more? A "yes" to any of these questions (and the use of visuals will sometimes result in a "yes" to all of them) is a good indication that visual support is an important ingredient in that person's therapy.

2. WHAT

What are visual supports? A visual support is an image (or sequence of images) that acts as a cue for the next activity to be performed. The choice of format (laminated cards versus stickers versus large signs etc.) depends on the teaching situation. Some equestrian programs prefer to use small laminated cards because they are durable and will not be ruined if stepped on by horse or rider. Other programs prefer large signs for group teaching. Still others mix formats. Regardless of what format you use, remember that it is important to have a distinct image for each activity (in other words, don't use a single image to cue two different activities). If our current vocabulary list doesn't have an image you want, check magazines and professional catalogs for an appropriate image…or call us and we'll design it for you!

What do you do with the visuals once you have them? Show the image to the rider immediately before the activity. If the rider is not deaf or hearing impaired, pair the image with a word or short phrase spoken at the same time. We strongly urge you to print the word or phrase on the image regardless of whether you believe your client can read: the words are there to prompt you and any other therapists to use consistent language in naming the activity. In general, you will want to start with single images, but as a client becomes more familiar with the images and with the regular routines in his or her lesson, you may want to start to show sequences. When you move to sequences, start with activities that are stationary (for example, grooming) so that the entire sequence is available at each individual step along the way.

3. WHEN

When should I use visual supports? In addition to showing an image before beginning an activity, visual cueing is important for many clients (for example, clients with autism) when transitioning between types of activity or locations. So, you will want to cue a change from the arena to the barn, or from riding time to grooming time. By choosing a particular image to stand for the client's equestrian program, a parent or support person can help prepare the client for the transition to therapy prior to arrival. Similarly, by choosing an image to represent the place or event that typically follows riding, you can help prepare the client for a smooth transition at the end of the lesson.

When should I eliminate the visual supports? This is a matter of some debate among professionals who work with cognitively impaired children. Our opinion: when the child no longer looks at them in order to organize him or herself for the task, relying instead on the verbal prompt or memorized routine. This may not ever happen for some children. It might help to think of the issue as being like the difference between a child with a broken leg in a cast and a child with cerebral palsy in a wheelchair. The child with the cast will eventually walk without it, in his or her own time and at his or her own rate of recovery. The child in the wheelchair, however, needs the wheelchair, and always will. Some of your children need visual supports in the same way; it makes no more sense to ask them to get along without them than it does to ask the child in the wheelchair to get up and walk. And keep in mind that the first child will need another cast if the other leg is broken - in the same way, a child who no longer needs visual cues for a familiar routine may still need them when working on a less familiar activity.

4. WHERE

Where do I keep all this stuff?! This is probably the hardest question to answer. It depends on you, your program and your client. Some therapists put all the images for a lesson in order on a single key ring or in a binder and flip through them one by one. Others keep a few related images together on a key ring and then carry a number of key rings at the same time. Still others have told us that carpenter aprons are useful for keeping different activity cards in different pockets. You will probably have to devise your own system; what is important, however, is that you are able to get to the image you want quickly and easily, with minimal interruption to the flow of the lesson.

5. WHY

Why do visual supports work? All people with intact visual systems use visual information as one way of organizing and remembering ideas and events. In childhood, neurotypically-developing individuals begin to use language information to organize and remember as well. As they grow, neurotypical individuals come to rely more and more on their language system for learning and remembering. We say they become "language dominant." Visual thinkers, on the other hand, continue to rely on visual information. They remain "vision dominant." When you give a visual thinker visual information you are teaching to his or her strengths. Visual supports alone will not make your client a better rider, they will simply make your riding instruction more accessible and more interesting - leaving it up to you to do the rest!
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