Visual Schedules/Timetables

These are very simple to make and incredibly useful!

We all use diaries, smart phones, calendars and lists to help us remember what we and maybe other family members are doing day-to-day. However, we expect

our service users to just remember this information. The fact that they have a learning disability/difficulty means they automatically will have processing

difficulties. Therefore, it is harder for them to process and retain information so it’s not surprising that they cannot remember everything you tell them.

Without my diary I would have no idea what I am supposed to be doing!

That’s where a visual schedule comes in – it is a simple system that will support people to remember and process information visually.

If I say a word, for example, ‘painting’ and ask you to try and remember that word – then I ask you to think of your favourite sweet or what you watched on TV

chances are you will have forgotten the word I had asked you to remember. If I say and sign a word you will be able to remember it for longer as you will have

the auditory (word) and visual (sign) memories but if I again engaged you in different activities over time you will still forget the word.

However If I give you a symbol as well as saying and signing the word, it would not matter how much I distract you, when I ask what the word was all you have

to do is look down and there it is….the symbols are permanent and tangible so long as you have it with you, you do not need to remember it.

The same applies with visual schedules – I don’t need to ask you 100 times when we are doing art – I can just look at my schedule and see – ah yes after lunch

I’m doing art.

Who would benefit:

• Pretty much anyone who has a learning disability/difficulty or autism.

• people who have memory difficulties – they are used effectivity for people with dementia

• English as a second language

• sequencing and organisation difficulties e.g people with dyslexia often benefit from visual schedules

• People who have difficulties understanding

• People with difficulties reading or writing

• People who have difficulty coping with changes to their routine or transitioning between tasks

• people who find it difficult to express their choice of activity -what do you want to do today is a very open question

• People with short attention spans

Visual Timetables help by:

• Offering people more control and predictability over their life.

• Creating opportunities for independent choice making and planning of their day.

• Helping them to understand concepts such as before/after and progress of time /sequence of events

• Helping them understand changes of routine or when activities are cancelled

• Helping with transitions (moving from one activity/environment to another)

• Reducing stress, anxiety and behaviours that challenge.

• Encouraging engagement and independence in activities

• Helping to reduce obsessive behaviours

• Also helpful for staff to quickly see and know what the plan is for the day

How to we make one:

1) Cut out a strip of card to your desired size and either laminate or sticky back plastic it.

2) Place a strip of velco (scratchy side) along the centre

3) Select your symbols cut them out, laminate or sticky back plastic them

4) Stick a tab of Velcro on the back (soft side as they will be handling the symbol so this along with rounding the corners when cutting them out will reduce

the risk of accidental injury)

NB: If you are working with someone whom you think will be distracted by shiny surfaces then using matt laminating pouches would be useful.

If the person you are working with is able to it is really great if you can make the schedule together – let them choose the colour of the strip, put

Velcro on etc. this helps them own it, input to it and realise its theirs. This is also a really enjoyable activity for both staff and service user.

What symbols should we use:

As a gold standard we would recommend using black and white Makaton or rebus symbols however in our current situations

use whatever you have to hand. We have attached a selection of symbols that we thought might be useful to this document.

Why do we recommend black and white?

• Black on white is the easiest contrast for our brains to process – black on yellow can also work well if you are working with someone who is visually

impaired

• They are clearer and there is less risk of people being distracted by things in the background or drawn to particular colour e.g. someone may select a

symbol purely because it has red on it which is their favourite colour.

• You can draw them quickly and easily – all you need is a pen and paper – if you are using coloured symbols not only do you have to have a whole set

of colour pencils it will also take double the time. Likewise, if printing the symbols coloured ink is a lot more expensive.

▪ They can be generalised – a black and white symbol of a biscuit can represent any biscuit – however if you show someone a photo of a chocolate

biscuit and then give them a custard cream, the chances are they won’t be happy!

• The Makaton symbols have also been very carefully researched and tested and have clear themes so are a good choice.

• Think about which symbols are most meaningful to someone – there is no point using a symbol of a coffee pot if they only ever have coffee in a cup.

• We would always have the word written at the bottom of a symbol this is useful for staff or other people who may not be familiar with the symbols – it

can also help service users who can read or to learn to sight read those words (use a clear font – we recommend Arial at least size 16, written in

lowercase letters)

Size and shape:

Think about the needs of the person you are working with:

• Visual difficulties: make sure the symbols are big enough for them to see.

• Physical difficulties: having larger or thicker symbols would make it easier for them to handle.

• Portability: for your portable symbols think about the size and ease of fitting it into a bag etc.

• Safety: make the edges slightly rounded to reduce risk of cuts or scratches.

Can I use Photos?

You can use photos for specific people, places or objects, but try to make them as clear as possible with no background distractions e.g.,

a staff member in front of a plain background instead of in the park.

Be aware that photos may not be useful for people with autism as they are harder to generalise - e.g., if the symbol shows a red tea cup

then that’s what they will be expecting to be given.

You can use a mixture of photos and symbols so long as the photos are clear and of a specific person, place or object.

Whatever you choose, make sure all images and symbols are the same size. This makes the timetable look less chaotic and reduces the

likelihood of an individual picking a symbol purely because they like the size of it in comparison to the others

Orientation:

We recommend horizontal going left to right – this follows the pattern for reading, writing,it helps with the understanding of concepts for before

and after and lends its self-better to signing these concepts too. If you are using the TEACHH program, then you may prefer to go vertically.

Time span:

I usually use schedules for part of the day, whole days or activities. I avoid using weekly schedules as these tend to end up looking far too

busy and complicated – they often do not get changed so end up as what we often call ‘symbol wallpaper’ which is pointless for everyone.

Most of us do not have their entire week planned out in detail a week ahead – a calendar or diary would be useful to use in addition if there are things they

need to remember over the week or month.

How do we use a visual schedule?

The visual schedule is personal to the person you are working with and they have to be central to the process. If you just fill it in and

place it on the wall it will be meaningless to them.

Before getting started, check the diary/calendar to see whether the person has any pre-planned activities or appointments for that day (you will need

to remind them of these and support them to place these in the right place later on).

1) Sit down with them and show them the blank strip and explain that we are going use it to help plan their day/morning/activity etc.

2) Try and give only 2 or 3 symbol choices at a time – if you put too many down it will be overwhelming for many people.

Use speech and sign (if you know Makaton) to reinforce the choices.

Ask them to give you/point to different symbols this is a good way to check they can recognise and understand the symbols.

3) Start with something fairly concrete like breakfast or cup of tea and ask them to place it on the schedule. Then you can give them available choices for

the selected period (again avoid offering too many choices at once).

Please only offer choices that they can do – there’s no point offering cinema if they cannot actually go.

4) Once all the symbols have been placed on the strip go back over it. Then encourage them to place their timetable in an accessible place of their choice e.g. their room, a wall in the day room etc. It is important that they can easily see their timetable whenever they want or need to. If they’re going out remember to take a portable timetable with you with the symbols you need while out.

5) Once each task is completed they should remove this symbol and place it in an agreed place – you might have an envelope under the schedule, stick

them on the back or put them in a box etc. – this is important to avoid the symbols getting lost.

Removing the symbols once an activity is completed helps them see what is happening next and see their day or the task progressing. This can be

particularly useful if they have a favourite activity later as they can see it getting closer.

6) By the end of the day/morning/activity the strip should be empty ready for the next day – which again reduces the risk of the schedules just being left

as symbol wallpaper

Other Benefits of visual timetables:

Changes in routine/cancelled activities:

Visual schedule are a great way of help to support people to understand or cope when the routine changes or something has been cancelled. Many of our

clients rely on routine to help them understand and navigate their days.

In fact, often people with learning disabilities appear to have a better understanding than they actually do because they are able to follow the routine. For

example, when you say “let’s get ready to go swimming”, they get their swimming bag not because they understood what you said, but because that’s what we

always do after morning coffee.

So you can imagine how distressing it is if something in your usual routine does not happen…will the other things still happen? If I’m not going swimming does

that mean I’m not having lunch or music or dinner?!

With a visual schedule you can help them to understand the change and reassure them about the rest of their routine:

1. Go through the routine – indicate the item that has changed and explain that there is no swimming today as the pool is closed and remove the symbol.

2. Offer them a choice or the alternative option and replace swimming with this option.

3. Go over the timetable again emphasising the new item and the things which are still the same afterwards e.g. lunch, games, skype, dinner, music time

etc.

It is important you then take a portable version of the timetable with you, so they can be reminded of the schedule throughout the day. They are likely to be

anxious following a change and will need the visual reminders to help reassure them.

Clients who perseverate on certain activities

Many of the people we work with have certain things which are highly motivating such as having cups of tea, watching a particular TV

show or playing a certain game. Sometimes they can become very fixated on these and when they are going to have them so will

constantly ask for them throughout the day. In an ideal world, maybe they could have them 24/7, but for health reasons or practical

day-to-day reasons they can’t.

A visual schedule is a great way to help with this. For example, if the person you are supporting is constantly asking for cups of tea then you section up your

activities with cups of tea – that way they know they will get their tea after they have done some art or got dressed etc.

Initially you would have fairly short activities and perhaps just one before each reward, but then you can gradually increase the length of an activity or the number

of activities before the rewards.

If your service user is frequently asking about a regular event e.g., asking multiple times a day “when is my brother coming?” and they always see their brother

on the weekend – this might cause staff to feel frustrated:

1. You can make a simple schedule with sleeps counting down to when their brother will visit, with the service user removing a sleep each morning, so they

can see the progression and when they will see their brother.

2. Or even simpler make a card showing weekend and brother with the sentence Saturday brother Ken coming – that way they can look it as often as

they like for reassurance and if they ask staff, then they can give the same consistent response whilst pointing to the card.

Print these on A3 then cut out and laminate/sticky-back plastic

Template and selection of symbols

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Please contact the Enfield Integrated Learning Disabilities Speech and Language Therapy Service if you would like further support or advice.