Children with Asperger's learn most successfully through visual modes. They are visual learners, as well as visual thinkers. Generally, areas of strength include word recognition, oral reading, spelling, and letter/number recognition all areas requiring visual learning. Therefore, visuals become a crucial part of almost every prevention strategy. Visuals serve to enhance understanding when new concepts are presented. They do this by:
- Helping to focus attention
- Acting as a backup when new information is presented, giving the child something to look at in case information is forgotten or confused
- Providing external organization and structure, e.g., by showing the sequence or steps needed to complete a task
- Remaining stable over time, allowing the child the needed time to process and respond
- Making concepts more concrete, which also decreases anxiety
- Acting as cues when the child is ready to practice the concepts
- assignment sheets
- cartoon bubbles
- color coding
- cue cards
- hand signals
- lists of rules
- masking tape
- planning sheets
- problems and solutions sheets
- problem wheels
- sequence cards
- signs with key words and phrases
- social stories
- written scripts
My initial response was to complete, with Tim's help, a problems and solutions sheet. First, we outlined his neighborhood playground problems to ensure that he understood what was occurring. Next, we discussed both appropriate and inappropriate ways to respond in these situations. This was done in a very clear, step-by-step fashion and, ultimately, became his "game plan" for neighborhood play. It included both the rewards for appropriate behaviors and the consequences for inappropriate behaviors, using naturally occurring rewards and consequences as much as possible. For instance, when you play appropriately, other children will want to play with you and will be less likely to tease you.
During this process with Tim, it became clear that even with reading the "game plan" right before he went out to play, he needed a visual available to him while he was actually outside. Since his common response was to push or hit with his hands, I decided to put a symbol on his hand. Again, this was discussed with Tim. It was presented like many of the other strategies, as something that would help him solve his problem. I explained that we'd use his right hand, because this was the hand he used for pushing or hitting. I allowed him to choose the color of the marker we would use and what symbol we would draw. He selected a purple star; this was placed on his hand every day before going out to play, at which time the problems and solutions sheet was also reviewed.
When Tim returned home the first time the purple star was used, he said, "It worked. I was going to push John and when I saw the star it made me stop." The power of visuals! Both the problems and solutions sheet and the purple star were used for three weeks. Beginning with the fourth week, the reading of the sheet before going out to play was eliminated, and the following week the star was discontinued. By then, Tim had internalized a new way of responding. Remember, this does not replace ongoing social skills training and helping Tim to expand/generalize his interactions with peers.