The Picture Scheudule: A Solution Looking for a Problem

If you are using the picture schedule with your kid and it is working, then Kudos to you!  I am happy for you!   I accept that it works for many, but please accept that it is not the answer for everyone.   I am ready to punch the next person that asks “Have you tried using a picture schedule?”  Let’s run down the different people who have said this to me: Behavior analysts, teachers, counselors, early intervention specialists, PTs, OTs, Speech therapists, developmental pediatricians, teachers and administrators, RDI consultants and probably someone else out there with a professional title.

And the answer is, ‘Yes, I have tried it’ and ‘No, it has not been particularly effective. ‘  I can see how it may work in a classroom environment where the boundaries of space, time and activity are measured with precision for a period of the day.  I don’t know about anyone else out there, but my life does not work that way.  Even in the classroom, teachers have reported back to me that Naomi will look at the schedule and switch out the activities she doesn’t care for with preferred activities. Hey, I guess that shows some problem solving skills! But one thing is for sure – seeing an activity posted on a picture schedule does not make Naomi accept that it is the way things must be.

I hear all the professionals say this phrase over and over.  “If you have met one child with autism, you’ve met one child with autism.” But I yearn to hear one professional say “The picture schedule may be good for one child with autism but it may not be particularly effective for another child with autism.”  When I tell them the picture schedule hasn’t really worked for us, the answer is not “Well, all kids are different.”  The answer is quite often a polite version of “Well, you must be doing it wrong.”

For me, the picture schedule is a lot more trouble than it’s worth.  For one thing, it follows the idea that people with autism are particularly visual and I really don’t think that Naomi is. She’s not one for looking at picture books, computer screens or even TV unless there is a musical theme on.  When I made my carefully laminated and velcroed pictures she would use them to stim, flicking the corners against each other. If I put them on a velcro strip schedule the minute I turned my back she would rip them off and start stimming with them.  She may take a few favorites from the pictures and carry them around, until inevitably, one gets lost.  Losing anything is the prelude to a panic and obsession for Naomi, so I made several copies of each picture.  Did I mention how insanely tedious this job is? People have told me “Just put it somewhere where she can’t touch it, but she can look at it.”  Asking Naomi to just look at something and give it significance without touching it, is kind of like asking someone to develop a taste for something he/she has never eaten.  It’s not how her sensory system works and it is a way to set me up for a huge battle that I will lose. 

I explained to one counselor, “I set up picture schedule.  Then when I arrived to pick her up from school the weather was much nicer than it was supposed to be.  We ditched the picture schedule and went ahead and walked to the park where we fed the ducks.  Luckily, she didn’t care that we weren’t following the schedule and neither did I.”

“Well,” the counsellor said “You need to be consistent with the picture schedule so not just Naomi sticks with it, but you stick with it too.”

Why?  After a cold, nasty winter it was finally a nice spring day and we had nothing particularly pressing to do that afternoon.  I wanted to feed the frigging ducks with my kid.  So I was supposed to say “No.  If it’s not on the picture schedule, it is just not happening,”?  If we ever wish to feed ducks it must be on a picture schedule?  If I put feeding the ducks on the picture schedule and we show up at the pond and find there are no ducks there how am I supposed to deal with these raised expectations since duck migration is not something I have control over?  Are all activities that do not fit on a picture schedule out of bounds? Did you really think we needed to put more normal family activities out of our grasp?  Haven’t we suffered enough?

My goal for Naomi is not to get her into a more ridged lifestyle.  I want more flexibility!  I want her to be able to assess that making an impromptu visit to the park to feed the ducks on a nice day is a good idea even when it doesn’t jive with the schedule.   My greatest difficulty with her now when things do not go according to schedule.  I want her to learn to accept a snow day, a power outage, a traffic jam, something that is sold out, missing, lost, broken or unexpectedly unavailable.   In my experience, handing her a little picture with snow on it does not make the snow days go any easier.  Because many of these unplanned occasions are ‘last minute’ they can’t be set up on a picture schedule.  In fact, the picture schedule just reinforces the idea that things are not going according to plan and that sure as hell isn’t going to make my day easier.

I have also found it a huge pain to find, print, laminate and velcro a picture for everything that may come up in your day.  Aside from being tedious, it is hugely time consuming.  Every time I think I’ve got a complete set, something changes, gets added or there’s something I haven’t thought of.   For example, I don’t have a duck-feeding picture.  Using empty cards confuses the whole thing.  Naomi often thinks this means it’s her free choice.  Explaining that it is not free choice, but simply something I don’t have a picture for is not a conflict I’m eager to partake in.

How is a picture schedule supposed to help us? I have yet to get an explanation that applies to the needs of our family.  I can only see that the picture schedule is a solution looking for a problem. I understand that it may be helpful if you’ve got a kid who is anxious about going out into the world and needs to get used to the idea.  However, I have a kid that cannot wait to get out the front door every day.  She is telling us the daily scheduled from the moment we get up. “First coffee, then school, then Mr. Mark, then library, then Kroger, then go home, mommy make some dinner.”  I’ve told this to the professionals to which they respond “The picture schedule is more concrete.”  Why does it need to be more concrete?  It ain’t broken.  Let’s not fix it!    The other reason I have been given for the picture schedule is that it will make her more independent.  Again, I can see how this might work in a classroom, but until the picture schedule can make a meal, drive a car and find whatever trinket she has recently lost, I can’t see much independence coming from it.  Virtually everything that is on a picture schedule requires our supervision so I don’t see how it helps her be independent.

Finally, I don’t always want visual reminders for something she doesn’t want to do.  I offer verbal reminders that a doctor’s appointment or a visit to a new therapist is coming up a few times during the week and she usually responds by saying something to the effect of “No therapist”, “Bye-bye doctor.”  I can usually distract her a few minutes later and although the appointments haven’t changed, she isn’t focused on them anymore.  Having pictures that constantly remind her of an unwanted visit or activity does not make it more enticing.   It is just inviting conflict.  The verbal perseverations will go on and on and become obsessive. “No, doctor!  Bye bye therapist!”  We really don’t need more of this in our lives.

At the last support group meeting a parent that was fairly new to the world of autism told us that she was starting to put a picture schedule together.  I turned to a veteran of the autism world and asked.  “Did you ever find the picture schedule particularly helpful?”

“No.”  She said “it works in a classroom because that is its structure, but for life I haven’t found it very useful.” Vindication!  I am not a loser or a bad parent or hopelessly disorganized for finding that the picture schedule does not make life easier!  It’s not just me!

So if the picture schedule helps you and your family, lowers conflict, lowers anxiety and fits neatly into your lifestyle, then by all means use it!   For us, the picture schedule causes far more problems than it solves.

Update: After writing this, I read The Reason I Jump by Naoki Higashida.  Here is some of what he had to say about the picture schedule:

Speaking for myself, I am not a big fan of having visual schedules around the place. People with autism may look happier with pictures and diagrams of where we are supposed to be and when, but in fact we end up being restricted by them. They make us feel like robots with each and every action programmed. What I suggest is instead of showing us visual schedules, you talk through the day’s plan with us, verbally and beforehand.  Visual schedules create such a strong impression on us that if a change occurs we get flustered and panicky.

I can't get a better reference than Naoki Higashida!