Visual Schedules

Taking a visual schedule into the community setting may not seem like the most convenient approach but it can be very helpful. The visual schedule is valuable because it provides concrete images of
what to expect and what is expected in the community setting. The
schedule can be as detailed or as brief as necessary. These familiar items are used in the home and school settings and they are helpful in building expectations and providing instruction.

Transitions are always difficult but if a visual schedule is designed that outlines the events that are about to occur the individual with autism will make smoother transitions. A simple schedule would include the following:
Car
Walk
Shopping Cart
Wait
Cashier
Walk
Car
Home
All Done

The focus of this visual schedule is the transitional moments. As each event is accomplished, the child can remove the picture from the visual schedule.

Safety Awareness

One of the most important factors to consider in the community setting is safety. Many children with autism are not fully aware of their surroundings. They also have difficulty with body awareness (the relation of their self to their environment).

Cars and steep hills do not feel threatening to many children with autism and they often do not understand the rules when it comes to crossing the street or entering and exiting buildings. Many individuals with autism also like the sensory feedback they receive from running, especially with the added sensation of being outdoors.

Drilling the individual with autism on issues about safety awareness is crucial when embarking on community outings. The drills typically involve a lot of physical and verbal prompting to help the child understand what is expected.

Rewards and positive reinforcement are important when engaging in safety awareness drills. It is a good idea to save very special treats for the safety awareness drills. The child does not receive the same treat in other settings. Bringing that specific treat into the community setting will help the individual with autism make a strong connection to the powerful motivator.

For example, a therapist or parent may want to focus on the command "stop" and they want to associate that command with chocolate chips. The drill would include an image of a stop sign, the verbal cue "stop" and the sign for stop as well.

When the cues and pictures are used in the community setting with the presence of the reward, the individual with autism is more likely to attend and follow through.

Sign Language

Sign language is a valuable tool in the community setting. This form of communication is visual in nature and the child can attend to the signs easier than most spoken words. Facilitating communication through sign language can help to ease stress and frustration in these unfamiliar surroundings. The individual with autism benefits from seeing familiar signs that help him navigate through stressful situations. The ability to make a connection with all of the distractions present in the community setting is very valuable.

A parent or therapist does not have to be fluent in sign language to effectively communicate using this system. The individual with autism is usually taught a lot of useful signs that are helpful and knowing these key signs will help facilitate communication.

Sign language is also unobtrusive. It requires no pictures so there is no fumbling around for icons. If the individual with autism is familiar enough with the sign language he will attend to them.

Common signs that are used in the community include:
Stop
Wait
Help
All Done
More
Potty
Eat

Many of these signs are commonly used in the home, school and therapy settings. Integrating them into the community setting will provide a great means of communication and it will help make the surroundings less intimidating by introducing familiar elements.

Social Stories

One of the most valuable tools that can be used to prepare for community settings is social stories developed by Carol Gray. These stories are effective in helping the individual with autism build expectations.

The autistic person uses a script to help him anticipate the events that are about to occur. This is a valuable way to ease stress in these unfamiliar surroundings. The social stories are also useful in helping the individual with autism understand what others around him might be thinking and feeling.

The social stories serve as a guide that helps the individual with autism rehearse what to say and what actions to take in the community setting. The focus of the stories is on the various "Wh" questions that are so baffling to many autistic individuals: who, what, where, and when.

The stories detail where and when the community outing will take place. They describe who will be there and what activities will occur. This information is often taken for granted but it is so valuable for an individual with autism.

Many choose to use social stories with higher functioning autistic cases. However, some therapists believe that they can benefit almost all children with autism. The child may not respond to the story but he may receptively process some of the valuable information.

Preparing for Community Settings

Some preventative measures can be taken to help the individual with autism thrive in the community setting without incident. Some steps can be taken to insure that the likeliness of a tantrum will be lessened and some interventions can be used when a tantrum is forming while in the community setting:

• Planning ahead for the outing involves preparing the individual for the activities and experiences. Social stories are used as preventative measures through building expectations and rehearsing responses.
• Safety awareness drills can be completed in a safe environment and practiced until the outing takes place in the community setting. The familiar verbal cues and visual aids along with motivating rewards help the individual follow safety instructions in the community setting.
• Organizing a visual schedule as well as valuable PECS is a big part of planning for a community setting and choosing the most opportune time of the day is important as well.
• Considering the individual with autism's prime time of day may take a little time and a lot of observation. Avoid taking the child on a trip when he is typically tired or hungry
• Preparing some sensory integration activities like a quick stop at a park can serve as a release as well as an reward. Community settings can offer great opportunities for an individual with autism to learn and play.
  

DeadTime

Dead time is any period of time in which the individual with autism is not engaged. Basically, dead time involves moments when the child is left in his own world with nothing to absorb. With all of the sensory input that surrounds people in community settings, dead time seems as if it would not be a problem. However, some individuals with autism have hypoactive sensory systems. This means that everything is blocked out, including significant input.

The individual with a hypoactive sensory system will be seen staring off into space. He won't respond to questions or sounds and he will appear to stare though people and objects rather than directly at them. When an individual has a hyperactive sensory system, he may shut down in order to avoid the unpleasant bombardment of sensory input. He experiences dead time as he concentrates on his sensory needs.

Activities That Fill Dead Time

There are interventions and activities that can be helpful in filling dead time when in community settings. Planning ahead by bringing some supplies is helpful but you can engage the child with autism in the community setting in a number of ways.

Bringing play items and interesting materials on a trip is a great way to engage the child while addressing sensory needs as well. Dead time can be filled with simple tactile experiences. A rattle stimulates both vision and hearing.

Dead time can also be filled with language. Ask the child questions and encourage him to attend to specific objects and sounds. A child with autism may enjoy counting the number of times that a speaker is used while in a retail or grocery store. Encouraging him to tell you when he hears the speaker helps him attend to a sound and communicate with others.

Keeping the child with autism engaged at all times is not realistic. However, a community outing will be more interesting and beneficial if there is less dead time.

PECS: Picture Exchange Communication System

The Picture Exchange Communication System is the core of most visual schedules. The images are printed on laminated cards that are 2" by 2" or 1" by 1" and are attached to the schedule with Velcro. This makes placing and removing the images quick and easy. Once a task is completed the PEC is put into a "done" envelop in most cases.

While the PECS approach is used to help make smooth transitions, facilitate communication and build expectations, it can also be helpful in calming and organizing behavior as well. When the child with autism knows what to expect and he is able to communicate a little better he feels less stress and frustration.

However, the unexpected often occurs that can really through things off. Using certain PECS can help the individual with autism calm and organize his behavior in the community setting.

PECS that can be used include:
Quiet
Quiet hands
Okay
Good Job
Wait

These images are used in the home, school and therapy settings and they are strongly tied to dealing with anxious moments and unexpected events. One of the most effective is the "Okay" PEC that lets the child know that everything is fine.

Community Settings

Years ago, the autistic individual was kept out of community settings. Most were housed in institutions and left in a highly structured environments. Many families preferred to keep their children with autism in the home and away from the challenges in the community. Community settings include stores, parks as well as locations for
occupational and speech therapy. Community outings should not be
restricted to doctor's appointments and therapy.

Today, parents and therapists are encouraged to integrate the autistic individual into the community settings. There are challenges to be faced but there are many more learning opportunities and positive experiences to be shared.

Introducing an individual to community settings can be easier if it is approached in systematically. Some planning and forethought is required and the challenges that the community setting poses.

Challenges in the Community

The community setting offers many opportunities for learning but it may bombard the autistic individual with many challenges as well. Understanding these challenges can help parents and therapists deal with some negative behaviors that can occur.

Sensory problems are a significant problem in the community setting. The individual with autism may feel uncomfortable and overwhelmed with all of the different sights and sounds. Consider a trip to a large retail store as an example.

There is a lot of noise in this community setting that many people block out but the individual with autism is unable to do this. He has to sort through a plethora of voices and beeps and rattles that may wreak havoc on his nerves.

The child is also bombarded with images, products, unfamiliar faces and bright lighting. An autistic child may not know what to process and what to ignore and is not sure what sights and sounds are relevant and what are not.

Waiting in line may be a painful experience because it seems to serve no purpose. The child may feel restrained and uncomfortable and very unwilling to wait. The frustration may be magnified by an inability to communicate or release the feelings.

Most community settings pose a great challenge because they are not structured. The child does not know what to expect and he does not know what is expected of him. In addition, all of the sensory input can be overwhelming.