Journal of Developmental & Behavioral Pediatrics:
Division of Child Development, Rehabilitation, and Metabolic Disease The Children's Hospital of Philadelphia Philadelphia, PA
With the majority of my clinical practice focused on treating children with autism spectrum disorders (ASD), I find myself frequently recommending the use of visual schedules to parents as a way of increasing compliance and/or reducing unwanted repetitive behaviors or language. Unfortunately, for a number of families, the concept of visual schedules is foreign, and I often find it helpful to refer them to online or written guides for creating and adapting visual schedules to meet their needs. Although visual activity schedules have proven quite useful to many of my patients' families, I often receive feedback that children with ASD continue to struggle with identifying appropriate leisure activities during unstructured times in their day. Additionally, families often have difficulty incorporating social activities into schedules meant initially to structure their child's day. Activity Schedules for Children with Autism: Teaching Independent Behavior by Lynn McClanahan and Patricia Krantz addresses both of these challenges in a relatively short and easy-to-read book.
Throughout the book, the authors incorporate photographs and sample schedules as well as short descriptions of children and adults, with varying intellectual capabilities, who have successfully learned to use activity schedules in their daily lives. For readers, the book chapters flow nicely, beginning with introductory topics and progressing to step-by-step instructions for creating and teaching activity schedules to individuals with ASD. Chapter 1 prepares readers by explaining what activity schedules are and how they can be used to increase independence, flexibility, and social interactions. Chapter 2 further prepares readers by providing the prerequisite skills that the individual with ASD will need to have begun to acquire to successfully master the use of activity schedules. In Chapters 2 through 5, readers are instructed on how to develop a simple activity schedule, teach it, and measure their child's success in mastering it. Some of the technical teaching skills, such as graduated guidance, spatial fading, and shadowing, as well as data collection strategies for monitoring success are explained in detail with the visual support of algorithms and photograph examples. Appendices in the back of the book provide worksheets for data collection of prerequisite skills and schedule following.
Chapters 6 through 10 provide readers with another layer of activity schedules, offering parents and teachers more flexibility for advancing skills. In addition, readers are introduced to strategies to increase a child's independence during unstructured times in the day, offering parents a tremendous solution for times when they cannot be actively engaged with their child. Instructions for adding new activities or rearranging activities within a schedule are offered in Chapter 6, and introduction of timers and choices to promote variation in play are discussed in Chapters 7 and 8. Chapters 9 and 10 further advance skill development by teaching the transition from pictures to words for individuals with ASD who have acquired reading skills and incorporating peer interactions and imitation for children at all levels of language development. Finally, incorporating activity schedules into adulthood is discussed in Chapter 10. Two additional chapters refresh readers on the variety of ways that activity schedules can be used to teach skills to individuals with ASD and provide answers to common questions or concerns expressed by parents who have implemented the activity schedules successfully. A list of references and an index are also provided.
Throughout the book, the authors frequently remind readers that everyone relies on a schedule, and they discuss the importance of schedule following being designed to look as natural as possible for individuals on the autism spectrum. Many of the real-life examples also provide parents with reassurance and hope that their child with ASD can develop skills that will increase independence and functionality in adulthood. I would strongly recommend this book to savvy parents, educators, and developmental or behavioral therapists who work with children with ASD.
Disclosure: The author declares no conflict of interest.
Amanda E. Bennett, MD, MPH
Division of Child Development, Rehabilitation, and Metabolic Disease
The Children's Hospital of Philadelphia