# Visual schedules for autism and ADHD: pictures, timers and first/then boards Canonical: https://romeoapps.app/en/bravi/visual-schedule-autism-adhd/ Author: Roméo Gambino · Published: 2026-09-23 · Updated: 2026-09-23 · App: Bravi (https://romeoapps.app/en/bravi/) What visual supports are, what research says for autistic children, where they sit in ADHD care, and how to build a picture schedule your child can use. ## A tool, not a treatment Visual schedules are widely used with autistic children and with children who have ADHD, and many parents build one at home. This guide explains what the research does and does not say, and how to make a schedule your child can use. It is not medical advice. A visual schedule supports daily life; it does not diagnose, treat or replace the care of a doctor, psychologist, therapist or teacher. ## What visual supports are In autism research, a visual support is defined as a visual display that supports the learner in engaging in a desired behaviour or skill without additional prompts. Picture schedules, first/then boards and visual timers are all displays of that kind. The underlying idea is simple: information that stays in view is easier to use than information spoken once and then gone. ## What the evidence says for autistic children A 2021 systematic review by Hume and colleagues, covering studies published between 1990 and 2017, identified 28 practices that met its criteria for evidence-based practice with autistic children and youth. Visual supports were one of them, backed by 65 studies. An earlier review by Knight, Sartini and Spriggs concluded that visual activity schedules can be considered an evidence-based practice for people with autism, especially when combined with systematic instruction, and that they can be used from preschool through adulthood. Almost all of the supporting studies were single-case designs, so they show that the approach works when it is taught carefully, not that any chart works by itself. ## Where visual schedules sit in ADHD care For ADHD, the recommended care is organised differently. The American Academy of Pediatrics guideline recommends evidence-based parent training in behaviour management and/or behavioural classroom interventions as the first line of treatment for preschool children aged 4 and 5, and, for children aged 6 to 11, approved medication along with parent training and/or classroom interventions. A picture schedule at home does not replace that care. It can be one of the practical tools a family uses every day, and a clinician or parent-training programme can help you fit it into a wider plan. ## Start with one routine that matters Pick one moment of the day that is reliably hard, such as the school morning, coming home or bedtime, and build a schedule for that moment only. Write down the steps as they really happen, then keep only the ones your child needs support with. A small schedule that works is a better start than a whole-day timetable that nobody follows. ## Make each step concrete Use one picture per step, showing the action itself rather than an abstract symbol, with one or two words underneath. Some children recognise photos of their own toothbrush or school bag more easily, others prefer simple drawings; try both and keep what works. Use the same picture for the same action every time, because recognising it instantly is part of what makes the schedule useful. ## Now and next: the first/then board For many children the whole day matters less than the next transition. A first/then board, also called a now-and-next board, shows just two pictures: what to do first, and what comes after it. It is handy when the first step is the less appealing one: “First shoes, then park”. Keep the promise on the second card. If the next activity is not really going to happen, it should not be on the board. ## Prepare transitions before they arrive Changing activity is a frequent source of friction. Show your child what is coming before it arrives: point to the next picture and give a warning a few minutes before the switch. A visual timer makes the time left concrete for a child who cannot yet read a clock. Hume and colleagues also list antecedent-based interventions, arranging what happens before an activity so that the desired behaviour becomes more likely, among the evidence-based practices for autistic children; previews and warnings are an everyday form of that idea. ## Teach the schedule, then step back Knight and colleagues found that visual schedules worked best when combined with systematic instruction. At home, that means showing your child how the schedule works rather than simply putting it on the wall: go through it together, point to each picture, and help less as your child becomes more independent. The goal is for the schedule, not your voice, to carry the routine. ## Keep sensory load low if it helps Some children are sensitive to noise, busy animation or sudden sounds. If that describes your child, keep the schedule visually calm, avoid alarm-like timer sounds and put it somewhere quiet. This is a matter of comfort and attention, not a therapy. ## Praise and rewards Hume and colleagues also count reinforcement among the evidence-based practices. At home, that can be as simple as specific praise when a step is done, or a token such as a star that adds up to a reward chosen in advance. Keep it predictable and agreed beforehand; our guide to reward charts explains how to set one up without it turning into bargaining. ## Keep it stable, change one thing at a time Predictability is a large part of the value. Use the same schedule, in the same place, for the same routine. When something needs to change, change one step at a time and tell your child before it happens. When a day is going to be different, such as a doctor’s appointment or a trip, show the different steps in advance with the same kind of pictures. ## Work with the people around your child If your child sees a speech and language therapist, an occupational therapist, a psychologist or a teacher who uses visual supports, ask which pictures and words they use and use the same ones at home. Consistency between home and school makes each picture quicker to learn. Share what you notice too: which steps go smoothly and which do not is useful information for them. ## Where Bravi fits Bravi is a visual routine app for iPhone and iPad, designed so that it can work well for children with ADHD or autism among others, without claiming any clinical effect. During setup you can say whether your child has ADHD or attention difficulties, is autistic, or is very sensitive to noise. Bravi then turns on a gentle warning before timers end, reads every card aloud, or switches to calm mode, with no sounds or animations. The child view shows one step at a time with a picture and one word, a First / Then board puts two pictures side by side, and a calm corner offers one minute of breathing with the Bravi star. Your answers stay on the device. ## Questions ### Do visual schedules help autistic children? Research reviews count visual supports, including visual activity schedules, among the evidence-based practices for autistic children and youth, especially when they are taught with systematic instruction. Most supporting studies are small single-case studies. ### Do visual schedules help children with ADHD? They are a common practical tool, but the main recommended treatments for ADHD are parent training in behaviour management, classroom interventions and, from age 6, medication, according to the American Academy of Pediatrics. A schedule at home can sit alongside that care, not replace it. ### What is a first/then board? A two-picture visual support: the first card shows what to do now, the second what comes next. It helps with a single transition, such as “First bath, then story”, and only works if the second card is a promise you keep. ### Should I use photos or drawings? Whichever your child recognises fastest. Some children respond better to photos of their own things, others to simple drawings. Keep the same picture for the same action every time. ## Further reading - Hume et al. (2021), Evidence-based practices for children, youth, and young adults with autism: Third generation review, Journal of Autism and Developmental Disorders — https://doi.org/10.1007/s10803-020-04844-2 - Knight, Sartini & Spriggs (2015), Evaluating visual activity schedules as evidence-based practice for individuals with autism spectrum disorders, Journal of Autism and Developmental Disorders — https://doi.org/10.1007/s10803-014-2201-z - Wolraich et al. (2019), Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents, Pediatrics — https://doi.org/10.1542/peds.2019-2528