Here we share a visual picture schedule example used to improve learning and understanding for our loved one with autism to prepare him for a trip to the hospital for oral surgery under dental anesthesia.
A few weeks before our loved one was admitted to the hospital for oral ambulatory surgery, he needed to be prepared before the event. Although we tried to explain step-by-step those things most likely to happen, we understand that he needs a visual picture schedule to help him better understand the process leading up to most new experiences.
Our family member likes to read and loves being read to. The first step was to find the right children’s book to help us explain to him in a clear, non-threatening manner that children sometimes need to go to the hospital for surgery. The book would also need to tell the story in a way which does not makes him fearful of the hospital.
Luckily for us, we found a wonderful classic children’s book
Curious George Goes to the Hospital.
When his friend, the ‘man with the yellow hat’ gives Curious George a picture puzzle, poor accident-prone George swallows a puzzle piece and must go to the hospital and have it removed – surgically.
The second step was to make a preoperative hospital visit which allowed us to actually take the road trip with our loved one, see the sights, the hospital, visit with a nurse, and meet the anesthesiologist. We asked the nurse and anesthesiologist to tell us what we could expect to happen from the time we arrived until the time we left to go home after the surgery. They were happy to tell us what to expect on the day of surgery.
A phone call with a nurse and anesthesiologist will be helpful if there is no preoperative hospital visit.
Based on the information they gave us, the third step was to put together a visual picture schedule we could introduce to our loved one after reading Curious George Goes to the Hospital many, many, many times over -- as a social story.
Below is a visual picture schedule example we made with a 8 ½ x 11 sheet of laminated construction paper with round sticker word and picture icons.
If I can't picture it.
I can't understand it.
Row 1: The first row of word and picture icons in the visual picture schedule example help us to explain the procedure of having to get undressed to put on a hospital gown, then have a physical examination and preoperative tests.
Row 2: The second row of word and picture icons in the visual picture schedule example help us to explain when it was time for our family member to prepare to go into the operating suite. He would be given a liquid sedative, await the arrival of the surgeon, and an intravenous needle would be inserted into his hand.
Row 3: The third row of word and picture icons in the visual picture schedule example help us explain that he must lie down on a gurney to be wheeled into the operating room. He should not be afraid because he would be fine. He was going into the operating room to go to sleep and get his teeth fixed.
Row4: The fourth row of word and picture icons in the visual picture schedule example allowed us to show him while he was still sleepy from the anesthesia that the procedure was finished! And praise him for his bravery. Soon it is time to leave the hospital. However, you will be sit in a wheelchair until you leave the hospital. Now it’s time to go home!
Row 5: The fifth row of word and picture icons in the visual picture schedule example is to show our loved one he will take another dose of medicine to help relieve his discomfort as soon as we get home. A praise is given as a reinforcement for getting through this stressful day.
In hindsight there are just a few important facts we could have included in this visual picture schedule example to help us explain:
Admitting Office – the place where a plastic bracelet will be put on your wrist. The bracelet is worn to identify you to all the hospital workers. It will not come off until you leave the hospital.
Wait Time – there is a period of wait time after you are admitted to the hospital until the time of surgery. Books, games and other favorite activities for your child is helpful to pass the time – along with lots of patience.
Discomfort/Pain – there may be some degree of nausea, discomfort and pain after a medical procedure or surgery.
Feelings/Sensations – whenever teeth are drilled, filled, pulled or capped your mouth may feel differently and will feel better very soon.
Visual Picture Schedule Resources
Richard John Novak, M.D. Clinical Associate Professor, Stanford Department of Anesthesiology offers information on the effects of children with autism and dental anesthesia, standards of care, drugs commonly used, and how emotionally uncooperative patients are treated.
Practical Visual Picture Schedule Resources
The PAC Kit is a downloadable daily
Planner, Agenda and Calendar
especially designed to help disorganized students at any age get organized with their homework, notes and assignments from school to home and back again.
View the visual picture schedule examples we've made for our loved one to help improve learning and understanding both at home and school: