Visual schedules are a series of pictures that demonstrate steps in a process. Visual schedules are used to teach skills like toothbrushing or getting dressed. They can be used to show a child what the schedule is during the day. Dental professionals use this method every day in practice, we just refer to it as the patient schedule rather than a visual schedule. I have found using a visual schedule especially helpful for my patients with autism. This presentation does not discuss autism or the research behind visual schedules. It was created in response to the need for dental professionals and parents to have access to a visual schedule and how to use it. Feel free to contact me for additional information.

1. USING A VISUAL SCHEDULE
TO HELP PATIENTS WITH
AUTISM DURING A DENTAL
HYGIENE APPOINTMENT
Josalyn Sewell, RDH, OMT
josalynsewell@gmail.com
autismaintforsissys.blogspot.com
Facebook: Autism Ain’t for Sissys
Twitter: @autismstrong

2. Introduction
Josalyn Sewell is a
Registered Dental
Hygienist. She
specializes in treating
individuals with autism
spectrum disorders in a
dental setting. Her
greatest instructor in all
things autism is her 10
year old son, Ethan who
has classic autism and
is mostly non-verbal.
Included in this
presentation is the visual
schedule Josalyn uses
with her patients to help
desensitize them before
the appointment and
guide them during the
appointment.

3. What is a visual
schedule?
• Visual schedules are a series
of pictures used to depict steps
to a process.
• Individuals with autism are
highly visual. Using pictures
helps decrease anxiety and
increase understanding.
• The pictures in this
presentation can be printed
and used. It may be beneficial
to take pictures of your office
and your equipment as it is less
confusing.
I recommend giving
parents a copy of the
visual schedule a couple
of weeks ahead of time.
Include descriptions of
what to say for each
picture. Have them
practice several times a
week (every day is best)
before the appointment.
Be sure the pictures are
in the order you expect
the appointment to go
and be sure to label
them for the parents. I
laminate my copy of the
pictures in the operatory
so if they get wet they
are not ruined.

4. What should it
look like?
Visual schedules can be
vertical with the first step
on the top or can be
horizontal with the first
step on the left. It is best
to have all of the
pictures up on a board
like this attached with
velcro; as each step is
completed the picture is
removed and put to the
side. This allows the
individual to the steps in
a series and focus on
what is happening now
and what will happen
next.

5. #1
This is a special chair
used in a dental office. It
can go up and down and
the back lays flat like a
bed so the dentist and
hygienist can look inside
your mouth.

6. #2
When you go to the
dentist you get to be the
special patient that sits
in the chair.

7. #3
To protect your eyes
from the bright lights you
get to wear sunglasses.
To make sure that your
shirt does not get dirty
with water or toothpaste
you will wear a napkin.

8. #4
The hygienist or dentist
will have special items to
wear to protect you from
germs.

9. #5
She will wear:
Goggles
A mask
Gloves
It may look silly but
makes cleaning your
mouth much easier.

10. #6
This is a special camera.
It takes a picture of your
teeth. The picture is
black and white and
checks to see how
healthy the tooth is. The
picture is called an x-ray.

11. #7
To the take the picture
you will wear a heavy
coat. This makes sure
the camera only takes a
picture of your tooth.
The hygienist will also
put a special holder in
your mouth. It will sit by
your tongue. It is very
important to hold your
tongue and your body
very still while the
picture is taken.

12. #8
It is time to lie down in
the chair. This makes it
easy to see inside your
mouth.

13. #9
These are special
instruments used to see
in your mouth.

14. #10
Open your mouth nice
and wide so that the
hygienist can use her
instruments to look at
and count your teeth.

15. #11
This is a special
toothbrush and
toothpaste used by the
hygienist.

16. #12
The hygienist will use
her special toothbrush
on every tooth. It spins
in a circle and vibrates, it
may tickle!

17. #13
These instruments are
used to rinse the
toothpaste off of your
teeth. There is a squirt
gun (on the far left) that
squirts water onto your
teeth and a vacuum
(middle) that will suck
the water out. If there is
a lot of water she may
use the big vacuum
(pink). The vacuums will
sound like this _______
(make a sloshing sound)

18. #14
This is called fluoride.
Fluoride is a special
vitamin that we paint on
your teeth with a paint
brush to protect it from
sugar bugs.

19. #15
The hygienist will dry
your teeth off with her
squirt gun and then paint
the vitamins on your
teeth. The vitamins will
stay on your teeth until
you brush it off. It may
feel funny to your tongue
but it is important to
keep it on as long as
possible.

20. #16
YOU DID IT! You get to
pick a prize. Great job
being a good patient!

21. Additional tips
• It is ok to put several
reward cards in the
schedule especially when
first starting or after a task
that is especially difficult
for the child
• Many individuals with
autism may not be able to
complete the entire
appointment the first time.
Be consistent and patient.
• Take time to interview the
family members before the
appointment to get to know
as much about the patient
as possible. Be prepared.
• Ask the parents to practice
brushing the patient’s teeth
while lying down several
times a week before the
appointment. It can be
intimidating to lie flat and
have someone look in your
mouth if you have never
experienced that before