How to use a First-Then board at home

What is a First-Then board?

A First-Then board is a strip of cardstock with two spaces. One shows what your child is doing first. The other shows what comes next. Some people call it a First and Then board.

It is one of the simplest visual supports. AFIRM, a free training program from the University of North Carolina team that reviews autism research, describes a first/then schedule as "a type of visual support that includes the sequencing of two events to help a student understand what comes next" (AFIRM).

Two pictures keep things simple. Your child only has to hold on to one idea: after this, that. A picture also stays put after your words have gone, so your child can look again whenever they need to.

You may have seen First-Then boards used in ABA (applied behaviour analysis) sessions. AFIRM says visual supports can be used by teachers, therapists and early interventionists, and that "parents and family members also can use Visual Supports in the home". This guide is about the board itself, as a tool for home. You don't need a diagnosis, a referral or a program to use one.

When can a First-Then board help?

Use it at the moments when your child has to stop one thing and start another, and before something new. A tip sheet from Children's Autism Services of Edmonton lists uses such as helping to "support transitions (activity to activity or between locations)" (Children's Autism Services of Edmonton). A good place to start is the moment that is hardest every day.

Use it for good moments too: "First lunch, then swings." That way, the board doesn't only appear before things your child dislikes.

How do I make a First-Then board?

You need cardstock, photos or symbols, Velcro dots, an envelope or small box, and clear contact paper or a laminator if you have one. Paper, a pen and tape are enough to start tonight.

1. Make the board. Use a strip of stiff cardstock. Draw a line down the middle, and write "First" on the left and "Then" on the right. Or print the free First-Then board, which prints on standard letter-size paper.
2. Choose the kind of picture. Use what your child understands: real objects, photos, symbols or written words. Photos of your child's own things are often easiest to start with. Research with minimally speaking autistic children suggests colour photos can help children connect a picture with the real thing (Hartley and Allen 2015).
3. Take the photos. Photograph a handful of everyday things, such as their cup, the bath, the car seat, their jacket, the daycare door and their bed, plus a few favourite things.
4. Add the word. Write the word under each picture, so every adult says the same thing.
5. Make them last. Cover the board and pictures with clear contact paper or wide packing tape, or laminate them.
6. Add Velcro. Put a Velcro dot on each space on the board, and the matching half on the back of each picture.
7. Make a "finished" place. Tape an envelope or small box to the side of the board, labelled "finished" (or "all done"). Pictures go in here when an activity ends.
8. Store the spares. Keep the other pictures in a pouch, or on a strip of Velcro on the back of the board.

Make a second, smaller board for your bag, the car or a grandparent's house. For symbols instead of photos, ConnectABILITY's free Visuals Engine builds printable picture supports in English or French (ConnectABILITY).

How do I use a First-Then board every day?

Show the board before the change, say very little, and do what the board says. The Edmonton tip sheet puts it simply: "Avoid repeating verbal instructions. Instead, point to the sequence on the first-then board."

1. Set it up. Put the current activity under "First" and the next one under "Then".
2. Show it before the change. Get down to your child's level, point to each picture in turn, and say the same short words each time.
3. Wait. Give your child a moment to take it in. When you wait for a child to communicate, the Hanen Centre in Toronto suggests you "Stop talking", lean in and show you're interested (Hanen Centre).
4. Show it again at the change. Point to the "First" picture and say "finished".
5. Do the finished routine. Your child takes the "First" picture off and puts it in the finished envelope. If they don't want to, do it together, or do it yourself while they watch.
6. Move Then across. Move the "Then" picture into the "First" space, and add a new "Then".
7. Keep your word. Only put up what will really happen. If plans change, change the board and show your child.

How do I make it work for my child, not against them?

A First-Then board works best when it feels helpful to your child, not like a list of orders.

In ABA and other behaviour-based programs, the board is often set up with a less-liked activity first and something the child enjoys second. The Edmonton tip sheet bases the board on the principle that a person's motivation "to complete a less preferred activity is increased when it is followed by a more preferred activity". The board can also simply show the order of things: "First bath, then story." Either way:

• Use it for good things too. If it only appears before bath time or leaving the park, it becomes a sign that something unwelcome is coming.
• Make sure the Then happens. If the board shows something your child enjoys, give it once the first step is done, even if you helped. The Edmonton tip sheet says to "Ensure the preferred item/activity is available for the child when the work is completed."
• Never use it as a threat. Avoid "First shoes, then no tablet", and never take the "Then" picture away as a punishment.
• Keep it in the same place. Put it at your child's eye level, where the change usually happens, such as by the front door or on the bathroom wall.
• Use the same board at daycare, school and therapy if you can. AFIRM advises using visual supports "consistently and across settings". Share your photos, or ask for copies of the symbols your child's daycare, kindergarten (JK and SK in Ontario) or therapist uses.
• Offer a choice for "Then". Hold up two pictures: "Then swings or slide?" In a small study of three students with high support needs, being given choices reduced serious distressed behaviour (Dyer, Dunlap and Winterling 1990).
• Listen to "no". If your child pushes the board away or points to "no", that is a message. Respond to it, even if the plan can't change.

What if my child throws it, ignores it or gets upset?

Most problems have a simple cause. Change one thing at a time, and give each change a few days.

My child throws the board or pulls the pictures off

Throwing a board is often a way of saying "no" or "I don't want that". That is communication, not misbehaviour.

• Check what usually goes on the board. If it is often something your child dislikes, add more things they enjoy.
• Make taking the picture off part of the routine, so your child has a job to do.
• Fix the board to the wall or fridge, and give your child a separate "no" or "break" card to use instead.
• If the board has become a sign of bad news, put it away for a few days. Bring it back with only enjoyable things for a while.

My child ignores it

• Try an easier kind of picture: real objects, or photos of their own things.
• Take the board to your child, at their eye level, rather than pointing from across the room.
• Show it at the moment of change, rather than leaving it up all day and hoping they notice.
• Use fewer words.
• Check the board has been reliable. If what it showed often didn't happen, rebuild trust with simple, sure things.

My child gets upset when they see what comes next

Being upset can mean your child has understood what is coming and doesn't like it. The board is getting its message across; the next step is to make the change itself easier.

• Show the next picture earlier, so your child has time to get used to the idea.
• Give something worth moving to, such as a favourite toy to carry or something nice straight after.
• Offer a way back later: pause the show, take a photo of the block tower or put the toy on a "later" shelf.
• Add a finishing ritual, such as "one more turn, then finished".
• If one activity always causes upset, look at the activity itself. It may be noisy, uncomfortable or too long.

See meltdown, tantrum or shutdown if upset turns into overwhelm, and feelings and calm for ways to help your child settle.

What does the research say about First-Then boards?

We did not find any studies that test First-Then boards on their own with young autistic children. The support for them comes from wider research on visual supports, and from professional guidance.

• A large US review, by the National Clearinghouse on Autism Evidence and Practice (NCAEP), classed visual supports as an evidence-based practice for autistic children and young people, based on 65 studies (NCAEP 2020).
• A review of 31 studies of picture schedules concluded they can be considered evidence-based, "especially when used in combination with systematic instructional procedures". In plain terms, they worked best when adults taught children how to use them, step by step (Knight, Sartini and Spriggs 2015).
• In Canada, the Canadian Paediatric Society advises doctors to counsel families on strategies such as "structured, predictable routines" (Canadian Paediatric Society), and autism services such as Children's Autism Services of Edmonton give families First-Then tip sheets.
• They don't make every change easy. In a small study of two autistic children, picture schedules on their own did not reduce distressed behaviour when the children had to move from a liked activity to a less-liked one (Waters, Lerman and Hovanetz 2009). A 2026 review of 19 small experiments found that warnings on their own often did not reduce distress at transitions (Kim et al. 2026).

When is my child ready for a visual schedule?

When your child uses the two-picture board easily and starts looking for what comes after "Then", try adding a third picture: "First breakfast, then shoes, then car." Build up slowly to a short strip for one part of the day, such as the morning. This gradual build-up is common practice rather than something research has tested, so go at your child's pace.

The free visual schedule printable and the guide to visual schedules show how. You can keep using the First-Then board for hard moments, even once your child has a visual schedule.

Where can I get more help?

Ask for advice if you are not sure which pictures suit your child, or if the board still isn't helping after a few weeks of steady use.

• A speech-language pathologist (S-LP) can advise on the right kind of picture and how to use it. Your family doctor can tell you how to reach speech-language services where you live.
• Your child's daycare, school or therapy team can use the same board and pictures, so your child sees the same thing everywhere. At school, that may include a resource teacher or an educational assistant.
• Autism Canada runs a national support line, and provincial groups such as Autism Ontario, ACT in British Columbia and Autism Society Alberta offer information and support.