First/Then Card: Home

  • Situation

    My child tantrums or hits whenever he can’t get what he wants right away. For example, it takes me about 5 minutes to get all of his medications ready and while I’m doing this he’ll want me to sit on the couch and read with him. When I tell him to wait he tantrums or hits me.

  • Summary

    Use a First/Then card to show your child that he will get what he wants as soon as the first activity is complete. Many children with autism need to see this information visually to understand when they will get what they want and wait calmly for it. Using a First/Then card shows him that FIRST you will prepare his medicine, AND THEN you will read with him.

  • Definition

    A First/Then Card is a visual display showing the order of two activities from left to right. The visual of the activity that is going to happen first is Velcro’d to the spot on the left and the visual of the activity that is going to happen second is Velcro’d to the spot on the right. This visual is shown to your child to help him or her understand that the second activity will happen once the first one is finished. First/Then cards can be used for a variety of purposes, including helping a child wait for a preferred activity.

  • Quick Facts

    • Child's Age: 0-2, 3-5, 6-10, 11-13, 14-17
    • Planning Effort: Low
    • Difficulty Level: Easy
  • Pre-requisites

    Child recognizes and understands visual representations of activities. A First/Then card with photos or other visual representations of daily activities and activities preferred by your child.

  • Process

    1. It is best to arrange and show your child the First/Then card when the first activity is about to start but before your child is showing behavior problems, or in response to your child requesting the second activity but before showing behavior problems. However, you can also use the First/Then card with your child if he or she has already started to get upset or act out.

    2. Get the First/Then card along with a visual of the first activity and a visual of the second activity.

    3. Attach the visual of the activity that will happen first in the “First” box and attach the visual of the second activity in the “Then” box.

    4. Show your child the First/Then card and point to the visuals, saying for example “First medicine, then reading”.

    5. Begin the first activity.

    6. When the first activity is finished, show your child the First/Then card and say (for example) “Medicine is finished!” while taking the first visual off of the First/Then card. Then point to the second activity and say (for example) “Now, reading.”

    7. Allow your child to now engage in this second activity.

    Note: Your child may continue to have some behavior problems during the “first” activity until he or she understands the First/Then card. Respond to behavior problems by presenting the visual and reminding your child, “First X, Then Y.” If possible you may want to make the “first” activity very brief when your child is first learning the procedure, then gradually increase the duration of the “first” activity until it fits with your natural schedule.

  • Documents and Related Resources

    Work time and break time story (Word document)


    Work Time then Break Time Story (PDF)

  (website resource for pictures/icons)


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