An examination of the effects of a classroom activity schedule on levels of self-injury and engagement for a child with severe autism.

One team worked with a young learners boy in a special-ed class. The boy had severe autism and hit his head about 30 times an hour.

First they ran a 10-minute functional analysis in the classroom. They found the self-injury was worst when adults gave demands and ignored him the rest of the time.

Next they built a simple three-step schedule: 5 min of no adult talk, 5 min of free play, then 5 min of school work. They posted the steps on his desk with pictures.

Self-injury dropped from 30 hits an hour to almost zero. Engagement jumped from a large share to a large share.

The gains lasted five months with no extra rewards or restraints. The teacher only needed 30 seconds each morning to point to the schedule.

Grahame et al. (2015) looked at 31 studies and declared visual activity schedules an evidence-based practice. O'Reilly et al. (2005) is one of the studies inside that big review, so the review backs up this single case.

Pilgrim et al. (2000) used picture schedules with graduated guidance four years earlier. Their kids also stayed on task, but they taught the schedule like a new skill. Mark skipped heavy teaching and let the schedule itself do the work.

Orsmond et al. (2009) later moved the same FA-driven idea into general-ed rooms with eight kids. They changed lights, timers, and warning cues instead of using a fixed schedule. Both teams wiped out problem behavior, showing the method scales beyond one child.

You can cut severe self-injury without extinction bursts or token boards. Run a quick classroom FA, then line up the day so the hardest part (demands) always follows two easier parts (quiet time and play). Post the order with pictures. One minute of setup can give you months of calm and learning.