First-Then Board for Autism: How to Start

Last updated: October 12, 2026

A First-Then board helps many autistic children because it shows the plan as two pictures that stay in place. Start with one easy task and one strong reward, use the same short words every time, and always keep the promise on the Then card.

Why does a First-Then board help autistic children?

Spoken words are gone in a second, but a picture stays. The child can look at the board again and again and see what is asked now and what good thing comes after.

This is not only a parent trick. In 2020 the National Clearinghouse on Autism Evidence and Practice reviewed the research and named 28 evidence-based practices. Visual supports are one of them. A First-Then board is one of the simplest visual supports: a training guide from the University of North Carolina describes a first/then schedule as two events in a row that help a student understand what comes next (see Sources).

The order of the cards uses an old idea called the Premack principle: a thing the child likes to do can be the reason to do a thing the child likes less.

How do I start?

Start small, on a calm day, with a task your child can already do. This is true for an autistic child of any age. The first goal is not the task. The first goal is that your child learns to trust the board.

1. Pick an easy First. Something short that already goes well, like “Wash hands”.
2. Pick a strong Then. Something your child really wants right now, not something you think is good for them.
3. Show and say. Point to each card: “First wash hands, then bubbles.” Use few words.
4. Help if needed. Help with the task quietly. Do not add more talking.
5. Give the Then at once. The reward comes in the same moment the task is done, every time.

Do this a few times a day for a week. When the easy pairs work, put a slightly harder task on the First card.

Should I use real photos or icons?

Use the kind of picture your child understands best. For a child with autism who is new to pictures, that is often a photo of the real thing.

The same training guide lists the forms a visual support can take: real objects, photographs, drawings or picture symbols, and written words. A photo of your own sink is very concrete. An icon of a sink is more general, and your child may not yet connect it with your bathroom.

• Start with photos of your child’s own things: their shoes, their cup, their tablet.
• Take the photo with a plain background, with only one thing in it.
• If photos work well, you can try icons later. Icons are useful because one picture works in many places.
• If your child reads, add the word. Some children do best with words only.

What are the most common mistakes?

The most common mistake is not giving the reward, or giving it late. Then the board stops meaning anything.

• A weak reward. If the Then is not interesting today, the board will not work today. Change it.
• A task that is too big. “Clean your room” is too much. “Put the cars in the box” is one clear task.
• Changing the deal. Do not add a second task after the first one is done.
• Using it only for hard things. Then the board becomes a bad sign. Use it for easy and nice things too.
• Too many words. Say the same short sentence every time.
• Using it as a threat. “No park if you don’t…” is a different message. The board says what will happen, not what will be taken away.

What if my child refuses or gets upset?

Stay calm, make the task smaller, and show the board again. Do not give the reward before the task, and do not start a long talk.

Ask yourself three things. Is the task too hard right now? Is the reward strong enough? Is my child too tired or too upset to listen? If the answer to the last question is yes, wait. The board works before a hard moment, not in the middle of a meltdown.

How do I fade the board out?

Fade it slowly, one small step at a time, and only when things go well.

1. Use the board only for the hard moments of the day.
2. Later, show the board but say less.
3. Then say the words “first…, then…” without the board.
4. Stop when your child no longer needs it.

Many children do not stop using pictures. They move on to a bigger tool: a First-Then-Next board, and later a full visual schedule. That is progress too. Bring the board back any time, for example in a new place or after a change at home.

Should home and school use the same board?

Yes, if you can. The same pictures and the same words in both places make the board easier to understand.

Show the teacher or therapist the board you use. You can print it for the school bag, or move your boards to another device with the Backup button in the menu.

Sources

• Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., Szendrey, S., McIntyre, N. S., Yücesoy-Özkan, S., & Savage, M. N. (2020). Evidence-based practices for children, youth, and young adults with autism. The University of North Carolina at Chapel Hill, Frank Porter Graham Child Development Institute, National Clearinghouse on Autism Evidence and Practice Review Team. Report (PDF)
• Sam, A., & AFIRM Team (updated 2024). Visual Supports: EBP brief packet. Autism Focused Intervention Resources & Modules (AFIRM), UNC Frank Porter Graham Child Development Institute. Brief packet (PDF)
• Premack, D. (1959). Toward empirical behavior laws: I. Positive reinforcement. Psychological Review, 66(4), 219–233. doi.org/10.1037/h0040891

This page is general information from the makers of First Then Board. It is not medical or therapy advice. Every child is different: if your child has a therapist or a teacher, ask them what fits your child.

More guides

• Free printable First-Then board (PDF)Blank templates and label cards, A4 and US Letter.
• First-Then-Next boardThe 3-card board: what it is and when a child is ready.
• First-Then board for toddlersTiny tasks, tiny rewards, potty training and tantrums.
• First-Then board vs visual schedule vs token boardA simple table: when to use which.