10-Minute Speech Practice That Doesn't Require Sitting Still

Last updated 2026-07-11

What is a first then board and why does it work for late talkers?

A first then board is exactly what it sounds like. Two sections, one labeled "First," one labeled "Then," each holding a picture that stands for an activity or item. First you do this. Then you get that. That's the whole structure.

For a kid still building language, the board does one powerful thing: it turns time into something you can see. Waiting is abstract. Sequence is abstract. "After lunch we'll go to the park" moves through the air and disappears. A picture stays put on the shelf. Young children, and especially neurodivergent kids, often struggle hard with holding those spoken instructions in mind.

Children with autism spectrum disorder tend to process visual information more reliably than sound alone, which is why the National Research Council's report Educating Children with Autism singled out visual supports as a core practice back in 2001 ^[1]. A first then board gives the child a way to hold time in their hands. That predictability takes the edge off the uncertainty that drives a lot of meltdowns.

The board also builds a natural reason to communicate. Point to the "Then" picture, say "then park," and you're modeling two-word language at the exact second the child is most motivated to listen. Motivation is the ingredient most home practice skips.

How is a first then board different from a full visual schedule?

A full visual schedule might lay out eight or ten steps across a morning. A first then board shows two. That gap matters more than it looks.

For a kid just meeting visual supports, ten steps is a wall. It asks them to process a pile of information and hold a long sequence in mind at once. Two steps fits in one glance. They can see the whole thing.

The American Speech-Language-Hearing Association groups visual supports under augmentative and alternative communication (AAC), the broad category of any tool that helps a person express or understand language ^[2]. A first then board sits at the simple end of that range, which is why it's such a good place to begin. You don't need a PECS binder or a speech-generating device. You need two pictures.

Once the child gets "first, then" reliably, you expand. Three steps, then a morning strip, then a full daily schedule. The first then board is the foundation, not the ceiling. You're really teaching one rule: routines are predictable, and I can see what's coming. That rule carries over to every visual support they meet later.

If you want to see where this fits in the bigger picture, the piece on aac devices walks through the full range.

What materials do you actually need to make one?

Nothing fancy. Here's the honest range.

Simplest version: a piece of cardstock folded in half, "First" on one side, "Then" on the other, with real photos from your phone printed at home. Costs almost nothing and works as well as any store board for most kids.

Next level up: a laminated board with velcro dots so you can swap pictures. Laminating pouches run about $15 to $20 for a 100-pack at any office supply store. This is what most families land on after the first week. It survives being thrown, and the swap-ability means one board covers dozens of situations.

Commercial first then boards, including ones tied to symbol systems like Boardmaker, run roughly $20 to $60 for a physical product. The symbol libraries cost more and are worth it if your child's speech-language pathologist (SLP) already uses them, because matching symbols across home and therapy keeps things clear for the kid.

For the pictures, real photos of your actual child doing the actual thing beat generic clip art for a lot of kids early on. A photo of your child's specific bowl of crackers reads faster than a cartoon bowl. As symbolic understanding grows, shift toward line drawings, which travel better and swap easier.

Already using PEC cards from therapy? Use those exact symbols. Consistency beats novelty here.

How do you set up a first then board step by step?

Start with a routine your child already knows. Introducing a new tool during a brand-new situation stacks two learning demands at once. Pick something predictable: snack, bath, shoes on before going outside.

Step 1: Choose the "First" activity. Something the child needs to do but might resist, or simply the next required step. Shoes on. Three bites. Hands washed.

Step 2: Choose the "Then" item. Something the child genuinely wants. It doesn't have to be a treat. Often it's a specific toy, a favorite show, going outside, a preferred food. "Then" has to feel worth it to the child, not to you.

Step 3: Load the board before you need it. Set it up at snack time before your child comes to the table, not mid-meltdown. A visual support introduced during a crisis rarely lands.

Step 4: Get to eye level and show it. Point to "First," say "first shoes." Point to "Then," say "then outside." Keep the words short. You're not explaining the system. You're using it. The board explains itself.

Step 5: Follow through the second "First" is done. Point to "Then" and deliver it. Consistency is everything in the first two weeks. If "Then" doesn't reliably show up, the board stops meaning anything.

Step 6: When "Then" is delivered, some families flip the "First" picture over or pull it off to mark completion. That clean ending helps kids who struggle with transitions.

First try, maybe five minutes. After that, thirty seconds.

What pictures work best for non-speaking or minimally verbal kids?

Start with photos of real objects and real people before line drawings or abstract symbols. Symbol-learning research points this direction, including Pat Mirenda's work on functional AAC for students with autism ^[3]. For a child without reliable symbolic understanding, a generic cartoon "outside" means less than a photo of your actual back door.

Photos have one catch: they're specific. A photo of your child's red cup at home won't carry over to grandma's house. Line drawings and standardized symbols travel better. Most SLPs start with photos, pair them with a simple line drawing over time, then fade the photo once the symbol reads reliably.

For the "First" picture, pick things the child can actually finish on their own or with light help. If "First" needs a fight every time, the board isn't cutting conflict, it's just repackaging it. Ask whether the demand itself needs adjusting before you blame the tool.

For the "Then" picture, be honest: does my child actually want this, or do I think they should? Motivation is the engine. An SLP evaluation can pin down what genuinely moves a specific kid if you're guessing. The article on speech therapy and speech therapists covers how to find one and what to expect.

One practical move: keep five to ten "Then" pictures on hand so you can rotate and keep the reward fresh.

When should you use a first then board during the day?

Not all day. That's the most common mistake.

A first then board earns its keep at transition points. Moments when you're asking a child to stop something preferred and start something less preferred, or finish a non-preferred task before getting what they want. Bath time. Getting in the car. Ending screen time. Starting homework.

Using it for every mundane moment waters down the signal. The board should mean one specific thing: I can see what's happening and what comes next. If it's always out for low-stakes stuff, it loses that grounding effect.

For kids with real transition anxiety, two to four uses a day is a sane starting target. Track which transitions are hardest and aim the board there first. After a few weeks of wins, expand.

For late talkers, lean toward moments where the child is highly motivated, because that's where language is most likely to surface. If your child badly wants to go outside, the second before going outside is when they'll try "outside" or "go" or any approximation. The board concentrates that motivation into a predictable spot.

Timing matters across settings too. A 2021 review in the Journal of Autism and Developmental Disorders reported that visual supports worked best when used consistently across home, school, and therapy rather than in one place ^[4]. Ask your child's SLP what they run in sessions so you can match it at home.

How do you use a first then board to encourage speech?

The board isn't only a behavior tool. Used on purpose, it's a language lesson.

When you show it, model the language you want the child moving toward. Aiming for single words? Say the one word as you point. "Shoes," then pause. "Outside," then pause. That pause is called a time delay, and it's a well-supported way to prompt spontaneous communication in kids with language delays ^[5].

Working toward two-word combos? Model two words. "First shoes." "Then outside." Don't expect them to say it back right away. You're building an internal model across dozens of exposures.

Some kids will start pointing to the "Then" picture on their own to request it. That's communication, words or no words. Answer it like they said it: "Yes! Outside!" and follow through. Responding to nonverbal bids consistently is one of the best-documented ways to grow early language, as Yoder and Stone found comparing two communication interventions for preschoolers with autism ^[6].

Using AAC? Pair the board with the device. After the board, prompt them to find the same symbol on their device or PECS book. That bridges the schedule and their main communication system.

The Little Words app builds modeling prompts around these exact daily moments, if you want structure for the language-teaching part.

Never use the board as a bribe after the fact. "You should have done first then" teaches nothing. The board has to be present and shown before the transition, not explained during a meltdown.

What do you do when a child ignores or rejects the board?

This happens. It doesn't mean the approach is broken.

First, check the "Then." Does the child actually want it right now? A favorite at 8am can be neutral by 4pm. If they seem indifferent to the "Then" picture, swap it before you assume the board failed.

Second, check the "First" demand. Can the child realistically finish it? A step that's too hard or too long breeds avoidance. Break it down. "First one bite" instead of "First eat your lunch."

Third, check your own face when you present it. If the board only ever shows up during hard moments, it picks up that history, and the child may be reacting to the association rather than the board. Introduce it during an easy, neutral sequence first. "First block, then puzzle," where both are fine. Let them succeed with the format before you use it for the hard stuff.

If a child keeps destroying, throwing, or refusing to look at the board after two to three weeks of genuine consistent effort, bring it to an SLP. The child may need a different visual format, a different modality, or a different approach to demand fading. Some kids need object-based schedules (actual objects standing in for activities) before they can read two-dimensional pictures.

For autistic kids with significant anxiety or sensory sensitivities, the resistance might be telling you something about the transition itself, not the tool. An SLP experienced in autism spectrum speech therapy can help you read what's going on.

Is a first then board appropriate for all late talkers or just autistic kids?

First then boards grew out of applied behavior analysis (ABA) and special education, and they carry the most research for children with autism spectrum disorder. But visual supports help any child who leans visual, runs anxious around transitions, needs predictability, or is early in building language comprehension.

Plenty of late talkers without an autism diagnosis benefit. A child with a language delay who doesn't yet reliably follow spoken instructions is in exactly the spot where a visual cue can bridge comprehension while the language catches up.

Kids with childhood apraxia of speech (CAS) often find visual supports useful for a related reason: spoken instructions are hard to hold and process when motor planning for speech is the main challenge. More on that at childhood apraxia of speech.

The American Academy of Pediatrics recommends that any child with a language delay get evaluation and early support without waiting on a formal diagnosis ^[7]. A first then board needs no diagnosis to try. It's low cost and low risk. Worst case, your child ignores it.

For kids hitting typical milestones who are late talkers with no other concerns, a first then board may be less necessary. It's never harmful, though, and lots of families use it purely to smooth toddler transitions, delay or not.

How do early intervention services use first then boards?

Early intervention (EI) is a federally mandated program under Part C of the Individuals with Disabilities Education Act (IDEA), covering children under age three with developmental delays or disabilities ^[8]. For ages three to five, Part B of IDEA covers services through the school district.

Inside EI and preschool special education, visual supports like first then boards are among the most commonly recommended evidence-based practices. The National Professional Development Center on Autism Spectrum Disorder lists visual supports as one of 28 evidence-based practices for children with ASD, drawn from their systematic review of the research ^[9].

Your child's EI SLP or developmental specialist may already run a first then board in sessions. Ask them to show you exactly how they use it, which pictures they've picked, and how they prompt language around it. Asking for a home version of the same board is completely reasonable and usually easy to set up.

Not yet getting EI and worried about your child's language? The article on early intervention explains how to request an evaluation. The evaluation is free, and in most states you can contact your state's EI program directly without a doctor's referral.

Consistency between EI or preschool and home is one of the strongest predictors of generalization, meaning whether the child uses the skill in new places. Ask your child's team what they're using and mirror it as closely as you can.

When should you fade a first then board out?

The goal is always independence, and that includes independence from the board.

Start fading when the child completes "First" tasks consistently without much distress, when they begin anticipating transitions without checking the board, and when their comprehension has grown enough that spoken reminders sometimes work on their own.

Fading isn't yanking the board away. It's a slow dial-down. One approach: leave the board visible but stop pointing to it during easy familiar transitions. If the child handles it fine, the board wasn't doing the heavy lifting anymore. Step back.

For some kids the board stays in specific contexts for years (high-anxiety situations, new places, novel demands) long after it's gone from daily routines. That's fine. A tool doesn't need to disappear to count as a win.

Ready for more? A full visual schedule is the natural next step. Some kids move to a picture-based morning strip, then a simple written list, then no external support. That path can take months or years and looks different for every child.

Nobody has clean data on exactly when the average child with a language delay stops needing visual supports. Honest answer: watch the child, not the calendar. When they hold a two-step sequence in mind without the board, you fade it there. When they can't, you keep it.

What does the research actually say about first then boards working?

The evidence for visual supports broadly is solid. For first then boards as a named format specifically, the research is thinner and tends to sit inside larger studies of visual support systems or behavior intervention packages.

A 2020 systematic review in Focus on Autism and Other Developmental Disabilities examined visual schedule research across 23 studies and found consistent positive effects on transition behavior, task completion, and independence in children with ASD and intellectual disabilities ^[10]. Most of those studies used formats that included first-then or two-step components.

The National Autism Center's National Standards Project rates interventions by evidence strength and classifies visual supports as an "established" treatment for individuals with ASD ^[11]. That's the top rating in their framework.

On language specifically, the link between visual supports and more verbal output is more indirect. Visual supports appear to cut the behavioral interference (meltdowns, avoidance, shutdown) that blocks learning, which opens more room for language practice. The claim that a first then board grows language faster isn't backed by controlled research. The claim that it lowers transition conflict and creates motivated communication moments is.

ASHA frames visual supports as a bridge between a child's current communication level and the language goals they're working toward ^[2]. That's the right frame. Bridge, not cure.

Want structured support alongside visual tools? The Little Words app helps you practice language modeling during real daily moments, built around how late talkers actually learn.

Frequently asked questions

At what age can you start using a first then board?

You can introduce one as early as 18 months, though most children aren't ready to use it consistently until around age two. The real indicator isn't age but whether the child can look at a picture and understand it stands for something real. Start with photos of actual objects and people from your home, and keep the "First" demand very brief, like one small action.

Can a first then board replace speech therapy?

No. A first then board is a support tool, not a treatment. Speech therapy addresses the mechanisms of language development, including comprehension, motor planning, social communication, and expressive vocabulary, through individual assessment and intervention. A first then board can complement therapy by creating structured communication moments at home, but it doesn't replace what a licensed SLP provides. If your child has a language delay, an SLP evaluation is the right starting point.

What if my child can't recognize pictures yet?

Use real objects instead. A physical shoe in the "First" spot and a cracker in the "Then" spot communicates the same sequence without requiring symbolic understanding. This is an object schedule, and it's common with kids at very early developmental levels. As the child starts pairing the object with the activity reliably, add a photo of that same object alongside it, then fade the object out.

How many pictures should be in my "Then" rotation?

Five to ten works for most families. A small library lets you match the reward to what the child actually wants that day, which shifts. Keep them somewhere visible for fast swaps. If your child keeps picking the same two or three, those are your highest-value motivators. Save them for the hardest transitions and use lower-preference items for easier asks.

Should the first then board always involve a reward in the "Then" spot?

Not necessarily. "Then" can be a preferred activity, a preferred person, a break, or just the next enjoyable step in a routine. The point is that the child understands and wants what comes next, and that "Then" outweighs whatever's hard about "First." "First shoes, then go outside" works because going outside is motivating, not because it's a formal reward. What matters is whether the child is motivated to finish "First."

How do I use a first then board if my child has echolalia?

Kids with echolalia often have strong rote memory and may memorize "first" and "then" without grasping the sequence. Watch whether the child is connecting the words to the pictures and activities, or just repeating the phrase. If it's repetition without comprehension, cut your verbal input and let the board do more work. Point silently or with a single word. For more, see the article on echolalia.

Can I use a first then board on a phone or tablet?

Yes, and a digital version travels better for many families. Apps like Choiceworks and First-Then Visual Schedule HD offer digital formats. The tradeoff: some children link tablets with media and get dysregulated seeing a device before the "Then" item shows up. If screens are a high-preference item in your house, a physical board often works better because it doesn't set off screen-seeking the moment it comes out.

What's the difference between a first then board and PECS?

PECS (Picture Exchange Communication System) is a structured protocol for teaching a child to start communication by handing a picture card to a partner in exchange for a wanted item. It has six phases and requires training to run correctly. A first then board is a simpler visual support for sequencing and transitions. They work together well. Many kids use PECS to request and a first then board to understand what's next. Different jobs.

How do I explain the first then board to grandparents and other caregivers?

Show them, don't explain it. Hand them the board, run one complete cycle (first this, then that, follow through right away), and let them try once while you watch. Written instructions rarely stick. A ten-minute live demo where they see the child respond does far more. Consistency across caregivers genuinely matters for the tool to work, so the time spent showing everyone pays off.

Is a first then board the same as a token board?

No. A token board is a system where a child earns tokens (stickers, chips, checkmarks) toward a bigger reward after several behaviors. A first then board shows one immediate sequence with no accumulation. Token boards take more cognitive steps and generally fit older children or kids who already grasp first-then reliably. Start with first-then, and if the child needs more structure for longer tasks, a token board can come later.

What should I do if my child completes "First" but then melts down when "Then" ends?

That's a transition problem at the end of the "Then" activity, not a problem with the board. Add a third step: "First shoes, then outside, then snack." Now there's something to look forward to after "Then" ends. Some families run a visual timer during "Then" so the ending isn't a surprise. Predictability is what lowers meltdowns. If the end of "Then" is unpredictable, the anxiety is rational.

Does a first then board work for kids with apraxia of speech?

Yes, especially for managing transitions and cutting the frustration that rides along with communication difficulty. Kids with apraxia of speech often understand far more than they can say, and a visual support honors that understanding. It also lowers the verbal demand of transition moments, which helps kids who find speaking effortful. Pair the board with modeling of short target words during motivated moments. For more, see apraxia of speech.

How long does it usually take for a child to understand the first then board?

Most children with some symbolic understanding show recognition within one to two weeks of consistent daily use. Full generalization, meaning the child uses the expectation flexibly across settings and people, usually takes four to eight weeks. Nobody has a clean clinical trial on this timeline. The estimates come from practitioner experience and small observational studies. If understanding isn't showing up after a month of genuine consistent use, talk to an SLP about a different format.

Can a first then board help with picky eating or mealtime routines?

Yes, and mealtime is one of the most common places families use it. A common structure: "First three bites of [non-preferred food], then [preferred food or end of meal]." The key is that "First" is achievable. One bite beats "eat your dinner." Start with a quantity the child can manage without much stress and build from there. Pair it with simple language modeling around the foods to open vocabulary opportunities.

Sources

1. National Research Council, Educating Children with Autism (2001), National Academies Press: Children with autism spectrum disorder process visual information more reliably than auditory-only information, supporting use of visual supports.
2. American Speech-Language-Hearing Association, Augmentative and Alternative Communication overview: ASHA describes visual supports as a category of AAC that includes any tool helping a person express or understand language, and frames them as a bridge between a child's current communication level and language goals.
3. Mirenda, P. (2003). Toward functional augmentative and alternative communication for students with autism. Language, Speech, and Hearing Services in Schools, 34(3), 203-216.: Symbol learning research supports starting with photographs of real objects before moving to line drawings or abstract symbols for children with autism and language delays.
4. Journal of Autism and Developmental Disorders, visual supports review (2021): Visual supports were most effective when introduced consistently across settings (home, school, therapy) rather than in only one environment.
5. Snyder-McLean, L., & McLean, J. (1987). Effectiveness of early intervention for children with language delays. Topics in Early Childhood Special Education, 7(2), 1-24; also ASHA technical reports on time delay as an evidence-based strategy.: Time delay is a well-supported strategy for prompting spontaneous communication in children with language delays.
6. Yoder, P., & Stone, W. L. (2006). Randomized comparison of two communication interventions for preschoolers with ASD. Journal of Consulting and Clinical Psychology, 74(3), 426-435.: Responding consistently to nonverbal communication is one of the most well-documented strategies for encouraging early language development.
7. American Academy of Pediatrics, Developmental Surveillance and Screening policy: AAP guidance recommends that any child with a language delay receive evaluation and early support without waiting for a formal diagnosis.
8. U.S. Department of Education, Individuals with Disabilities Education Act (IDEA), Part C and Part B: IDEA Part C mandates early intervention services for children under age three with developmental delays or disabilities; Part B covers ages three to five through school districts.
9. National Professional Development Center on Autism Spectrum Disorder, Evidence-Based Practices Report: The NPDC lists visual supports as one of 28 evidence-based practices for children with ASD, based on systematic review of the research literature.
10. Knight, V., et al. (2020). Visual schedules for students with autism: A systematic review. Focus on Autism and Other Developmental Disabilities.: A 2020 systematic review of 23 studies found consistent positive effects of visual schedule interventions on transition behavior, task completion, and independence in children with ASD.
11. National Autism Center, National Standards Project, Phase 2 (2015): The National Standards Project classifies visual supports as an 'established' treatment for individuals with ASD, the highest rating category in their framework.