How to use a Now and Next board at home

What is a Now and Next board?

A Now and Next board is a strip of card with two spaces. One shows what your child is doing now. The other shows what comes next. Some nurseries and schools call it a First and Then board, and it works the same way.

It is one of the simplest visual supports. An NHS speech and language therapy leaflet from Cambridgeshire and Peterborough describes Now and Next boards as a way to help children with transitions and with understanding what happens next, and says the pictures can be objects, pictures, symbols or a mix (Cambridgeshire and Peterborough NHS Foundation Trust).

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. NICE's guideline for autistic children and young people lists "providing visual supports, for example, words, pictures or symbols that are meaningful for the child or young person" as one way to adapt the places where they are supported and cared for (NICE CG170).

When can a Now and Next board help?

Use it at the moments when your child has to stop one thing and start another, and before something new. A good place to start is the moment that is hardest every day.

Use it for good moments too: "Now lunch. Next swings." Then the board doesn't only appear before things your child dislikes.

How do I make a Now and Next board?

You need card, photos or symbols, Velcro dots, an envelope or small box, and sticky-back plastic or a laminator if you have one.

1. Make the board. Use a strip of stiff card. Draw a line down the middle, and write "Now" on the left and "Next" on the right. Use "First" and "Then" instead if that is what nursery uses. Or print the free Now and Next board.
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 coat, the nursery 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 sticky-back plastic, 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". 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.

How do I use a Now and Next board every day?

Show the board before the change, say very little, and do what the board says. The Cambridgeshire and Peterborough leaflet suggests keeping the board up to date through the day, showing and naming each picture before the activity, doing that activity straight after showing it, taking pictures off when an activity finishes, and moving "next" across to "now" (Cambridgeshire and Peterborough NHS Foundation Trust).

1. Set it up. Put the current activity under "Now" and the next one under "Next".
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. The National Autistic Society advises allowing "time for processing" (National Autistic Society).
4. Show it again at the change. Point to the "now" picture and say "finished".
5. Do the finished routine. Your child takes the "now" picture off and posts it in the finished box. If they don't want to, do it together, or do it yourself while they watch.
6. Move next across. Move the "next" picture into the "now" space, then add a new "next".
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 Now and Next board works best when it feels helpful to your child, not like a list of orders.

• 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.
• Never use it as a threat. The NHS leaflet says: "It is important not to think of 'first-then'/ 'now-next' visuals as a behaviour support to encourage compliance with an adult chosen task" (Cambridgeshire and Peterborough NHS Foundation Trust). So avoid "Now shoes, next no tablet", and never take pictures 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.
• Keep it the same at nursery if you can. The NHS leaflet also asks that all the adults working with a child know about their board and how to use it. Share your photos, or ask for copies of the nursery's symbols.
• Offer a choice for "next". Hold up two pictures: "Next: 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 naughtiness.

• Check what usually goes on "next". 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 the "next" picture

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. The National Autistic Society suggests "using a favourite toy or character to be part of the transition" (National Autistic Society).
• Offer a way back later: pause the programme, take a photo of the Lego model or put the toy on a "later" shelf.
• Add a finishing ritual, such as "one more go, then finished".
• If one activity always causes upset, look at the activity itself. It may be noisy, uncomfortable or too long.

See transitions and changes for more on the moments that stay hard, and meltdown, tantrum or shutdown if upset turns into overwhelm.

What does the research say about Now and Next boards?

We did not find any studies that test Now and Next boards on their own with young autistic children. The support for them comes from wider research on visual supports, and from UK 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).
• NICE lists visual supports as an adjustment for autistic children, and the NHS leaflet quoted above shows speech and language therapists recommending Now and Next boards to parents.
• 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 timetable?

When your child uses the two-picture board easily and starts looking for what comes after "next", try adding a third picture: "Now breakfast. Next 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 timetable printable and the guide to visual timetables show how. You can keep using the Now and Next board for hard moments, even once your child has a timetable.

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 and language therapist can advise on the right kind of picture and how to use it. Your GP, health visitor or nursery SENCO can tell you how referrals work where you live.
• Your child's nursery or school can use the same board and pictures, so your child sees the same thing everywhere.
• The National Autistic Society and Contact offer information and advice for parents.

For the bigger picture, including choice boards and picture sequences, see visual supports at home.