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The Incredible 5-Point Scale

Forum References FAQ's Quiz Lecture Introduction A 5-point scale can be used to help teach the person with ASD to recognize different levels of stress and anxiety. The scale visually breaks down a person’s responses to stress by labeling each level with what the behavior looks like, what the level feels like, and what stress reduction exercise or routines can be used to reduce the stress level (Buron, K & Curtis, M. 2003). The person with ASD and his caregiver can begin to think in terms of ‘being at’ a level 1, 2, 3, 4, or 5 using the scale as a visual prompt. After much practice and patience, the person can be prompted to bring their stress level down from a 4 to a 2 using the scale as a guide.

Consider the case of Colton, age 10, who has problems with explosive behavior at school. His teacher used the 5-Point scale as a worksheet (see left figure) to help Colton focus on the different levels of stressful behavior he exhibited during class. The teacher filled in the column describing what the behavior looks like based on her data and observations. Colton was able to give the teacher some ideas about how he felt when he was at each of the levels and they both collaborated on ideas for what he could try to do when he felt that way.

Colton’s teacher had her own small scale that she wore around her neck with her ID tag. When Colton exhibited level 2 behaviors, she would get his attention and point to the 2 on her scale to prompt him to get out relaxation his photo album. If Colton exhibited level 4 behaviors, she would point to the 4 on her scale and pull her finger down to a 2, visually illustrating (without words) that she wanted him to pull his level down to a 2.

The 5-Point scale has also been successfully used with nonverbal students with ASD who are not as able to contribute to the formation of a chart. Karen, who is 12 years old, would often scream during group time. Her teacher developed a voice level scale (see right figure) using pictures to illustrate a closed mouth, a talking mouth with a little talking bubble, a talking mouth with a bigger talking bubble, and large mouth with a talking bubble with big words, and a screaming mouth with a popped talking bubble. She taught Karen about the scale in a very direct and fun way by pointing to the closed mouth picture, pointing to her own closed mouth and having Karen close her mouth while looking in the mirror. Karen was rewarded with praise for modeling the closed mouth. The teacher taught the talking mouth by using a low hooting sound (which Karen was able to make), pointing to the picture and again encouraging Karen to model the sound in the mirror. The teacher then opened her mouth wide and made a modified screaming sound while pointing to the screaming picture. Karen enjoyed screaming and easily modeled the teacher’s scream. During the group, the teacher had the scale ready and prompted a classroom assistant to work with Karen, showing her the scale and pointing to the closed mouth. When Karen would scream, the assistant showed her the scale pointing to the scream and pulling her finger down the scale to the closed mouth. Within days, Karen began to respond to the visual prompt to stop screaming and within a month, Karen sat in group with a prompt card with the number 1 on it as a reminder to remain silent. The teacher used a #2 card to interact with Karen from time to time during the group and allowing her to verbally participate.

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