**Acknowledgements**

about what would happen during the visits. The staff had experienced difficulties in describing this in a concrete way, which now easily could be done using pictures in the invitation letter. The staff meant that texted information only, could not generate the same type of conversations between parent and child as now was the case. Without the pictures it was more difficult for the parent to explain to the child what would happen. Some of the staff had previously created their own pictorial support by drawing or using photos when they felt that this was needed. *"And there was a need for this because I used to say to the parents when I met them the first time that you can take a photo of me with your phone and show to the child..."*

The staff believed that the use of pictorial support was something that had come to stay within health care. They expressed that pictures would be good to use outside of pediatrics, for

To further investigate the role of pictorial support in health care and within neuropsychiatric clinical work, it would be interesting to do a controlled group study comparing both commu‐ nication and other aspects of care with and without the use of pictorial support. Doing a similar study like this, but with a larger number of respondents and interviews with children, parents and health professionals from different clinics that strengthen and further develop these results, is also important. It would also be interesting to study and compare the results for different groups of children – of varying age, diagnosis, communication profiles-and for

This study is one of the first that describes an intervention aiming at increasing the commu‐ nicative rights of children within the autism spectrum during clinical assessment and inter‐ vention. The pilot evaluation in the form of an interview with the multiprofessional team provides valuable information on how work with pictorial supports can function in practice.

The staff was generally very positive and expressed that the pictorial supports facilitated communication. The materials made both children and parents better prepared for the visits and the clinical procedures. The children liked the concrete visual material that also seemed to provide them with a higher degree of control in the situation. The children were more focused when the pictures were used and both children and parents also seemed to be more relaxed. However, it also emerged that there are still shortcomings and that further develop‐ ment is needed. The staff expressed the opinion that it was easier to use the pictorial supports in concrete activities, such as medical procedures, compared to for example assessments. Children at really early stages of development could not benefit so much of the existing materials but instead probably are in need of a more individually adapted support, as are some

*4.4.7.2. Pictures in other areas of care*

308 Autism Spectrum Disorder - Recent Advances

**4.5. Further research**

**5. Conclusion**

example within geriatrics, and with people with aphasia.

different activities and types of pictorial supports.

The major parts of this chapter was part of an unpublished Masters' thesis in Speech language pathology at University of Gothenburg, June 2014. Thanks to patients, parents and staff at the Neuropsychiatric clinic at Queen Silvia Children's Hospital in Gothenburg who took part in the study, specifically Julia Eldblom and Ulrika Johansson who developed all pictorial materials, educated and inspired their colleagues. Thanks also to all members in project KomHIT including the Association for people with autism and Asperger syndrome in the Gothenburg region. KomHIT is funded by the Swedish Heritage Foundation. The writing of this chapter was funded by the Research Foundation at Queen Silvia Children's Hospital.
