This can be used after learning about cause & effect. I like to use this in my "Listen to Reading" center with a book like "When You Give a Mouse a Cookie" but it can be used for any book that shows a cause and effect relationship.
Can also be used as a Demonstration of Learning, Exit slip, or quick check. This can really show what students truly grasp the idea of cause and effect. It allows them to analyze the situation instead of choosing from say multiple choice options.