How to Target Following Directions in Speech Therapy? As busy SLPs with limited time, it can be easy for us to get “stuck”: using our preferred materials over and over, copying and pasting goals, and targeting the same skills in the same ways. There’s nothing inherently wrong with any of this—predictable routines can be very helpful, and as human beings we all have our favorite ways of doing daily tasks.
However, in the interest of serving our clients as well as we possibly can, it’s also useful to re-examine why and how we’re doing what we’re doing, particularly when it comes to skills that we tend to target frequently, like following directions. In this post, I’ll offer some ideas for how to look at the skill of following directions in new ways, and how to update our instructional practices based on what we find.
Component Skills and Umbrella Skills Involved When Targeting Following Directions in Speech therapy
Like many of the skills we target in speech therapy, following directions can be thought of as an “umbrella skill”—a larger skill category made up of many component skills. For example, following directions involves auditory comprehension, attention, motivation, vocabulary knowledge, sequencing, and working memory—just to name a few! To help our clients master an umbrella skill, we need to drill down and figure out which of the component skills are most challenging for them, and then focus on building those skills. This process of determining the most important component skills for a given client doesn’t need to take a lot of time. When our formal assessment measures indicate difficulty in the area of following directions, we can often get a better understanding of how to proceed by answering a few simple questions:
- When does it seem to be most difficult for this client to follow directions? (Oral directions? Written directions? What types of tasks? What time of day?)
- What helps this client to be more successful with following directions? (Giving just a few at a time? Giving the client an opportunity to teach the task to someone else? Pre-teaching vocabulary before sharing the directions? Offering choices within the task?)
- What are this client’s strengths? (Often, strengths can be leveraged to support skill sets that aren’t as well-developed.)
For example, a client who struggles with following directions that are presented orally but who can follow written directions may be struggling with auditory comprehension in general.
A client who is unable to follow directions during group projects but excels when working alone may be distracted and/or overwhelmed by the social elements of the task.
A client who appears to understand the task itself but misses steps or does some of them out of order may be experiencing challenges with executive function that affect their ability to follow directions.
Answering these questions will require a bit of investigation (and possibly input from family members and/or school staff), but doing so ultimately saves time, as it allows us to make our therapy sessions as effective as possible.
Once we have identified the component skills to address within the larger category of following directions, we are ready to address them in therapy. Here’s how:
Make It Meaningful
Following directions is generally not a skill that is effectively practiced through rote, decontextualized activities. The reality is that directions are activity-dependent! If I’m following directions for making chocolate chip cookies and try to use the same steps to plant tomatoes in my garden, it doesn’t work. The context really matters! To this end, it’s incredibly important to practice following directions using real tasks that genuinely matter to the student—for example, a project that has just been assigned in a class, a chore that they keep getting in trouble for not doing at home, or a hobby they want to learn. For younger children, you might play a game they love, do their simple art project, or practice the steps for a school routine that causes challenges for them (e.g., lining up for recess).
Within all of these meaningful contexts, be sure you are emphasizing the component that is most challenging for the client (e.g., sequencing, transition words, vocabulary knowledge, etc.).
Make It Meta
For older children in particular, it’s very powerful to engage them in some meta-analysis as they work on following directions in speech therapy. Help them learn to think about their own thinking, especially if executive function is challenging for them. One way to accomplish this is through a “think-aloud”: provide instructions for a moderately complex (and meaningful!) task, and then have them talk about their process out loud as they move through the steps. (“Okay, I know I need to get out the paper and the paints first, but I just realized I forgot to decide what I actually want to make, so now I need to look at those books over there to get some ideas . . .”). You may need to model this strategy several times for the student; when you do so, be appropriately honest about the ways in which following directions can be tough for you.
Make a Change
Some clients, especially neurodivergent clients, may always have difficulty with certain elements of following directions in speech therapy. It’s important that we don’t see this as a failure; rather, it’s a helpful reminder that not all brains work in the same way, and sometimes we actually need to adjust the ways in which information is conveyed, or the types of assignments that are given. In these situations, we can actually target following directions by targeting self-advocacy skills. When we support students with their ability to identify the areas where they struggle and then ask for appropriate accommodations, we are teaching a skill that can be applied to following directions—and so much more.
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