Condition: Difficulty Following Directions

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Definition:

Children with language disorders and delays often have difficulty following directions.  This skill ranges from toddlers following functional directions like “come here” all the way up to high school-age children needing to follow complex directions to complete schoolwork or engage in daily living activities.  Directions can be presented as spoken directions or written directions.

Following directions requires the following skills: 

  • Auditory processing to hear the sound and convert it into a meaningful auditory signal.  Children with hearing loss or auditory processing disorders may have trouble with this step.
    OR
    Visual Processing is required if the direction is written.  The child must be able to see the words and translate those into meaningful symbols.  Children with visual problems may struggle with this step.  Children with reading problems, such as decoding unfamiliar words, may have trouble with this step as well.
  • Attention and Engagement are required for the child to understand that the direction given is important to that child and that he should continue with processing and responding.  Children with engagement issues, such as those with autism, may struggle with this step.
  • Receptive Language to understand the words in the directions and the meaning of the direction as a whole.  Children with receptive language or vocabulary problems may struggle with this step.
  • Working memory for the child to remember the direction that has just been given long enough to use it.  Children with memory problems may struggle with this step.
  • Sequencing and Planning for the child to determine what action should be taken, plan what he/she will do, and sequence the steps to the action/response in the correct order.  Children with executive functioning problems may struggle with this step.
As you can see, there are a lot of steps required to follow directions.  Children may struggle with one or more of these steps and the piece of the puzzle that is missing for them will determine what type of therapy approach may be best.  

Developmental Norms:

Here are some basic developmental norms for when children should be able to follow directions of varying complexities:

  • 1-2 Years: Follows 1-part directions like “roll the ball” or “kiss the baby”
  • 2-3 Years: Follows 2-part directions, like “Get the spoon and put it on the table.”
  • 4-5 Years:
    • Follows longer directions, like “Put your pajamas on, brush your teeth, and then pick out a book.”
    • Follows classroom directions, like “Draw a circle on your paper around something you eat.”
 
  • Kindergarten: Follow 1-2 step oral directions in order like “Pick a book and come sit in the chair.”
  • 1st Grade: Follow 2-3 steps in order like “Get a piece of paper find your pencil and write your of paper, find your pencil and write your name”.
  • 2nd Grade: Follow 3-4 oral directions in order like “Stay in your seat, wait for the bus to stop and don’t forget your backpack.”
 
  • 4th Grade: Follows Written Directions
 

More complex direction skills: 

As children get older, they need to be able to follow more complex directions.  These directions may be directions that are longer (such as written directions for an assignment), or directions that contain complex concepts.  The age norms for these complex directions depend on what is contained in the direction.  For example, basic time concepts typically aren’t acquired until the child is 4-5 years old so temporal directions would be acquired later than spatial directions using basic concepts like “in” and “on”.

Here are some ideas of other types of directions that are more complex: 

  • Quantitative Directions: Give me all of the candy.
  • Qualitative Directions: Give me the blue one.
  • Spatial Directions: Put it on the table.
  • Temporal Directions: Before you touch the ball, touch the frog.
  • Condition Directions: Raise your hand if you went swimming this weekend.
  • Mixed Directions: May contain a combination of the above types.

Evaluation:

Evaluating the ability to follow directions should be included with your comprehensive speech-language evaluation.  As mentioned before, you will need to evaluate all of the following types of skills to determine what part of “following directions” the child is struggling with: 

  • Auditory processing to hear the sound and convert it into a meaningful auditory signal.  Children with hearing loss or auditory processing disorders may have trouble with this step.
    OR
    Visual Processing is required if the direction is written.  The child must be able to see the words and translate those into meaningful symbols.  Children with visual problems may struggle with this step.  Children with reading problems, such as decoding unfamiliar words, may have trouble with this step as well.
  • Attention and Engagement are required for the child to understand that the direction given is important to that child and that he should continue with processing and responding.  Children with engagement issues, such as those with autism, may struggle with this step.
  • Receptive Language to understand the words in the directions and the meaning of the direction as a whole.  Children with receptive language or vocabulary problems may struggle with this step.
  • Working memory for the child to remember the direction that has just been given long enough to use it.  Children with memory problems may struggle with this step.
  • Sequencing and Planning for the child to determine what action should be taken, plan what he/she will do, and sequence the steps to the action/response in the correct order.  Children with executive functioning problems may struggle with this step.

Check out our other evaluation resources here:

Play-Based Assessments

Have a child who can’t sit down for standardized assessments?  Find out here how to conduct a play-based assessment instead.

How to Evaluate (and Treat) Non-Speaking Children

An hour-long webinar recording with an overview of how to evaluate and treat a non-speaking child.

How to Collect a Language Sample

A language sample can be a great part of a full evaluation.  Learn how I collect a language sample here.

Suggested Goals and Materials:

There are many different types of “following directions” goals that can be written for children, depending on the stage of development they are in.

Here are some goals that may be helpful for children who are struggling to follow directions.  You can click on one of the goals below to learn more.  Or, scroll down to the therapy section for more in-depth resources and support for treating this condition.

Click on any goals that are linked up to see any materials and no-prep kits for that skill.

  • Follow directions using quantitative concepts
  • Follow directions using qualitative concepts
  • Follow directions using spatial concepts
  • Follow directions using temporal concepts
  • Follow conditional directions
  • Follow written and oral directions during classroom activities

Therapy:

Here are some more resources and information that may help you when it comes to treating this condition.

Resources, Tools, and Training for Speech-Language Professionals

*** The SLP Solution is for informational and educational purposes only and does not provide medical or psychological advice.  We provide general resources but cannot tell you exactly what should be done for a specific client.  Every client is different and your clinical judgement should be used when making decisions about specific individuals.

 

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