Following directions is a crucial language skill and a common goal in speech therapy for students with receptive language impairments. 

It is an important skill needed to function successfully across various environments. If a student struggles to follow directions, it can impact their ability to complete tasks, participate in common activities, and affect their academic readiness. 

Following instructions requires the student to attend to and understand details in spoken language, sequence the information into appropriate steps, and ask for clarification if they have difficulty remembering or recalling the information.

Skills needed when following directions:

Receptive language: An understanding of language, such as concepts and vocabulary.

Attention and concentration: The ability to focus on an activity, and the capacity to hold that focus and apply effort long enough to complete the task.

Working memory: The ability to retain and manipulate the given information in the moment, to apply reasoning, and adapt the information as needed.

Rehearsal with Visualization:

Rehearsal with Visualization is an evidence-based intervention approach that utilizes direct instruction and a demonstration of skills needed to follow directions successfully. It has been shown to improve children's ability to follow directions and that 

skills taught using rehearsal with visualization were able to be retained over time (Gill et al., 2003).

Steps for students:

1. Repeat the direction. Before completing a direction, say it aloud. 

    This self-strategy can be faded over the course of generalizing the skill.

2. Visualize and picture the self following the direction.

3.  Take action and follow the directions.

Activities:

Hierarchical Cues and Strategies to use:

Get the student’s visual attention before giving them instruction.

Visual cues, such as gestures, body language and facial expressions can help the student understand the information that is being conveyed.

Start by giving the student only one instruction at a time.

Use clear, simple and direct language.

Break verbal instructions into steps.

The clinician can repeat the instruction as needed and also encourage the student to say the instruction themselves, either aloud or in their head.

Use sequencing words such as first, then, next, and last. This helps the student know in what order they need to complete the task.

Use visual aids. Pictures, either with or without words, can be used to aid in the student’s comprehension and recall of the directions. Visual aids can illustrate the order in which they need to complete the instruction and can also be used to refer back to if they are having trouble remembering what they need to do.

Encourage the student to ask questions if they forget part of the instruction or are confused about what they need to do. 

Data and Progress monitoring can be taken on a data tracking sheet. The tracking sheet can be used to record data on the levels of assistance required, such as independently or with verbal prompts, modeling, and gestural cues. Data can be taken on the number of opportunities given, number of successes the student had, and the specific areas of challenge needed to be worked on.

References

Gill, C.B. Klecan-Aker, J., Roberts, T., Fredenburg, K.A. (2003). Following directions: Rehearsal and visualization strategies for children with specific language impairment. Child Language Teaching and Therapy February 2003 vol. 19 no. 1 85-103.