One of the biggest concerns that SLPs get from parents and teachers alike is that a student is not following directions properly. 

When a student is not following directions, as an SLP there are several things that I check. 

Issues Related to Language

Does the child understand all of the words in the directions?  Sometimes, there are concepts in the directions that are difficult. These include words such as before, after, left, right.

Does the child understand the sentence structure? 

For example, did you know it is more difficult for a child to understand a negative sentence than a positive one?  So, when you say, "Don't run," they may only hear run. (That's why you hear many teachers ask children to Walk rather than tell them not to run).

I also check to see whether students can follow directions when there are lots of attributes (characteristics) in the directions.  For example

No attributes:  Pick up the pencil.

Two attributes: Pick up the green glittery pencil.

Finally, I check to see how many steps the directions have.  For example:

One step:  Pick up the pencil

Two steps: Pick up the pencil and go over to your desk.

Three steps: Pick up the pencil and go over to your desk after you hang up your coat. 

Adding attributes and concepts, directions can get quite complicated.

Pick up the green sparkly pencil and go over to your desk after you hang up your coat on the hook over the door.

Other Issues

Students with autism, ADHD, or other learning disabilities have difficulty following directions for a variety of other reasons as well.  Linda Hodgdon shares some of these reasons on her website:  https://usevisualstrategies.com/autism-difficulty-following-instructions/

The student:

 

Doesn’t listen to complete directions before acting

Doesn’t remember what to do

Has difficulty transitioning from another activity

Doesn’t want to do what requested

May not know how to do task

May not be able to do task for some reason

Has trouble knowing if teacher talking to him or another student

Might need more time to process the instructions

 

The environment:

Is too noisy

Has too many distractions

Speed of activity is too fast

 

The communication partner:

Doesn’t get the student’s attention before communicating

Doesn't give clear instructions

Does not mean what she says or does not say what she means

Talks too fast

Gives too many instructions or uses too much extra language

Repeats instructions quickly & uses different language so student needs to “start over” processing the request

 

What do we do?

Parents and teachers will often want SLPs to write a goal to address following directions. When students do not understand the basic concepts of goals this can be very helpful. However, when the student’s failure to follow direction is occurring for other reasons, it can be more helpful to accommodate the student instead. How can we do that?

Directions should be clear and free from excess language.  They should be stated slowly. Time to process the language should be given.

Use visuals to support directions – this will improve comprehension and focus

Break directions down into small chunks that the student can comprehend

Make sure that the student is focused before the directions are given. Make sure the student knows that the directions are being directed to them not to another student. Many children with autism will not understand that students at Table 1 includes them. They will need specific instructions including their names.

Students with autism, ADHD and other learning needs will need help completing tasks for the first few times. Only when they can do them independently will they be able to follow directions including these tasks.

It will be challenging for students to follow directions given in loud or stimulating environments  Or new environments.  Or right after a transition where the student has been particularly engaged. Some ways to improve communication in these situations include:  establishing  practiced, multistep routines, giving students checklists or other visuals to aid them, asking students to repeat back directions to ensure that they have heard and understood them.

In all cases it is more helpful and more fair to accommodate the student than it is to give a goal asking the student to change.