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Writer's pictureStacy Crouse

Targeting Following Directions in Teletherapy

Addressing following directions goals in speech therapy is not as straightforward as most SLPs would like. And when you add the virtual setting of teletherapy into the mix, targeting following directions can feel like an impossible task.


HOW TO TARGET FOLLOWING DIRECTIONS GOALS

The ability to follow a direction is, well, complicated. It requires a student to give and maintain attention, understand the vocabulary (and other language in the direction), remember and adequately sequence each component, utilize their working memory, and – in addition to all of that– have the motivation to do it.


Here are some tips and ideas to help teletherapists tackle following direction goals right from their teletherapy platforms.


Break it down and provide direct instruction.

Just like with other goals (and just like in an in-person setting), SLPs can use their clinical skills to identify specifically what the student is having difficulty with. Then they can provide direct teaching and contextualized practice of that skill to help students...

  • Understand embedded concepts (such as positional, size, or conditional).

  • Comprehend the syntactic structures.

  • Attend to the direction.

  • Use their working memory to recall and sequence each component.

  • Be motivated to begin and complete the direction.

An SLP engaging with a student in a teletherapy session

Use elements (rather than steps).

Critical elements are the important parts of a direction (or sentence) that carry significant meaning. A direction with only one step could have 4 or 5 critical elements. The more critical elements in a direction, the more difficult it is to comprehend.


Since training to be an auditory-verbal therapist, I've become a proponent of writing goals that include a certain number of critical elements, rather than a certain number of steps. I find that using critical elements makes it easier to control (and make smaller steps in) the difficulty of the direction, measure the student’s response, and identify specific areas needing further intervention.


This lunch-themed Boom Card deck (get it here on Boom) is an example of using critical elements to target following directions for a range of abilities. There are 7 levels to help you find the difficulty that's just right for each student.

a lunch-themed following directions Boom Card deck being used on a teletherapy platform


Teach auditory strategies.

Teaching compensatory strategies is a great way to tackle areas of deficit, including following directions. Students can use this visual to learn the strategies and use them as tools to retain auditory or written directions. With options for older and younger students, this is a great approach to incorporate into other therapy activities.

Handouts that include auditory memory strategies for students

TELETHERAPY ACTIVITIES FOR FOLLOWING DIRECTIONS

Depending on each student's specific needs, there are many teletherapy-friendly activities that SLPs can use to incorporate following directions goals.


Boom Cards

Boom Cards are awesome for following directions because of their movable pieces (among many other interactive features). Boom has following directions activities of all kinds and levels, but here's an example of a deck that targets various types of embedded concepts within directions (find it here on Boom).

A winter-themed following directions Boom Card activity being played on a laptop in a teletherapy session

Barrier Games

Barrier game activities are a great way to practice auditory recall strategies. In a teletherapy setup, these activities look a little bit different. In this Google Slides barrier game, there's a movable cover that you can slide over to reveal the "answer" once all directions have been completed.

A following directions Google Slides activity being played on a laptop computer in teletherapy

Scene or Object Creators

Open-ended activities provide so much flexibility, and there are several websites that offer digital options.

  • Toy Theater's Sticker activity gives tons of background and object options that make it fun and easy to create a scene.

  • ABCYa hosts several "Make A" games that you can use to give students directions as they put together a robot, cupcake, or other fun creation.

  • Boom Cards are worth another mention here because there are lots of open-ended scenes and activities that can be used to work on following directions. In this Boom Card pizza activity (get it here on Boom), students can pretend to take orders in a virtual pizza shop!

A pizza-making Boom Card activity being played on a computer in a virtual speech therapy session

Directed Drawing

Describing how to draw an object involves following some more complex directions. Teletherapy students and SLPs can use annotation tools in the platform or a website (such as Sketchpad) to draw each step.


Life Skills Activities

When it comes to working on following directions in speech therapy, the more functional, the better! There are many ways to incorporate executive functioning or job skills into a following directions activity.

  • Give the student directions for navigating a website to do a particular task or find a piece of information. For example, when looking at a pet store website you could tell the student, "Click the menu button and then click the 'Store Hours' option."

  • Help the student create and use a digital calendar (such as Google Calendar) with directions such as, "Add your mom's birthday to March 8th."

  • You could also give students directions for placing a website order (minus the actual payment and submission). For example, using a restaurant's online ordering site, you could tell your students what each person wants to order.


Following Directions Activities When You Can't Give Mouse Control

Many of the above activities assume that the student can manipulate the screen you're sharing with them. But there may be instances where you can't (or don't want to) share remote mouse control with your students.


Use actual objects.

Just because it's teletherapy, doesn't mean you can't use actual objects. Have the parent or facilitator send you a list (or take a picture) of an assortment of toys or items and make directions using those items.

Container of random toys to use for following directions in teletherapy.

For example, you could say, "Put the block under the teddy bear." You may even turn it into a scavenger hunt by having the student search the room for items with a given description. A document camera (on the student's end) may be useful for this activity!


Incorporate actions and movement.

No objects, no problem! Use directions that include movements, such as in the game Simon Says or creating a simple craft.


Use Google Slides.

I love using Google Slides in teletherapy for many reasons, including the personalization and flexibility it provides. A Google Slides presentation can be accessed by more than one person simultaneously, so you can share the document with one or more students to use at the same time.


Send a page to print.

A printout of any coloring page works, so you can find something that interests the student or coordinates with a therapy theme. This snowman page (free for email subscribers) is one example. It has directions on the page that can be cut off or folded back.

a coloring and following directions activity being used for a teletherapy student

For older students, you might send an article and work on directions such as, "Underline the last sentence in the first paragraph."


Have the student share their screen.

If your student can't control your screen, give them a link to an activity and have them share their screen with you while you give directions. For example, you can send them a fast pin to a Boom Card deck and watch them manipulate the items on the screen as directions are given.


Teletherapy SLPs don't need to lose sleep over how to incorporate following directions goals into their sessions. No matter the student's age, approach to following directions goals, or remote mouse control abilities, these skills can be targeted in the virtual setting.


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