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What is following instructions?

Following instructions is a part of everyday life. It is the child’s ability to act on requests by others. Following instructions requires the child to attend to detail in spoken language, to sequence the information in the appropriate steps and to seek clarification if they have trouble remembering or recalling the information. At home, parents ask their children to do things around the house (e.g. “Put the cup on the table”) and at school teachers ask their students to follow commands within the classroom (e.g. “Go to your bag and get your lunch”) and within academic tasks (e.g. “Copy the spelling words on the board, then put each of them into a sentence”). When children engage with their peers, they often give each other instructions in play (e.g. “Can you put the doll in the bed?” or “Let’s make the train go to the station, then get all the people”).

 

Why is the ability to following instructions important?

It is important for children to be able to follow instructions so that they can function effectively across different environments (e.g. home, kindergarten/school, when at the park or visiting a friend’s house). If a child struggles with following instructions this impacts on their ability to reach the desired ‘purpose’ or ‘outcome’ and thus complete tasks effectively.

 

What are the building blocks necessary to develop following instructions?

  • Hearing
  • Receptive (understanding) language: Comprehension of language, especially concepts and vocabulary.
  • Attention and concentration: Sustained effort, doing activities without distraction and being able to hold that effort long enough to get the task done.
  • Working memory: The ability to temporarily retain and manipulate information involved in language comprehension, reasoning, and learning new information and to update this information as change occurs.
  • 1 – 2 years of age: Can follow simple 1 step instructions (e.g. “Give the cup to mum”).
  • 2 – 3 years of age: Can follow 2 part commands (e.g. “Go to your room and get your jacket”).
  • 3 – 4 years of age: Can follow 3 part instructions (e.g. “Point to the cat, dog and monkey”).

 

How can you can tell if my child has problems with following instructions?

If a child has difficulties with following instructions they might:

  • Need instructions to be presented in a short and simple manner.
  • Struggle with following longer instructions and commands need to be repeated.
  • Fail to follow instructions accurately and often misinterprets information.
  • Appears to be distracted or non-compliant.
  • Look at you blankly when you give them an instruction.
  • Avoid carrying out instructions by talking about something else to distract the person.
  • Look to peers to work out what they need to do.

 

What other problems can occur when a child has difficulties with following instructions?

When a child has following instruction difficulties, they might also have difficulties with:

  • Behaviour: The actions of a person, usually in relation to their environment (e.g. a child may refuse to listen to instructions and/or engage in another activity of their choosing).
  • Completing academic work (e.g. the child may misinterpret or fail to comprehend verbal or written instructions for classroom activities and are therefore unable to complete work and fail to meet the task requirements).
  • Planning and sequencing: The sequential multi-step task/activity performance to achieve a well-defined result.

 

What can be done to improve following instructions?

  • Eye contact: Get the child’s visual attention before giving them an instruction.
  • Single instructions: Give your child only one instruction at a time.
  • Simple language: Keep language simple and direct.
  • Break verbal instructions into parts: Instead of “Go and get your lunchbox and your hat and go outside”, say “Get your lunchbox.” When the child has followed that instruction, say “Now get your hat” then “OK, now you can go outside”.
  • Repeat: Get your child to repeat the instruction to ensure that they have understood what they need to do (e.g. “Go and get your bag then sit at the table. What do I want you to do?’).
  • ‘First/Then’: Use this concept to help the child know what order they need to complete the command (e.g. “First get your jacket, then put on your shoes”).
  • Clarify: Encourage the child to ask for clarification if they forget part of the instruction or have trouble understanding what they need to do. Encourage them to ask for the command to be repeated or clarified (e.g. “Can you say that again please?”).
  • Visual aids (e.g. pictures, gestures, body language and facial expression) can be used to assist the child’s comprehension and recall of the instruction.
  • Visual cues can often be very useful to help the child to follow longer instructions as it provides them with something to refer back to if they are having difficulty remembering what they need to do. It also highlights the order in which they need to complete the instruction.

 

What activities can help improve following instructions?

  • Simon Says: Gradually increase the length of the command when playing this game (e.g. “Simon Says pat your head”; “Simon says first pat your head, then touch your nose”).
  • Robot game: Blindfold the ‘Robot’ (listener) so the child must listen very carefully to instructions to find something (e.g. go 3 steps forward, then 1 step to the right). This can be reversed so that the child has to give someone else the instructions.
  • Drawing games: Describe a picture that the child cannot see and they must try and draw a similar picture from your verbal instructions. Compare the two pictures at the end. Use previously drawn background scenes (e.g. street scene, park scene, shelves of a cupboard, rooms in a house). Take turns giving instructions about where to draw or stick on pictures of objects or people (e.g. ‘put the plate on the second shelf’).

 

Why should I seek therapy if I notice difficulties with following instructions in my child?

Therapeutic intervention to help a child with following instruction difficulties is important to:

  • Help a child to follow instructions within the educational setting (e.g. classroom instructions, academic task requirements).
  • Help a child to follow commands within social situations (e.g. playing games with peers, engaging effectively with individuals during out-of-school activities such as playing sport).
  • Help a child to understand and complete routine and unfamiliar tasks appropriately around the house or at school.

 

If left untreated what can difficulties with following instruction  lead to?

When children have difficulties with  following instructions, they might also have difficulties with:

  • Understanding instructions during social interactions with peers and unfamiliar adults.
  • Comprehending commands within academic tasks in higher levels of education.
  • Following instructions in the workplace, which impacts on task efficiency.

 

What type of therapy is recommended for difficulties following instructions?

If your child has difficulties following instructions, it is recommended they consult a Speech Therapist.

If there are multiple areas of concern (i.e. beyond just following instructions) both Occupational Therapy and Speech Therapy may well be recommended to address the functional areas of concern. This is the benefit of choosing Kid Sense which provides both Occupational Therapy and Speech Therapy.