Comprehension of the Message: Important Considerations for Following Directions
Contributed By: Beverly Vicker, Speech Language Pathologist
Understanding the Parameters
High on the list of expected school and life skill behaviors for an individual with an autism spectrum disorder (ASD) is the ability to “follow directions.” This multifaceted skill is based on the assumption that when given a request or directive, the student will comply. Implicit in this skill application are issues of:
- Comprehension of the instruction;
- Understanding the authority/role responsibility of the person giving the direction; choice/opportunity to or not to comply,
- Memory for the direction; and
- The ability to perform the requested action.
This brief article will focus on the underlying importance of the comprehension issue.
Ability to understand a direction depends on:
- The direction being clear and not too complicated for the person to understand and remember;
- The direction being presented at a speaking rate, loudness level and articulated clearly enough to facilitate comprehension;
- The person with ASD recognizing the words and the meaning conveyed by them and the syntax pattern inherent in the direction; and
- The person knowing how to translate the meaning of the message into the expected response.
Sometimes students on the autism spectrum appear erratic in their ability to follow directions. Some of these students may be performing a rote response pattern which is not based on total comprehension of the message. Instead, sometimes compliance may be cued by the student’s recognition of a single word in the direction. Alternately, the student may not understand any words in the verbal directive but will be cued about expected performance by gestures and nonverbal environmental cues. For example, a preschool child might understand that he is to go to Circle Time because he sees the other children going to Circle, or because he has learned to associate Circle Time with the ringing of a bell rather than as a response to the teacher’s verbal directive. In the latter instance, staff might be confused about a child’s failure to go to Circle Time when the substitute teacher fails to provide the cue that usually accompanies the verbal direction (i.e., ringing the bell). Staff are often unaware that a child really does not understand the verbal message or that he or she does not have generalized meaning beyond a specific person or set of circumstances.
If the ability to follow directions is an important functional lifelong skill that students should have, then school staff and family may wish to informally evaluate and track the ability of their students or children to follow various directions. This article will list some of the common verbal directions that students may be expected to understand in the everyday world. It will be the job of teachers, parents, and other caregivers to determine if a specific child or student does understands each direction, under what conditions he or she understands it, or, if there is no understanding, what teaching procedures and supports might be needed to assist the student in learning to follow a directive. (In some cases, rote associative responses may remain the best attainable option for a specific individual or for a set of particular circumstances, however.)
Some common directions are listed below. The list does not include every direction that a person needs to understand. Conversely, every direction is not equally important for every person to recognize. Much will depend on the person’s age, the expectations of others, and environmental demands or necessities.
|Come here||Stand up|
|Sit down||Get in (car or whatever)|
|Climb over||Climb up|
|Climb down||Get in line|
|Go get X||Bring me X|
|No talking||Throw X in ____ (e.g., trash)|
|Throw X away||Get a tissue|
|Blow your nose||Use two hands|
|Give X a turn||Wait for your turn (cease X)|
|Wash your hands||Dry your hands|
|Go to the bathroom||Go potty|
|Line up||No touching|
|Sit up||Keep your hands at your sides|
|Find X||Mark X|
|Color X||Cut X|
|Write X||Look at X|
|Match X||Choose one|
|Pick or take X||Pass out X|
|Sit at your table/desk||Hold the paper (use hand to steady it)|
|Find your chair||Put X away|
|Check the schedule||Move over (vague)|
|Chew your food||Drink your X|
|Button your X||Unbutton your X|
|Zip your X||Unzip your X|
|Tie your X||Untie your X|
|Stand still||Hold still|
|Put your name on your paper||Put your name at the top|
|Turn your paper over||Finish your work (vague)|
|Pick your foot up||Raise your hand|
|Clap your hands||Relax (internal feeling)|
|Shut the door||Pay attention (vague)|
|Come to Circle||Show me what you want|
|Tell me what you want|
Probing the Performance of Specific Students
Questions to ask or observations to make when probing comprehension/performance in natural settings might include the following:
- In a familiar setting, what happens if only the verbal direction is given by the usual person and no other cues are provided?
- In a less familiar or unfamiliar setting, what happens if the verbal direction is given by the usual person and no other cues are provided?
- If the child has performed correctly without additional cues, what happens if other people give the same directive? What if tasks are different? What if the environments are different? What if the person, task, and setting are all different?
The above is probing to determine if the child has the behavioral response in his or her repertoire and if it is generalized. If the response has been learned and it is not generalized, then the issue is one of teaching application outside of a narrow range of circumstances.
If the child does not perform without cues, then one would immediately probe to see if the child can perform the response with cues. The questions are different:
- What level and type of cuing is needed to enable the child to perform the desired response? Cues could be pictures, gestures, manual signs, touch, physical assistance, verbal, or text.
- Can the level or type of cuing be reduced and still get correct performance?
The above is probing to determine what support is needed to promote adequate performance and errorless learning. Perhaps the person needs more opportunities to learn the meaning of the directive and what is expected. While the person needs supports during this learning process, the goal will be to fade the prompts in order to produce independent performance. Teaching generalization would still be an important goal. See the list of additional reading sources for more information.
Sometimes the child seems to know what to do but just doesn’t respond consistently. Questions might include:
- Does he or she seem to respond appropriately if the adult ensures that he or she has the child’s attention before giving the directive?
- Does he or she get distracted by something else before he or she can respond to the direction?
- Does he or she refuse to comply with the request? This requires an analysis of the reason for the refusal, could require the need for a stronger reinforcer for compliance, and/or, if appropriate, might necessitate training about roles, responsibilities, and privileges of authority figures.
The above situations might necessitate the use of the prompts, but also other adjustments or strategies such as moving closer to the child, a tap on the shoulder, a cue card to aid memory, rehearsal strategy, the use of timers to mark an end of task before transition, or theory of mind information. Comprehension may not be the major factor or comprehension problems could extend to limited or negligible understanding of the social situation and not just the directive.
Sometimes the child doesn’t know how to perform the action needed and/or may not comprehend the message. Questions might include:
- Is the directive too vague or abstract (e.g., “Hold still.”)? Is the directive too global when really many steps are involved and the child is uncertain or anxious about the sequence (e.g., “Go potty.”)?
- Has the child ever performed the action on his or her own and not in response to a request? For example, does the young child know how to back up to a chair and lower himself onto the seat when the chair does not have arm rests? If not, then that might need to be taught as part of the response to “sit down.” Or, he may need to learn the response using a chair with arm rests since this makes him feel more secure.
- How does the child seem to learn various types of responses? Does repetition, demonstration, video, physical assistance, or backward chaining work, or does the child need another type of strategy?
- Has any active teaching of the directive been a part of the child’s program? Has there been an assumption that he or she already knows what is expected? Is he or she really being inappropriate because he or she is responding to a key word or is misinterpreting meaning? For example, a child who responds to the word “down” in “sit down” might get down on the floor rather than sit in the chair.
Teaching a child with ASD to follow a direction could be easy with some children when the variables are known and accounted for in the teaching procedure. For others, it could be a long process. One must ask oneself if the child needs to only understand the instruction in a given situation, or whether he or she is likely to encounter this directive over his or her lifespan in a variety of situations. Following an instruction is more than an issue of compliance. It involves the understanding of what is expected and organizing oneself to perform the required response. Many factors can be involved in both performance and good teaching. Hopefully this article will help teachers and families begin to examine the skill of following directions as it pertains to their specific student or child.
Information on Prompting and Fading
Baer, D. (1999). How to plan for generalization. (2nd Ed.). Austin, TX: Pro-ed.
Cuco, A. & Davis, P. K. (1998). Establishing and transferring stimulus control. In J. K. Luiselli & M. J. Campton. (Eds.) Antecedent control: Innovative approaches to behavioral support. (pp. 347-368). Baltimore, MD: Paul Brookes Publishing.
Donnellan, A., LaVigna, G. W., Negri-Shoultz, N., & Fassbender, L. L. (1988). Progress without punishment. New York, NY: Teachers College.
MacDuff, G. S., Krantz, P. J. & McClannahan, L. E. (2001). Prompts and prompt fading strategies for people with autism. In C. Maurice, G. Green, & R. M. Foxx. (Eds.). Making a difference: Behavioral intervention in autism. (pp. 37-50). Austin, TX: Pro-ed.
Vicker, B. (2004). Comprehension of the message: Important considerations for following directions. The Reporter, 9(2), 6-8, 19