Following Directions

Is your child not following directions?

Is your child:

  • Appearing lost when you ask him or her to do something?
  • Getting confused? If you give her three instructions, does she only do the third?
  • Saying, “Oh, I forgot!”
  • Failing to follow along with the teacher’s instructions?
  • Getting in trouble for forgetting directions?
  • Saying, “Brush my teeth, get my shoes, and then what?”
  • Getting lost partway through a task?
  • Doing something entirely different than instructed?
  • Completing procedures out of order?

LET'S TALK ABOUT IT

Do you catch yourself saying things like,

“If I had a dollar for every time I asked you to get ready for school, I’d be a millionaire by now?”

It can be frustrating when your child doesn’t do what you say. Your child might make comments like, “I didn’t hear you!” or “You never asked me to do that!” Your child may seem to require constant reminders.

You may only be able to give one instruction at a time or nothing gets done. You might give the child directions and then find her looking at a picture, organizing toys, or just studying her fingernails. Your child may give you a puzzled look when given directions.

The morning routine may take too long. Your child may still forget the procedure of getting dressed, eating breakfast and brushing teeth, despite the fact that you’ve had the same routine for the past two years. Your child may not start on the task, may require more time, or may ask you to repeat the instructions.

At school, the teacher might report that your child doesn’t listen. When you ask him about why he doesn’t follow directions, he might act surprised. Your child may have a poor vocabulary and might have trouble understanding how to complete assignments. Independent work may be challenging if your child is only given verbal instructions. Your child may rush through schoolwork without checking to see if the work is done right.

CLINICAL DESCRIPTION

Clinically, it could be that your child:

  • Doesn’t understand the directions: Receptive language
  • Doesn’t pay attention long enough to hear the directions: Attention
  • Doesn’t remember the directions: Memory
  • Doesn’t want to follow the directions: Behavior

Receptive language (Communicating): Difficulty with following directions can be due to a delay or disorder in receptive language, which means that the child is having trouble understanding or comprehending.

The term language delay is used when a child’s speech and language development is following the usual pattern and sequence, but it is slower than other children that age. A language disorder is used to describe language development that is not following the usual pattern or sequence.

Receptive language in ELL’s: An English language learner will demonstrate improved receptive language skills as vocabulary builds in English. This language acquisition process looks different from a true receptive language delay or disorder.

An ELL student without a disorder would not have problems in his primary language. If a receptive language delay or disorder were present, it would show up in all the languages a child speaks.

Attention (Focusing): A potential root cause of challenges with multi-step directions is an attention deficit. If your child does not focus on the information, he or she will not hold the steps in memory long enough to complete them.

If the challenges are attention-related, a licensed professional should consider whether Attention Deficit Hyperactivity Disorder (ADHD) may be relevant for your child. Children with ADHD often have trouble with directions due to challenges focusing. They may seem to need more help with daily tasks than other children. Children with attention deficits struggle with executive functions like organization and planning. Such difficulties can make following multi-step directions challenging.

Children with motor planning, attention, or sequencing problems have specific deficits that may interfere with following directions. These challenges could indicate an Autism Spectrum Disorder.

Often, children with autism seem to be in their own world and become internally distracted, which leaves less focus for the external environment. If your child is sitting on the floor, staring into space, he may be focusing on something in his own head. This tendency to be in one’s own world may cause difficulties following directions.

Memory (Remembering): Problems with directions could be related to memory. For example, when a child is given directions, like, ‘Go get your laundry, put it in the basket, and bring it downstairs,’ he has to remember the instructions to complete them. Procedural memory refers to the memory for tasks that we do all the time.

An example of procedural memory is driving a car. You may find yourself reviewing your grocery list, remembering what your kids’ activities are for the day, or thinking about what movie you might want to see this weekend, instead of concentrating on driving a car. You can think about other tasks because the driving skill is a part of your procedural memory. Children who get stuck on tasks like tying their shoes or making their beds, might be struggling with procedural memory.

Behavior (Behaving): Some children just don’t want to do what you say. If you have the sense that your child knows the directions, understands how to do them, and simply refuses, you may have a behavior problem on your hands. Psychologists refer to this issue as non-compliance.

WHAT TO DO IF YOUR CHILD DOES NOT FOLLOW DIRECTIONS

First, consider whether your child is developmentally on track.

Use the following simple guide when thinking about typical language development.

At 9-12 months: A baby begins to identify gestures, to respond to ‘no’ and to understand to start looking for something when someone asks, ‘where is ___?’ [1] If your baby is not following your eye-gaze, pointing, or gesturing, you may have a reason for concern.

At 15-18 months: A toddler should be able to follow simple single step directions such as, ‘Give me the ball.’ [1]

At 24-30 months: A toddler can follow related two-step directions. For example, ‘Close the book, and put it on the shelf.’ Children who are unable to follow simple instructions at this age may have a delay in comprehension skills.

At 42 months or older: A child should be able to follow two-three step unrelated commands such as, “Go get your shoes on, grab your backpack, and meet me at the door.” [1] If your kindergartener is not able to follow two-three unrelated directions, a delay may be present.

If your child seems to be behind on the developmental continuum, he or she may have difficulties with receptive language skills, attention, or memory. In this case, consider an evaluation for a developmental disability.

Second, request accommodations at school such as: 

  • Visual aids
  • Extra time to comprehend and complete tasks
  • Hands-on demonstration or modeling
  • Explanation of vocabulary terms to increase comprehension
  • Breaking down steps and providing help with sequencing
  • Verbal check-ins to ensure your child understands before initiating tasks

Third, provide behavior support at home:

It is important to be consistent. Keep routines predictable, and help your child practice the sequence of steps. Use visual chore charts, such as a morning routine poster that is in the bathroom, and tie following this routine to immediate reward. An example of an immediate reward is “When you get your routine finished, I will give you your iPad.”

Finally, if your child is struggling significantly:

Consider an evaluation by a psychologist or ABA Therapist.

SIMILAR SYMPTOMS

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

  • Auditory processing: it could be that difficulty hearing sounds and words correctly is impacting your child’s ability to follow directions
  • Receptive language: it could be that problems with oral language comprehension are impacting your child’s ability to follow directions
  • Sequential reasoning: it could be that a cognitive problem with doing step-by-step procedures is impacting your child’s ability to follow directions
  • Intelligence: it could be intellectual ability. It is important to consider fluency in cognitive processing. A child may not hear or encode information, which can impact ability to follow directions
  • Non-Compliance: it could be that refusal to follow instructions is a behavioral issue rather than a problem with understanding instructions
  • Attention problems (Focusing): it could be that problems with attention interfere with following directions
  • Executive functioning (Organizing): it could be that difficulties related to planning, sequencing, organizing information and carrying out a task in a timely manner are impacting your child’s ability to follow directions
  • Motor or sensory (Moving & Sensing): it could be that your child struggles with the motor skills needed to follow instructions, such as tying shoes, kicking a ball, or sitting in a chair in the classroom
  • Depression: it could be that your child appears forgetful or distracted due to underlying feelings of sadness and emotional distress
  • General memory (Remembering): it could be that your child has memory challenges in many areas that are impacting his or her ability to follow instructions

POTENTIAL DISABILITIES

Children who have significant problems in this area may have any of the following potential disabilities. *Note, this information does not serve as a diagnosis in any way. See the ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

  • Language Disorder (Expressive, Receptive, Pragmatic): some children with language disorders do not follow directions
  • Autism Spectrum Disorder (ASD): many children with autism have difficulties following directions
  • Intellectual Disability: many children with lower cognitive abilities struggle to follow directions
  • Attention Deficit Hyperactivity Disorder (ADHD): most children with attention challenges have difficulties following directions
  • Traumatic Brain Injury (TBI): many children with brain injuries have difficulties following directions [2]
  • Learning disability (Educationally Identified Disabilities): some children who do with learning disabilities may not follow directions

WHERE TO GO FOR HELP

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

  • Clear Child Psychology: to obtain a customized profile of concerns for your child or to consult ‘live’ with a licensed psychologist
  • Speech- Language Pathologist: to provide therapy for receptive language problems and communication skills
  • Licensed Psychologist: to diagnose associated disabilities such as autism or ADHD or behavior disorders and provide therapy
  • School Psychologist: to help with academic or social challenges that may be associated with following directions
  • Special Education Teacher: to help with academic challenges that may be associated with poor ability to follow directions
  • Pediatrician: to diagnose any medical issues that could be impacting your child
  • Board Certified Behavior Analyst (BCBA): to help teach your child how to follow directions, comply with rules, do chores, and succeed academically

These professionals may recommend or administer the following tests for this symptom:

LEARN MORE

[1] Speech Language Milestones: http://www.asha.org/public/speech/development/chart.htm

[2] Lewis, PhD, Jeanne, Calvery, Ph.D., Margaret, & Lewis, Ph.D., Hal (2002). Brainstars. Brain Injury: Strategies for Teams and Re-education for Students. US Department of Education: Office of Special Programs. 

[3] Barkley, Russell A. (2013) Taking Charge of ADHD, Third Edition: The Complete, Authoritative Guide for Parents. https://www.amazon.com/Taking-Charge-ADHD-Third-Authoritative/dp/1462507891/

 [4] Dawson and Guare (2009). Smart but Scattered

Amazon: http://www.amazon.com/Smart-but-Scattered-Revolutionary-Executive/dp/1593854455/

[5] Purvis, Karyn B., & Cross, David R., & Sunshine, Wendy Lyons (2007). The connected child: Bring hope and healing to your adoptive family.

Amazon: https://www.amazon.com/Connected-Child-healing-adoptive-family/dp/0071475001?ie=UTF8&hvadid=3523655623&hvbmt=be&hvdev=c&hvqmt=e

[6] Seigel, Daniel J. & Bryson, Tina Payne (2014). No drama-discipline: The whole-brain way to calm the chaos and nurture your child’s developing mind.

Amazon: https://www.amazon.com/No-Drama-Discipline-Whole-Brain-Nurture-Developing/dp/0345548043?ie=UTF8&hvadid=4162156440&hvbmt=be&hvdev=c&hvqmt=e

Image Credit:
Description Ear plugs turned boy XXXL
Image ID: #185233687 (iStock)
By: greg801
How-to-teach-a-child-to-follow-directions
Previously Licensed on: November 21, 2016
Stylized by Katie Harwood exclusively for CLEAR Child Pscyhology

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