Is this a cognitive problem or just bad behavior?

Question: My friend's 4 year old son is having difficulties following directions. He does not have good vocabulary skills, and in my personal opinion, could benefit from some intense speech therapy.

His speech is on a 2 year old level, I think...he just kind of jabbers. How can I determine if it is a behavioral problem or a cognitive issue... and how do you teach a child like this to actually follow simple directions?

Answer: If you believe there is a delay in speech then this is likely contributing to a difficulty in following directions immensely. This would be the first place to start in terms of some type of speech therapy.

When you do want the child to learn to follow directions you will want to do the following:

1. Use as few words as possible.
2. Speak very clearly and articulately.
3. Try modeling or physical prompting and if he still doesn't do it, make the child follow through on the direction within 3-5 seconds with gentle hand over hand if necessary.

So for example, if you want him to pick up his toys, avoid saying things such as, "It's time to clean up your toys and put everything away. Let's go do that and get all of our toys cleaned up." Too many words.

Simply say, "Clean up time." You may even sing the Barney clean up song to help him associate the song with the behavior that will help him remember in the future.

Model by picking up the toys as well, point to the toys and the place to put them. If he ignores or adamantly refuses, then gently walk him over to the toys and hand over hand help him clean up the toys, while saying "Clean up time."

For brushing his teeth, you would simply say, "Brush your teeth." Guide him to the bathroom and give him his brush and paste. If he just stands there, hand over hand guide him to put the paste on his brush and brush his teeth, while saying, "Brush your teeth."

Try to use the exact same command for each behavior to avoid any confusion until it seems like he is getting the idea, then vary it slightly to something such as, "Time to brush your teeth."

Hope this helps!

Rachel

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