Do you have students or clients who don’t have a good understanding of first/then commands? If they don’t follow first/then directions, it can make it tricky to participate in therapy activities or understand reward schedules. Today I am going to share my tips for teaching first/then concepts.
We use first/then commands all the time. I use it to reinforce myself. First you finish 5 more progress notes, then you can have a glass of wine/dish of ice cream/go to bed/insert random reward here. It’s a functional goal to use in therapy. Today I’m going to share my tips for teaching first/then in therapy. But I’m going to start with what you should not do.
How NOT to teach first/then
Here’s the biggest mistake I see when introducing a schedule or starting to work on first/then: starting with a less preferred followed by the client/student’s preferred activity.
Since they don’t understand first/then, it is difficult to get compliance with these tasks. I know I’ve heard people say, “They need to learn how to work so they can be successful,” This is true. But it’s not super effective to spend multiple sessions with an upset client-when there is an easier way to teach the skill.
Teaching First/Then
Here’s how I do it:
I choose a small set of fun/motivating directions that my client can do.
I always introduce first/then directions with two fun activities or preferred activities. I really like physical activities to start.
For example, “First throw the ball and then jump into the pillows.”
I like to introduce this skill using a set of 4-5 simple commands. For example if you have access to a gym area, you could choose:
- kick the ball
- jump in the pillows
- throw the ball
- fall down
- spin around
I follow the same teaching strategy that I use to teach before and after. I start with 2 directions. We work on those-maybe varying the order.
- First throw the ball and then jump in the pillows.
- First jump in the pillows and then throw the ball.
When my client is able to do that-I increase the task difficulty by adding a set of 5 directions that I am alternating in the first/then pattern.
I check for generalization using a sixth command (for example:clap your hands). Are they learning the routine or are they learning the first/then concept? For example, if I vary the instruction saying, “First throw the ball and then clap your hands.” Do they follow the first/then direction and clap their hands or do they continue to follow one of the familiar directions?
Once they have mastered first/then in physical activities, I check to see if they are ready for following a schedule first/then. If I am not certain they will be successful, I may start with 2 preferred activities.
First we play trains and then we play popper toy. I use transition songs and duration maps to improve their ability to transition between activities. Once we have established a pattern then I add in a non-preferred/preferred first/then direction.
QUESTION: Do you have a method for introducing schedules or teaching first/then? I’d love to hear about it in the comments below!
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