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Following Multi-Step Directions

SKILL: Listening

DIFFICULTY: 3

LEVELS: 10 based on the number and order of directions and the number of picture foils

BRIEF RATIONALE:  This treatment builds auditory comprehension for sequenced and time-based directions.

In Following Multi-Step Directions, you will hear a request to perform a few actions. Then you will put the pictures in order to match what you hear. The treatment auto-adjusts in difficulty based on performance.


HINT: A hint button is available in the lower-left corner of the screen to reveal the text of the audio stimulus. Using the hint will mark the item as incorrect (as it was not answered with the audio only), but it may help you put the pictures in order.

FOR THE CLINICIAN:


Following Multi-Step Directions is a direct auditory treatment to address comprehension. Auditory comprehension is rarely intact, even in cases of mild aphasia (Helm-Estabrooks, 2011). Therefore, there is a need for higher-level treatments in this domain, preferably those that gradually increase in difficulty and allow for repeated practice.


Following Multi-Step Directions includes realistic directions with temporal concepts that you hear in everyday life. It's accessible for individuals with reduced verbal expression, as it does not require spoken language. It has levels of increasing difficulty, 1500+ stimuli for repeated practice, and the opportunity to practice comprehension strategies such as:

  • Slower: Slow the speaking rate to help process information.
  • Replay: Listen again if needed.
  • Keywords: Listen specifically for temporal words.

According to Wallace and colleagues (2022), studies show positive behavioral changes following direct auditory comprehension treatment using auditory stimuli. The goal of using Following Multi-Step Directions is to generalize skills to untrained audio with the help of learned strategies.

Read more about how to treat auditory comprehension impairments in our article: What SLPs Need to Know: Treating Auditory Comprehension.

Selected References:

  1. Helm-Estabrooks, N. (2011). Treating attention to improve auditory comprehension deficits associated with aphasia. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 21(2), 64–71.
  2. Wallace, S. E., Patterson, J., Purdy, M., Knollman-Porter, K., & Coppens, P. (2022). Auditory comprehension interventions for people with aphasia: A scoping review. American Journal of Speech-Language Pathology, 31(5S), 2404–2420.