This is a guest blog post by Monica, a school-based SLP, she reviews the importance of targeting sequencing and shares tips and therapy ideas.
Why do we target sequencing?
It is important to target sequencing because it is involved with so many daily tasks and is a foundation to academic success.
We want our students to be able to listen to a sequence of directions and be able to follow them, to retell stories, and answer WH questions. The question really is, how do we target sequencing in a way that will generalize into these skills?
Kamhi (2014) states that sequencing is not a process that should be targeted in isolation. The article goes on to review how working memory, attention, and conceptual knowledge are at the core of this challenge, and that targeting sequencing with contextualized narrative intervention is the path to generalization.
What do students need to be able to sequence?
Students need to hold that information as a visual representation in their head to use later (Barkley, 2012; Ward & Jacobsen, 2014).
Students then need to use self speech which uses verbal working memory (Ward & Jacobsen).
With this in mind, would your sessions targeting sequencing stay the same or would they change?
What if we thought about some of our students that we know may already struggle with executive functioning skills, like our students with ADHD or our autistic students? Same or different?
Universal supports in our sessions to support executive functioning makes a lot of sense!
The Challange
Research has shown that contextualized language intervention is where the magic happens. Contextualized language intervention effect sizes were three times larger on average than effect sizes for decontextualized language intervention (Gilliam, Gilliam & Reese 2012).
Move away from sequencing tasks like brushing your teeth and how to make a peanut butter sandwich. Start to incorporate narrative retells as a more functional target that will help build communication and academic skills (Kamhi, 2014).
Use transitional words like first, next, then, and last to help students become familiar with the vocabulary for when they are self-generating retells.
The next step is story grammar, which has been shown to help with comprehension (Stetter & Tejero Hughes, 2010). We should always be keeping the next steps in mind when planning for a student’s success.
Now that we see the flow and how it builds to working on comprehension, we can see the importance of targeting sequencing in the framework of narratives instead of by themselves.
The challenge then becomes…
What do these supports look like?
How do we fade those supports?
And how do we incorporate them into our goals and therapy sessions?
Session Solutions
An article by Dempsey (2021), showed that strong story comprehension skills were best predicted by a child being able to use a verbal account of a story (without pictures), followed by enactment (acting it out with prompts), then sequencing (retelling a story with pictures). This sets up a natural progression for fading support.
Preschool
Supports: I do a book walk and use parts of the story for a simplified retell. Videos that tell a story are another fun way to work on sequencing. You can use a graphic organizer with sticky notes or props if needed. Remember to use transitional words like first, next, then, and last when talking about the story to model the language.
Early Elementary
Supports: Use a first, next, then, last template (link below) and sticky notes while you are reading a story to mark what happens. You can adapt it to a three-part story if needed. This is the build-up to using story grammar and later generating stories of their own. Fade visuals as needed.
Tip: I use lots of narrative-based language during the session so that it’s familiar by the time we get to it.
> Point out that the bear is a character. When we answer WHO questions, we’re talking about the characters.
> Talk about the problem. If a question asks WHAT HAPPENED, we can think back to the problem.
That way by the time we have a WH question goal, we’ve been working on these language strategies and the student has had many many exposures to the language. We all know it takes repetition!
Additional Blog Posts for Narrative Therapy
Targeting Narratives with Literacy-Based Therapy: Preschool
Targeting Narratives with Literacy-Based Therapy: Early Elementary
Targeting Narratives with Literacy-Based Therapy: Later Elementary
Using Books to Target Sequencing (Scroll to the bottom of this post for a freebie!)
Additional Supports
Check for understanding by having students repeat the directions in their own words.
Have additional visuals available as needed.
Check for emotional and sensory regulation before you start your session.
Fahy (2014) states that there are six components to executive functioning: attention, working memory, inhibitory control, flexibility of thought and effort, initiation and persistence, and self-monitoring and regulation. Ensuring that your students are able to have “sustained attention over time” and are regulated prior to the sessions will be critical for student success.
A Sample Sequencing Goal
Goal: By XX/XX/XX, (in setting), after being read a story, Student will independently use self-generated language to retell a story on first trial data using at least 3 utterances, as measured by SLP observation and data.
Objective 1: By XX/XX/XX, (in setting), after being read a story, Student will sequence pictures in the correct order and repeat a 3-part story on first trial data, given picture prompts, as measured by SLP observation and data.
Objective 2: By XX/XX/XX,(in setting), after being read a story, Student will act out and verbalize a 3-part story on first trial data, given props, as measured by SLP observation and data.
Examples of Collaborating with Teachers
Push-in lessons (Brandal, 2014) are also a great way to make sure that the teacher is using the same language to talk about sequencing. Talk to the teacher ahead of time to see where they’re at with talking about stories. Taking a look at Common Core Standards is a great place to start to know what to ask the teacher. I usually talk about story grammar because it’s easily adaptable to different grade levels. This is also a great way to fade support so that the support is being provided inside the classroom.
Meetings
In meetings, it’s important to talk about targeting sequencing skills as a foundation for later narrative and retell skills by building on the student’s strengths. It’s also a great way to talk about something that can be practiced at home without adding too much to a family’s already busy schedule. Talking about supporting the student’s executive functioning skills can also lead to a great discussion with the team about other areas of need besides sequencing.
Sometimes I’ll recommend that families print out daily activities onto a sticker magnet page and cut it out to put on the fridge. It can help children sequence the dreaded “How was your day at school” question. Children can see what they might have done that day that they want to talk about and then be able to sequence and verbally describe it.
References
Barkley, R. A. (2012). Executive functions: What they are, how they work, and why they evolved (pp. xi, 244). The Guilford Press.
Brandel, J. (2014). Making Evidence-Based Decisions Regarding Service Delivery for School-Age Students Participating in Narrative Intervention. 13.
Dempsey, L. (2021). Examining the validity of three methods of measuring pre-readers’ knowledge of storybook events. Child Language Teaching and Therapy, 37(2), 137–148.
Fahy, J. K. (2014). Assessment of Executive Functions in School-Aged Children: Challenges and Solutions for the SLP. Perspectives on School-Based Issues, 15(4), 151–163.
Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: Results of an early efficacy study. Language, Speech, and Hearing Services in Schools, 43(3), 276–291.
Kamhi, A. G. (2014). Improving Clinical Practices for Children With Language and Learning Disorders. Language, Speech, and Hearing Services in Schools, 45(2), 92–103.
Stetter, M., & Tejero Hughes, M. (2010). Using Story Grammar to Assist Students with Learning Disabilities and Reading Difficulties Improve their Comprehension. Education and Treatment of Children, 33, 115–151.
Ward, S., & Jacobsen, K. (2014). A Clinical Model for Developing Executive Function Skills. Perspectives on Language Learning and Education, 21(2), 72–84.
I am currently in grad school for speech-language pathology, and I was in the midst of searching for why I’ve been seeing so many sequencing goals in my elementary school placement. Your article was incredibly helpful, and I really appreciate the research base supporting your position! Thank you for sharing.